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AIM: To evaluate prevalence of osteoarthrosis (OA) in metallurgists in conditions of high tension of the locomotor system and exposure to industrial pollutants depending on the age, sex and duration of service. MATERIAL AND METHODS: Epidemiological survey covered 713 workers (284 females and 429 males) of the Orsko-Khalilovsky Metallurgical Company. OA detection was made basing on screening questionnaire N 1, record N 2 and OA diagnostic criteria designed and tested in the RAMS Rheumatism Institute. RESULTS: Prevalence of OA among workers of the metallurgic company reached 71.6%. 83.5 and 63.8% females and males had degenerative changes in the joints and spine, respectively. This rate got higher with age and duration of service. Combination of OA with osteochondrosis (OC) was registered in 61.7%, isolated OC and OA--in 25.0 and 13.3%, respectively. OC developed most frequently in the lumbar, cervical-lumbar, cervical-thoracic spine while OA was found in the knee, shoulder and hand joints. CONCLUSION: Workers engaged in metallurgic industry work in conditions of high static-dynamic tension of the osteomuscular system and exposure to industrial chemical and physical hazards. The above risk factors contribute to high OA incidence. With age and longer exposure, both men and women fall ill with OA more frequently and have combined lesions of the spine and peripheral joints: 64.5 and 59.1% for women and men, respectively.

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AIM: To examine microcirculation in patients with systemic lupus erythematosus (SLE) showing clinical signs which may deteriorate hemodynamic indices: arterial hypertension (AH), atherosclerosis, antiphospholipid syndrome (APS). MATERIAL AND METHODS: Microcirculatory changes were studied in 63 patients with SLE using biomicroscopy of bulbar conjunctival vessels (Zeiss slit-lamp, 32 times magnification). The following conjunctival indices were estimated: general (GCI), vascular (VCI), intravascular (IVCI), extravascular or perivascular. RESULTS: Microcirculatory changes in SLE patients covered disturbances of microvascular architectonics, microvascular blood flow. VCI, IVCI, GCI were significantly higher than in control subjects: 6.16 +/- 0.31, 3.69 +/- 0.36 and 9.87 +/- 0.57 scores vs 3.20 +/- 0.50; 120 +/- 0.20 and 4.20 +/- 0.50 scores, respectively. The degree of structural changes in the vessels depended on the disease duration while intravascular changes depended on the activity of lupus process. In patients with AH and atherosclerosis microcirculatory disturbances were similar and related to vascular architectonics. In APS there were marked intravascular disorders (IVCI was 7.50 +/- 0.59 scores, GCI was 16.13 +/- 1.41 scores). CONCLUSION: In SLE patients with AH and/or atherosclerosis microcirculatory changes involved primarily structure of the vascular wall and may be brought about by compensatory-adaptive mechanisms of the microcirculatory bed in high hemodynamic load. Intravascular microcirculatory changes were most pronounced, first of all as sludge-phenomenon, in APS and high SLE activity.

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Clinical manifestations of osteoarthrosis were studied with reference to gender of the workers engaged at metallurgic plant and their working conditions. The examinees were divided into three groups: workers doing hard mechanical labor and exposed to chemical and physical factors (group 1); workers doing the above labor and exposed to physical factors only (group 2); intellectuals (group 3). In group 1 women, nodular polyosteoarthrosis (x-ray stage II) was encountered significantly more frequently than in men of this group and males and females from groups 2 and 3. Oligoarthrosis without nodules (x-ray stage I) occurred more frequently in men. In group 2 nodular polyosteoarthrosis occurred more frequently in women. Oligoarthrosis without nodules stage I both in males and females was more frequent than in group 1. Polyosteoarthrosis in females and oligoarthrosis in males was more incident in group 2 than in group 3. In group 3 males and females diagnosis of monoarthrosis without nodules (x-ray stage I) was made significantly more frequently than in groups 1 and 2.

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AIM: To study lipid peroxidation (LPO) in Bechterev's disease (BD) treated with antiinflammatory and antioxidant drugs. MATERIAL AND METHODS: LPO was estimated in 75 BD patients before medication and during this treatment. 30 healthy volunteers served control. RESULTS: Levels of LPO products was high but activity of antioxidant defense enzymes low in BD patients. CONCLUSION: Antiinflammatory drugs meloxicam, indometacin and an antioxidant drug triovit depressed LPO activity, improve the patients' condition and results of functional tests.

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AIM: To evaluate effects of an ACE inhibitor captopril on intrarenal hemodynamics during acute test in patients with lupus nephritis (LN) and chronic sclerodermic nephropathy (CSN). MATERIAL AND METHODS: Renal hemodynamics was studied using ultrasound duplex scanning of renal vessels (UDS) on Vingmed SD-100 unit in 5 patients with SLE with renal affection, 5 patients with scleroderma systematica (SS) with renal affection. The hemodynamic parameters were measured before and 1 hour after administration of 50 mg captopril. RESULTS: LN were found to have low arterial perfusion. CSN patients exhibited low intrarenal blood flow in high resistance of small vessels. Captopril improved intrarenal hemodynamics (enhancement of linear and volume blood flow) in LN patients; in CSN renal artery dilated and resistance of small vessels reduced while renal arterial perfusion increased. CONCLUSION: Improvement of intrarenal hemodynamics in LN and CSN patients in response to captopril allows to recommend administration of ACE inhibitors in SLE and SS with renal damage. Ultrasonic duplex scanning of renal vessels provides detailed information about the condition of intrarenal vessels without invasion.

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AIM: To determine the effect of high industrial pollution on development of Raynaud's syndrome and impairment of pulmonary hemodynamics in patients with scleroderma systematica (SS) and systemic lupus erythematosus (SLE). Two groups of patients were examined: 20 SS and 33 SLE patients living in highly polluted territories, 15 SS and 27 SLE patients living in moderately contaminated territories. The tests included capillaroscopy, thermography, rheovasography of the fingers, zonal rheopulmonography. Semiquantitative spectral analysis measured content of 3 trace elements (Ti, Ba, Li) and 16 heavy metals (Cu, Zn, Pb, Ni, Mn, Sn, Cr, Y, Ga, Ag, Mo, Bi, Co, Cd, Fe, Zr) in the patients' hair. RESULTS: Patients living in highly polluted areas had a severe course of Raynaud's syndrome. Metal accumulation is decisive in patients of group 1; in development of staging of Raynaud's syndrome the key role belongs to lead, nickel, tin and iron; realization of the factor of the disease activity is related to lowering of zinc, copper concentrations and growing concentration of nickel. CONCLUSION: Vascular disorders in SS and SLE in patients living in heavily contaminated areas aggravate due to direct damage from heavy metals.

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AIM: To study intrarenal hemodynamics (IRHD) in patients with systemic lupus erythematosus (SLE) and sclerodermia systematical (SS). MATERIALS AND METHODS: IRHD was studied in 30(28 females and 2 males) and 25(22 females and 3 males) patients with SLE and SS, respectively, and mean duration of the disease 5.6 +/- 0.5 and 7.5 +/- 1.2 years, respectively. Lupus nephritis was diagnosed in 21(70%), sclerodermic nephropathy in 10(40%) patients. Patients with chronic renal failure were not included. IRHD was investigated using protein loading which provided the index of functional renal reserve (FRR). RESULTS: Impaired IRHD was detected in 21(70%) patients with SLE. 19 patients had lupus nephritis. FRR depletion was found also in 2 patients free of lupus nephritis symptoms. 10 of them (8 with active nephritis and 2 with intact kidneys) had arterial hypertension. FRR depletion was found also in 12(48%) of SS patients. 7 of them had sclerodermic renal lesions. CONCLUSION: Impaired IRHD was encountered frequently both in SLE and SS patients and can develop in the absence of renal affection symptoms.

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AIM: To characterize clinical features of systemic lupus erythematosus (SLE) in persons living under various environmental pollution. MATERIAL AND METHOD: Three groups of SLE patients living in the Orenburg region were examined: those exposed to intensive production pollution (n = 35 patients), exposed to mild pollution (n = 15), unexposed to production pollution (n = 25 patients). The pollution intensity was assessed by total aerogenic, water and soil pollution rates. RESULTS: The hair from 69 patients contained 24 chemical elements. More severe clinical symptoms of SLE were registered in patients living in conditions of intensive production pollution. These symptoms' severity directly correlated with the level of heavy metals in the hair of SLE patients and inversely correlated with hair levels of essential chemical elements. CONCLUSION: Chemical pollutants directly impair organs and tissues of SLE patients and indirectly do this via damaged immune system.

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AIM: The study of osteoarthrosis (OA) course in the region of goiter endemia regarding thyroid status. MATERIAL AND METHODS: The examination of 62 females with OA included enzyme immunoassay of blood TTH, T4, T3 and ultrasound investigation of the thyroid. RESULTS: OA patients were found to have subnormal levels of thyroid hormones and low thyroid index. Blood TTH rose with thyroid size. Joint changes were also directly related to thyroid size. CONCLUSION: Alterations in the thyroid status influence the course of degenerative-dystrophic process in the joints.

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The authors provide the results of a sociological interview of the collective of a mixed feed plant. The interview concerned information about health, healthy way of life and routine behavior. Noticeable differences were revealed between the theoretical background of the respondents and daily routine. A rapid method was employed to objectively evaluate the level of the physical health status. A considerable percentage of subjects with low health status were detected. This requires carrying out of the goal-oriented treatment, prophylactic and organizational measures at the plant.

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The authors studied the morbidity rate accompanied by temporary incapacity for work in workers of the agricultural and industrial complex suffering from diseases of the joints. It has been established that rheumatic diseases take the first place as to their duration (number of days) and the second place at to their incidence (number of cases) per 100 workers. An annual rise in rheumatic disease prevalence, especially of a degenerative dystrophic nature was noted. Of importance are the age of patients service record in agriculture, intensity of load, nature of work, season. Machine operators were most liable to the mentioned disease.

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A comparative clinicoinstrumental study of the cardiorespiratory system in 29 patients with systemic scleroderma (SSD) and 56 patients with chronic nonspecific pulmonary diseases (CNPD) made it possible to specify the genesis of roentgenomorphological and functional pulmonary changes in SSD and to work out some clinical and functional tests to differentiate between the sclerodermic lung and CNPD. It was emphasized that differential diagnosis of the pulmonary syndrome in SSD and concomitant pulmonary pathology should be based on a combined study not only of clinical and x-ray findings but also of indices of pulmonary ventilation, hemodynamics of the greater and lesser circulation. A conclusion was made of the leading role of bronchial obstruction in the pathogenesis of hemodynamic pulmonary disorders in CNPD and the primary vascular and cardiac components in SSD.

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Fifty RA patients receiving prednisolone and prednisolone combined with retabolil were examined. Prednisolone made a negative effect on central hemodynamics, the effect being less with the use of retabolil. A dystrophic action of prednisolone on the myocardium and the weakening of this effect in a combined use of prednisolone and retabolil were shown on a RA model in rabbits.

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The authors presented the results of a combined instrumental study of the cardiorespiratory system in 100 patients with rheumatoid arthritis (RA) and 26 patients with systemic scleroderma (SSD). Disturbances of the pulmonary circulation and central hemodynamics in the absence of roentgenomorphological and ventilation disorders in the bronchopulmonary apparatus were revealed. The dependence of hemocirculatory parameters on a degree of the expression and genesis of pulmonary changes was shown. Some reasons for a rare development of the pulmonary heart in rheumatic diseases were described. In the detection of bronchoobstruction in RA and SSD patients the use of drugs controlling it was recommended.

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Comparative clinical and instrumental examination of 33 patients with seronegative and 67 patients with seropositive rheumatoid arthritis (RA) has revealed that patients with seropositive RA often manifest the functional and roentgenomorphological signs of lung damage. Pulmonary lesions related pathogenetically to RA were encountered equally often in patients of both groups, whereas those caused by concomitant chronic nonspecific pulmonary diseases were more characteristic of patients with seropositive RA apparently because of a more powerful suppression of immunity. In addition, in spite of the fact that the latter patients did not make any complaints on the part of the heart, they did manifest abnormalities of the phase structure of the cardiac cycle and central hemodynamics.

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