Comparative characteristics of atherogenesis factors in patients with symptomatic and asymptomatic atherosclerotic carotid stenosis

2021 ◽  
Vol 41 (1) ◽  
pp. 70-76
Author(s):  
V. Ju. Anysienkova ◽  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Internal Carotid ◽  
Clinical Manifestations ◽  
Control Group ◽  
Clinical Group ◽  
Atherosclerotic Stenosis ◽  
Group I ◽  
Atherosclerotic Process

To study a comparative assessment of risk factors for atherogenesis in patients with different clinical manifestations of carotid atherosclerotic stenosis. The study included 106 patients (men — 74, women — 32) aged 39 to 79 years (mean age 62.6 ± 0.9), which devided to 3 clinical groups: Group I — 35 patients with acute atherothrombotic stroke with ipsilateral carotid stenosis, group II — 41 patients after acute cerebrovascular events and carotid endarterectomy, group III — 30 patients with asymptomatic atherosclerotic carotid stenosis and the control group, which consisted of 20 relatively healthy individuals. The degree of stenosis of the internal carotid arteries was highest (> 70 %) in the group of patients who underwent carotid endarterectomy. In addition in this group was prevalence younger men, compared with the group of asymptomatic stenosis and women (p = 0.00300), there was an older age of patients and moderate stenosis of 50–69 % (p = 0.00647). In patients with stenotic atherosclerosis of the internal carotid artery, there was a significant increase in the level of Lp-PLA2 compared with the control. This confirms that Lp-PLA2 can be considered as a marker of carotid atherosclerosis and influence the development of ischemic stroke. The highest level of Lp-PLA2 was observed in the clinical group of patients who underwent carotid endarterectomy after ischemic stroke and there was a tendency to a more significant increase in total cholesterol. This suggests a more aggressive course of the atherosclerotic process in patients in this group.

scholarly journals The prognostic value of the serum inflammatory biomarkers in patients with carotid atherosclerosis

2021 ◽  
pp. 26-33
Author(s):  
Olga Dubenko ◽  
Tetyana Litovchenko ◽  
Victoria Anysienkova ◽  
Maryna Nessonova ◽  
Liudmyla Kovalenko
Keyword(s):  
Ischemic Stroke ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Prognostic Value ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Operating Characteristics ◽  
Asymptomatic Group ◽  
Logistic Regression Models ◽  
Asymptomatic Patients

20 % of ischemic stroke appear to originate from carotid artery atherosclerotic disease. Serum biomarkers reflecting the activity of atherosclerotic process and may help for estimate risk of acute cerebrovascular events. Several serum inflammatory markers have been proposed for risk assessment, but their prognostic role less known. The aim of this study is to clarify the prognostic value of biomarkers of atherosclerosis lipoprotein-associated phospholipase A2 (Lp-PLA2) and E-selectin in patients with symptomatic and asymptomatic carotid stenosis. Materials and methods. The study involved 106 patients with atherosclerotic carotid stenosis >50 % (74 men and 32 women, mean age 62.6±0.9) from which 76 symptomatic (35 with acute ipsilateral atherothrombotic stroke and 41 after carotid endarterectomy) and 30 asymptomatic patients. The control group consisted of age- and sex-matched 20 healthy subjects. The level of serum Lp-PLA2 and E-selectin was determined using a commercially available enzyme-linked immunosorbent assay kit. Results. The level of Lp-PLA 2 was in general significantly higher (p<0.05) in patients groups than in the control group and most high Lp-PLA2 concentration was in groups of symptomatic patients who underwent carotid endarterectomy. The level of E-selectin in the study patients was significantly higher than in the control group (p<0.05). The correlation of Lp-PLA 2 with E-selectin was significant for total patients (R=0.365664, p=0.00085) and group after carotid endarterectomy (R=0.429143, p=0.01796), but not for asymptomatic group (p>0.05). Receiver Operating Characteristics curves of logistic regression models which takes into joint both indicators was specificity and sensitive for predicting the occurrence of ischemic stroke. Conclusion. Conducted study show that the levels of Lp-PLA 2 and E-selectin have a significant impact on the development of stroke in patients with atherosclerotic carotid stenosis and can be used to predict it. A multidimensional model of the dependence of the probability of stroke on a linear combination of Lp-PLA 2 and E-selectin allows to obtaining significantly higher characteristics of the accuracy of stroke prediction than models with each factor alone.

scholarly journals Markers of atherosclerosis lipoprotein-associated phospholipase A2 and E-selectin and vascular risk factors in patients with carotid stenosis

2021 ◽  
pp. 16-21
Author(s):  
Olga Dubenko ◽  
Victoria Anysienkova
Keyword(s):  
Risk Factors ◽  
Serum Level ◽  
Phospholipase A2 ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Vascular Risk Factors ◽  
Control Group ◽  
Vascular Risk ◽  
Stroke Risk Factor ◽  
Atherosclerotic Stenosis

The aim of this study is to evaluate serum level biomarkers of atherosclerosis lipoprotein-associated phospholipase A2 and E-selectin in patients with atherosclerotic carotid stenosis with different clinical manifestation in associated with vascular risk factors. Materials and methods: A total 106 patients with atherosclerotic carotid stenosis (74 men and 32 women, aged from 31 to 74 years, mean 62.6±0.9) were included: with acute ipsilateral atherothrombotic stroke (35), history of stroke and carotid endarterectomy (41) and 30 patients with asymptomatic carotid stenosis. The control group consist of 20 health subjects without cardiovascular disease. All participants underwent duplex sonography. Lipoprotein-associated phospholipase A2 and E-selectin was measured using commercially available (ELISA) kit. Results: The level of lipoprotein-associated phospholipase A2 was in general 55.664±3.537 ng/ml, which was significantly higher (M-W U=10, p=1.023136´10-11 <0.05) than in the control group (9.296±0.935 ng/ml). Level was significantly higher in groups of symptomatic patients who underwent carotid endarterectomy (p=0.04893), and proportion patients with high degree stenosis >70 % was greater in this group. The level of E-selectin in the study patients was significantly higher (7.653±0.246 pg/ml) than in the control group (3.101±0.503 pg/ml) p<0.05. No association the serum level of lipoprotein-associated phospholipase A2 and E-selectin with common stroke risk factor such as hypercholesterinemia, smoking and body mass index were found, but positive correlation of lipoprotein-associated phospholipase A2 with E-selectin was significant (p=0.00085). Conclusions: Increasing plasma level lipoprotein-associated phospholipase A2 and E-selectin in patients with the carotid atherosclerotic stenosis were observe. Statistically significant correlation between the level of lipoprotein-associated phospholipase A2 and E-selectin were found in symptomatic carotid atherosclerotic stenosis

scholarly journals Relationships between urinary neural and immune factors in the patients with interstitial cystitis/ bladder painful syndrome

2020 ◽  
Vol 22 (5) ◽  
pp. 879-886
Author(s):  
R. F. Sholan
Keyword(s):  
Mast Cells ◽  
Interstitial Cystitis ◽  
Pearson Correlation ◽  
Control Level ◽  
Clinical Manifestations ◽  
Control Group ◽  
Bladder Tissue ◽  
Bladder Pain ◽  
Group I ◽  
Group Ii

The purpose of this work was to study the relationships between urinary cytokines, mast cells and nerve growth factor (NGF) in the patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Sixty-eight women with clinically diagnosed IC/BPS were under study. Their mean age was 54.2±12.4 years. Urinary concentrations of interleukins (IL-1β, IL-6, IL-8), tumor necrosis factor-α (TNFα), and NGF were determined by ELISA technique. Mast cells were identified in biopsies of mucous membranes from urinary bladder harvested during cystoscopy. Statistical evaluation was performed by Statistica program in Microsoft Excel. Pearson correlation quotients were calculated. Depending on the type of IC/BPS, the patients were divided into 2 groups: group I included 36 patients with classic type of disease; group II comprised 32 patients with non-ulcer type of IC/BPS. No significant differences were revealed between the groups. In 13.9% of patients from group I, the onset of clinical manifestations of the disease was observed at the age of less than 40 years; in group II, 28.1% of the examined mentioned appearance of the disease symptoms at this age. The levels of IL-1β in the patients from group I was 2.4 times higher than in controls (p < 0.05). IL-6, IL-8 and TNFα concentrations exceeded control values by 2.0 (p < 0.05), 2.5 (p < 0.05) and 2.0 times (p < 0.05), respectively. In the patients from group II, the content of IL-1β, IL-6, IL-8 and TNFα was 2.4 (p < 0.05), 2.0 (p < 0.05), 2.0 (p < 0.05) and 1.9 (p < 0.05) times higher than in the control group, respectively. There were no significant differences between groups I and II, in IL-1β, IL-6, and TNFα levels, except of IL-8 in women of group I that was 20.3% higher than in group II. The urinary NGF level in the patients with IC/BPS exceeded the control level 1.6 times (p < 0.05) for group I, and 1.5 times (p < 0.05) for group II. The number of mast cells in the patients of group I was significantly higher than in controls and in group II, i.e., 1.6 (p < 0.05) and 1.4 times (p < 0.05), respectively. In most cases, a direct weak correlation was revealed between the indices. Only in group I, a moderate correlation (r = + 0.508) could be detected between IL-1β and mast cells. Determination of cytokine levels allows to detect activation of inflammatory cells in bladder tissue and provides an opportunity for developing diagnostic strategies. Increased numbers of mast cells may indicate the importance of these cells in the disease progression, whereas elevated levels of NGF in urine suggests that IC/BPS may be caused by chronic inflammation.

↵​Haemato-biochemical and Therapeutic Studies on Ovine Babesiosis in Kashmir

2021 ◽  
Author(s):  
A.U. Haq ◽  
N.A. Tufani ◽  
H.U. Malik ◽  
T.A. Najar
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Control Group ◽  
Diminazene Aceturate ◽  
Group I ◽  
Blood Smears ◽  
Imidocarb Dipropionate ◽  
Calcium Phosphorus ◽  
Healthy Control ◽  
Therapeutic Study

Background: The clinical study was designed to evaluate the haemato-biochemical changes in sheep affected with babesiosis and therapeutic regimes of various drugs used against babesiosis. Methods: A total of 24 clinically affected sheep with 6 animals in each group were selected for the haemato-biochemical and therapeutic study. The diagnosis was based on clinical manifestations, microscopic examination of blood smears and molecular confirmation of Babesia by PCR technique. For therapeutic study Group I, II, III and IV were treated with imidocarb dipropionate, imidocarb dipropionate+oxytetracycline, diminazene aceturate and diminazene aceturate+oxytetracycline, respectively. Result: The clinical signs recorded were high fever, pale mucous membranes, presence of ticks, inappetence, coffee-coloured urine and diarrhoea. The vectors identified were Haemaphysalis ticks. Hb, PCV, TEC, total protein, albumin, calcium, phosphorus and blood glucose were significantly (P less than 0.05) lower in the diseased group as compared to healthy animals while TLC, globulin and iron levels were significantly (P less than 0.05) higher compared to the healthy control group. The study revealed that the combination of imidocarb dipropionate and oxytetracycline was highly effective for ovine babesiosis.

scholarly journals Extensive Mobile Thrombus of the Internal Carotid Discovered After Intravenous Thrombolysis

2016 ◽  
Vol 7 (2) ◽  
pp. 96-99 ◽  
Author(s):  
Eugene L. Scharf ◽  
Jennifer E. Fugate ◽  
Sara E. Hocker
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Clinical Outcome ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Intravenous Thrombolysis ◽  
Rare Presentation ◽  
Favorable Clinical Outcome ◽  
Hemodynamic Augmentation

This case report describes a rare presentation of ischemic stroke secondary to an extensive internal carotid artery thrombus, subsequent therapeutic dilemma, and clinical management. A 58-year-old man was administered intravenous (IV) thrombolysis for right middle cerebral artery territory ischemic stroke symptoms. A computed tomography angiogram of the head and neck following thrombolysis showed a longitudinally extensive internal carotid artery thrombus originating at the region of high-grade calcific stenosis. Mechanical embolectomy was deferred because of risk of clot dislodgement and mild neurological symptoms. Recumbency and hemodynamic augmentation were used acutely to support cerebral perfusion. Anticoagulation was started 24 hours after thrombolysis. Carotid endarterectomy was completed successfully within 1 week of presentation. Clinical outcome was satisfactory with discharge modified Rankin Scale score 0. A longitudinally extensive carotid artery thrombus poses a risk of dislodgement and hemispheric stroke. Optimal management in these cases is not known with certainty. In our case, IV thrombolysis, hemodynamic augmentation, delayed anticoagulation, and carotid endarterectomy resulted in a favorable clinical outcome.

Laboratory criteria of the risk of ischemic stroke in patients with severe atherosclerotic stenosis of the internal carotid artery

2016 ◽  
Vol 5 (2) ◽  
pp. 6
Author(s):  
L. N. Solov’eva ◽  
A. A. Shmonin ◽  
Yu. V. Emanuel ◽  
M. S. Stolyarov ◽  
E. A. Bondareva ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Atherosclerotic Stenosis

scholarly journals Optimalus vidinės miego arterijos endarterektomijos laikas sergant insultu ir didelio laipsnio vidinės miego arterijos stenoze

2006 ◽  
Vol 4 (1) ◽  
pp. 0-0
Author(s):  
Auksė Meškauskienė ◽  
Egidijus Barkauskas ◽  
Artūras Mackevičius
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Carotid Artery Stenosis ◽  
Group Iv ◽  
Operative Risk ◽  
Group Iii ◽  
The Third ◽  
Group I ◽  
Significant Difference

Optimalus vidinės miego arterijos endarterektomijos laikas sergant smegenų insultu ir didelio laipsnio vidinės miego arterijos stenoze Auksė Meškauskienė, Egidijus Barkauskas, Artūras MackevičiusVilniaus universiteto Neurologijos ir neurochirurgijos klinikosNeuroangiochirurgijos centras,Šiltnamių g. 26, LT-04130 VilniusEl paštas: [email protected] Įvadas / tikslas Miego arterijos endarterektomija yra veiksmingas gydymo būdas, padedantis išvengti insulto esant didelio laipsnio simptominei miego arterijos stenozei. Ankstyva, tuoj po insulto atlikta endarterektomija sukelia daug komplikacijų, todėl dauguma chirurgų siūlo operaciją atidėti 4–6 savaitėms. Tačiau operacijos atidėjimas didina insulto pasikartojimo riziką. Naujausios literatūros duomenimis, per 30 dienų nuo insulto pradžios atlikta endarterektomija nedidina komplikacijų skaičiaus, tačiau nėra vienodos nuomonės dėl tikslaus operacijos laiko. Darbo tikslas – nustatyti operacijos riziką ligoniams, kurie serga smegenų insultu ir didelio laipsnio vidinės miego arterijos stenoze, atsižvelgiant į atliekamos endarterektomijos laiką. Ligoniai ir metodai Į analizę įtraukti duomenys 243 ligonių (192 vyrų ir 51 moters, amžiaus vidurkis 65,4 metų), kurie sirgo išeminiu insultu ir jiems buvo operuota simptominė didelio laipsnio miego arterijos stenozė. Iki operacijos visų analizuotų ligonių neurologinė simptomatika buvo stabili arba gerėjanti. Atsižvelgdami į laiko trukmę nuo ligos pradžios iki operacijos, ligonius suskirstėme į keturias grupes: I grupę (n = 59) sudarė operuotieji pirmą savaitę, II grupę (n = 61) – antrą savaitę, III grupę (n = 67) trečią ar ketvirtą savaitę, IV grupę (n = 56) – po keturių savaičių nuo ligos pradžios. Rezultatai Po operacijos komplikacijų buvo 14 (5,6%) ligonių, pusei iš jų įvyko insultas ir tiek pat ligonių mirė. Komplikacijų pasireiškė 5 ir 59 (8,5%) pirmos grupės ligonių, 4 iš 61 (6,5%) – antros, 1 iš 67 (1,5%) – trečios ir 4 iš 56 (7,2%) – ketvirtos. Mažiausia komplikacijų ištiko ligonius, kuriems endarterektomija daryta trečią ar ketvirtą ligos savaitę, nors komplikacijų skirtumas tarp grupių nebuvo statistiškai reikšmingas. Išvados Mirties ir operacinio insulto rizika ligoniams, sergantiems insultu ir didelio laipsnio vidinės miego arterijos stenoze, tiesiogiai nepriklausė nuo endarterektomijos laiko, tačiau mažiausiai komplikacijų ištiko ligonius, operuotus trečią ar ketvirtą savaitę nuo insulto pradžios. Reikšminiai žodžiai: insultas, miego arterijos endarterektomija, laikas, operacinė rizika The optimal timing of carotid endarterectomy in patients with stroke and severe carotid artery stenosis Auksė Meškauskienė, Egidijus Barkauskas, Artūras MackevičiusVilnius University, Clinics of Neurology and Neurosurgery,Center of Neuroangiosurgery,Šiltnamių str. 26, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Background / objective Carotid endarterectomy is highly effective in preventing stroke in patients with recentl symptomatic severe stenosis. Some studies showed early carotid endarterectomy to carry a high risk. Therefore, many surgeons delay carotid endarterectomy for 4 to 6 weeks after stroke, but any delay leads to reduced benefit because of the risk of stroke before surgery. Recent data have suggested that the operative risk is not increased in patients operated on within 30 days of stroke; however, controversy remains regarding the timing of this intervention. The purpose of the current work was to determine the operative risk of death and stroke in patients with stroke and severe carotid stenosis in relation to the time of carotid endarterectomy. Patients and methods A retrospective study of 243 patients undergoing carotid endarterectomy after stroke is presented. All patients had either stable or improving neurological examinations. The patients were divided into four groups: group I (n = 59) patients who had carotid endarterectomy between 2–7 days after stroke, group II (n = 61) patients who had carotid endarterectomy during the second week, group III (n = 67) patients who were operated during the third–fourth week after stroke and group IV (n = 56) patients who were operated on later than 4 weeks. Results Of the 192 men and 51 women who underwent surgery, there were 7 strokes and 7 deaths, with the total rate of complications 5.6%. Postoperative stroke and mortality was respectively: group I – 8.5%, group II – 6.5%, group III – 1.5%, group IV – 7.2%. There was no statistically significant difference in operative risk among the groups; however, a trend toward a decreased operative risk was noticed in patients operated on during the third–fourth week after stroke. Division to early (<2 weeks) and late (>2 weeks) endarterectomy also did not reveal any significant difference in the operative risk. Conclusions The perioperative risk of stroke and death was unrelated to the timing of carotid endarterectomy in patients with stroke and severe carotid stenosis. Carotid endarterectomy can be performed safely after 2 weeks of ischemic stroke in patients with severe carotid artery stenosis. Key words: stroke, carotid endarterectomy, time, operative risk

scholarly journals FEATURES OF CLINICAL MANIFESTATIONS, CELLULAR AND HUMORAL IMMUNITY OF NEWBORNS WITH INTRAUTERINE MIXED INFECTIONS

2020 ◽  
pp. 427-433
Author(s):  
M.A. YUSUPOVA ◽  
◽  
K.I. ISMOILOV ◽  
Keyword(s):  
Humoral Immunity ◽  
Phagocytic Activity ◽  
Clinical Manifestations ◽  
Main Group ◽  
Phagocytic Index ◽  
Control Group ◽  
Mixed Infections ◽  
Secondary Immunodeficiency ◽  
Group I ◽  
Cellular And Humoral Immunity

Objective: To study the features of clinical manifestations, cellular and humoral immunity of newborns with intrauterine mixed infections (IUMI). Methods: A comprehensive survey of 45 infants with IUMI was carried out. Depending on the classification of IUMI they were divided into 3 main groups: group I – 24 patients (53%) with the viral-bacterial association, group II – 12 patients (27%) with the viral-viral association, and group III – 9 patients (20%) with the viral-parasitic association. The control group consisted of 10 newborns born from uninfected, somatically healthy mothers. Diagnosis of IUMI was based on the detection of specific antibodies of the IgA, IgG and IgM classes, as well as phagocytic activity and phagocytic index of leukocytes. In addition, general clinical, biochemical, bacteriological and instrumental research methods have been conducted. Results: The blood serum IgA and IgM indices in patients of the main group were significantly higher, and the mean IgG values were lower compared to the control group. Analysis of cellular immunity parameters in the main group showed a decrease in the number of mature T-lymphocytes (CD3), B-lymphocytes (CD20), the number of T-helpers and cells that produce IL-2 in the peripheral blood, compared with the control group. In the main group, there was also an increase in the number of apoptosis cells (CD95), cells with high cytotoxic activity (CD25, CD71) and the percentage of natural killer cells (CD16). A decrease in the phagocytic activity and phagocytic index of neutrophils was recorded, which indicates the insufficiency of the nonspecific component of immunity. Conclusions: In newborns, various changes were found both on the part of specific and nonspecific components of immunity. This indicates the development of secondary immunodeficiency in this category of patients and makes it necessary to add to the main treatment of immune corrective therapy. Keywords: Congenital infections, mixed intrauterine infections, TORCH syndrome, opportunistic infections, secondary immunodeficiency.

scholarly journals Clinical Manifestations of Periodontal Tissue Diseases in Patients with Rheumatoid Arthritis Who Live in Anthropogenically Loaded Areas

2020 ◽  
Vol 27 (3) ◽  
pp. E2020310
Author(s):  
Khristina Kovalyshyn ◽  
Mykola Rozhko
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Manifestations ◽  
Environmentally Friendly ◽  
Severe Form ◽  
Control Group ◽  
Periodontal Tissues ◽  
Group I ◽  
Periodontal Index ◽  
Somatic Diseases ◽  
Degree Of Severity

The objective of the study is to clinically assess the condition of periodontal tissues in patients with rheumatoid arthritis, living in anthropogenically loaded and environmentally friendly areas and in people with generalized periodontitis without concomitant somatic diseases. Materials and methods. There were examined 137 patients, including 82 patients with generalized periodontitis of the I degree (subgroups A) and the II degree (subgroups B) with rheumatoid arthritis, living in anthropogenically loaded areas (group I), environmentally friendly areas (group II) and without concomitant somatic diseases living in environmentally friendly areas (group III). Control group – included 18 healthy people. Periodontal tissues were evaluated according to the indices: Greene-Vermillion, PMA, periodontal index offered by Russel and the depth of periodontal pockets.  Results. Women (80%) dominated in each group, patients with generalized periodontitis of the II degree of severity dominated, too.  The highest depth of periodontal pockets was 5.02±0.11 mm in the IB subgroup and differed significantly from this figure in the IIB subgroup 1.07-fold (pIB-IIB<0.05) and from that in the IIIB subgroup 1.2-fold (pIB-IIIB<0.001). The value of the Greene-Vermilion index in patients with GP of the I degree of development in all subgroups A corresponded to “unsatisfactory”. In patients with GP of the II degree of development, the state of hygiene corresponded to “bad” in subgroups IB, IIB and was 3.04±0.11 points (pIB-IIB˂0.01, pIB-IIIB˂0.001, pIB-K˂0.001); 2,63 ± 0.07 points (pIIB-IB˂0.01, pIIB-IIIB˂0.001, pIIB-K˂0.001), in ІІІB – “unsatisfactory”. According to the indicators of the PMA index in patients with GP of the I degree of severity, we’ve found the average severity degree of gingivitis (within the range of 43.25±2.02 – 48.06±1.46%) and severe degree of gingivitis in patients with the GP of the II degree >50 %. The highest indicator of periodontal index was found in the IB subgroup – 6.16±0.10 points (pIB-IIB˂0.01, pIB-IIIB˂0.001, pIB-K˂0.001), which indicated a severe form of periodontitis. Conclusion. Most often, GP in patients with RA was diagnosed in women, most of whom were patients with GP of the II degree (most in group I – 69.04%). The highest depth of periodontal pockets was 5.02±0.11 mm in the IB subgroup. The performed clinical and index assessment of periodontal tissues in patients of three groups indicates a more severe course of GP of the I and II degree in patients with rheumatoid arthritis living in anthropogenically loaded areas (IA, IB subgroups).

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