Rheumatic and Musculoskeletal Diseases (RMDs) Public Awareness Program of Georgia 2019–2020

Clinical Rheumatology - The program’s goal is to launch the platform of positive perspectives for people who are suffering from/working in rheumatic and musculoskeletal diseases through the...     

Asymmetric dimethylarginine determines the improvement of endothelium-dependent vasodilation by simvastatin: Effect of combination with oral L-arginine.

OBJECTIVES: We hypothesized that the level of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of endothelial nitric oxide (NO) synthase (eNOS), might determine the endothelial effects of statins. BACKGROUND: Endothelial NO synthase is up-regulated by statins. However, statins failed to improve endothelial function in some studies. Asymmetric dimethylarginine inhibits eNOS by a mechanism that is reversible by L-arginine. METHODS: Ninety-eight clinically asymptomatic elderly subjects had their plasma ADMA levels screened. Those in the highest (high ADMA, n = 15) and lowest quartiles of the ADMA distribution (low ADMA, n = 13) were eligible to receive, in a randomized order, simvastatin (40 mg/day), L-arginine (3 g/day), or a combination of both, each for 3 weeks. Endothelium-dependent vasodilation (EDD) was assessed by brachial artery ultrasound. RESULTS: Simvastatin had no effect on EDD in subjects with high ADMA (6.2 +/- 1.2% vs. 6.1 +/- 0.9%), whereas simvastatin plus L-arginine significantly improved EDD (9.8 +/- 1.5% vs. 5.3 +/- 0.8%; p < 0.01). In subjects with low ADMA, simvastatin improved endothelial function when given alone (9.5 +/- 3.2% vs. 6.1 +/- 3.8%; p < 0.001) or in combination with L-arginine (9.0 +/- 3.1% vs. 6.3 +/- 3.3%; p = 0.001). L-arginine alone improved endothelial function in both groups. Endothelium-independent vasodilation was not affected. CONCLUSIONS: Simvastatin does not enhance endothelial function in subjects with elevated ADMA, whereas it does so in patients with low ADMA. Combination of simvastatin with oral L-arginine improves endothelial function in subjects with high ADMA, but has no additional effect in subjects with low ADMA. As NO-mediated effects may play a major role in the therapeutic effects of statins, ADMA concentration is an important factor that influences the "pleiotropic" effects of simvastatin.     

Deep venous thrombosis following transurethral resection of the prostate: diagnosis by phleborheography.

Deep venous thrombosis is a potential complication of transurethral resection of the prostate. We evaluated 150 paients undergoing transurethral resection of the prostate for benign and malignant disease to determine the postoperative incidence of deep vein thrombosis, using phleborheography as the instrument of detection. Phleborheography is an accurate, inexpensive, non-invasive method that uses low pressure transducers to detect volumetric changes in the lower extremity through recording cuffs. A 4.6 per cent incidence of deep venous thrombosis was detected by this technique. At the time this complication was discovered no patient exhibited clinical signs of thrombophlebitis, which reinforces the belief that clinical diagnosis alone is not a reliable screening technique for deep venous thrombosis. Anticoagulant therapy appears to be effective and safe in the treatment of this postoperative complication.     

Pelvic lipomatosis: diagnosis by computerized tomography scan.

Pelvic lipomatosis is a rare, relatively self-limiting disease characterized by the overgrowth of unencapsulated lipomatous tissue within the pelvis. The diagnosis is suggested, but not substantiated, by the striking roentgenographic changes noted on barium enema and intravenous pyelogram. Previously, pelvic laparotomy with tissue diagnosis was essential for documenting the disease. We report three cases in which computerized tomography was utilized as a safe, noninvasive and accurate method of diagnosis. The role played by partial venous obstruction is discussed in addition to rectal bleeding as a mode of presentation.     

Effect of the antioxidant ionol on myocardial energy metabolism and the course of traumatic shock]

Energy metabolism was studied in experiments on rats with due regard for the individual features of the organism's reaction to trauma. The animals were divided into 2 subgroups according to the survival period during the experiment. Disorders of mitochondrial function were revealed in both subgroups, but they differed in degree according to the severity of the process. Preliminary injection of the antioxidant ionol prolonged the animals' survival and prevented disorders of mitochondrial function. The article discusses the possibility of preventing activation of free-radical oxidation of the membrane lipids and removal of their damaging effect on the mitochondria with ionol.