The diagnostic criteria and treatment strategy, which are used for patients with acute gouty arthritis in primary health care practice is given in the article. The algorithm of primary medicine doctor’s action in the management of patients with the acute gout attack is represented.

The aim: To determine the features of atherosclerotic process, cardiovascular risk in patients with PsA. Materials and methods: The study included 42 patients with PsA who did not have atherosclerotic CVD, diabetes, chronic kidney disease and other serious diseases, did not take statins, the comparingl group consisted of 20 patients with psoriasis (PS) and 20 practically healthy individuals who had no signs of rheumatic, infectious and other inflammatory diseases were screened. Results: It was revealed that in patients with PsA, the severity of the atherosclerotic process is more compared with patients with PS (the RF profiles were the same). The highest levels of C-reactive protein, fibrinogen, uric acid, intima-media complex thickness, atherosclerotic plaque frequency were found in patients in the PsA group, which may indicate a pathogenetic association of additional RF with the development of a more common atherosclerotic process. Conclusions: In the development of the atherosclerotic process in patients with PsA, the pro-traditional risk factors play an important role as the immune-inflammatory factors (CRP, IL-10) and additional risk factors (uric acid).

Національна медична академія післядипломної освіти імені П.Л. Шупика, м. Київ Моё глубокое убеждение состоит в том, что СКВ-прежде всего неврологическая болезнь, при которой могут быть вовлечены другие органы. Graham r.V. Hughes (1998) У статті наведені сучасні літературні дані щодо діагностики уражень нервової системи у хворих на системний червоний вовчак, диференційна діагностика нейролюпуса та розсіяного склерозу, наведені спільні риси та відмінності проявів уражень нервової системи у пацієнтів із cистемним червоним вовчаком та розсіяним склерозом, тактика лікування обох захворювань. Також представлено власні дані двох клінічних випадків, один з яких демонструє клінічну та діагностичну схожість нейролюпусу та розсіяного склерозу, другий клінічний випадок свідчить про можливість поєднання двох описаних захворювань в одного пацієнта. Ключові слова: cистемний червоний вовчак, розсіяний склероз, нейролюпус, ураження нервової системи.

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The aim: To determine efficacy and safety of allopurinol and febuxostat in treatment of patients with CKD to reduce the sUA level and analyze its influence on glomerular filtration rate (GFR). Materials and methods: The study included 45 CKD patients (stages 3b-5) without other severe/decompensated diseases and contraindications to the allopurinol/febuxostat. All patients underwent a comprehensive clinical and laboratory examination, and were divided into the study groups: Group I (28 patients, 61,3±3,2 y.o., CKD3b-12, CKD4-10, on hemodialysis-6 patients) received febuxostat, Group II (24 patients, 60,7±4,1y.o., CKD3b-9, CKD4-10, on hemodialysis -5 patients) took allopurinol. Results: Achievement of the target level of sUA was significantly often registered in Group I: after 1 month – in 45.5% (in group II – in 15.9%, p<0.001); after 3 months – in 67.5% (in group II – 21.2% p<0.01); after 6 months, these figures were 90% and 37.1%, respectively (p<0.01). sUA level <300 μmol/l was accompanied by significant positive GFR changes in group I patients; in group II there was a gradual progression of GFR deterioration in 31.8% of patients. Conclusions: In patients with pre-dialysis stages of CKD febuxostat demonstrates renoprotective abilities. Use of febuxostat in patients with CKD stage 3b-4 and in patients on hemodialysis is safe and more effective for target sUA level achievement than the use of allopurinol.