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{"title":"Onset of Rheumatoid Arthritis with eye manifestations (clinical case report)","authors":"A. I. Akulova, A. R. Avakian, G. R. Dolishniaia, N. M. Nikitina","doi":"10.33667/2078-5631-2024-10-53-56","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-53-56","url":null,"abstract":"Objective. Rheumatoid Arthritis may onset with ocular manifestations. The purpose of our work was presentation of clinical case of the onset of rheumatoid arthritis with an eye lesion.Materials and methods. A clinical case of rheumatoid arthritis with an atypical onset was analyzed. As well, a search and review of relevant literature was performed.Results. Patient with rheumatoid arthritis got bilateral ulcerous keratitis, refractory to conventional treatment and complicated by bilateral corneal perforation with iris prolapse. Due to the atypical clinical course of ophthalmic lesions being insusceptible of medical treatment, the patient was examined further. Laboratory immunological workup revealed positive rheumatoid factor, anti-CCP and anti-MCV antibodies. The typical symmetric presentation of arthritis developed 8 months after the onset of ophthalmic disorders. Baseline therapy of rheumatoid arthritis has demonstrated efficacy both in controlling the joint manifestations and preventing relapse of keratitis.Conclusion. The development of eye syndrome may precede articular manifestation of rheumatoid arthritis. While managing patients with recurrent bilateral keratitis, rheumatologic pathology should be suspected.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":"25 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141815353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peculiarities of laboratory parameters dynamics during helicobacter pylori eradication in patients with rheumatoid arthritis","authors":"V. Aleksandrov, E. A. Zagorodneva, N. V. Aleksandrova, E. G. Cherkesova, L. N. Shilova, A. Aleksandrov","doi":"10.33667/2078-5631-2024-10-57-62","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-57-62","url":null,"abstract":"Helicobacter pylori (H. pylori) is able to participate in the pathogenesis of a number of autoimmune diseases, actively maintains chronic inflammation and stimulates the systemic immune response. The virulence factor of H. pylori is cytotoxin-associated gene A (CagA) is associated with more severe inflammatory reactions, increased risk of poor clinical outcomes and is able to influence the efficacy of infection eradication in patients with rheumatoid arthritis (RA).Purpose of the study. To evaluate laboratory parameters of H. pylori eradication efficacy in RA patients with chronic infection with the strain encoding cytotoxin-associated gene A.Materials and methods. Forty women with RA and confirmed chronic H. pylori infection were included in the study (mean age 55.5±8.7 years; mean disease duration 13.9±9.1 years; DAS-28–3.96±0.56). CagA-IgG associated H. pylori infection was diagnosed in 22 (group I, CagA+) and not diagnosed in 18 (group II, CagA-) patients. All RA patients underwent a course of H. pylori eradication therapy.Results. The process of H. pylori eradication had the most significant effect on laboratory parameters of CagA-negative RA patients (group II). In this group the levels of rheumatoid factor (p=0,028), C-reactive protein (CRP, p=0.001), interleukin-6 (IL-6, p=0.002), tumor necrosis factor alpha (p=0,023), angiopoietinlike protein type 3 (p=0.026) and antibodies to cyclic citrullinated peptide (ACCP, p=0,016) decreased significantly. In patients from group I (CagA+) most parameters remained practically unchanged (p>0.05), except for CRP (p=0.01) and IL-6 (p=0.011). In the short term, the success of eradication in CagA+ patients was significantly lower than in CagA- patients (p=0.033). Moreover, confirmation of successful eradication of H. pylori within the established period of time was extremely rare (p=0.009) in the combination of CagA+ and high titers of ACCP and antibodies to modified citrullinated vimentin.Conclusions. The effectiveness of H. pylori eradication in RA patients depends on the presence of chronic infection with the strain encoding the cytotoxin-associated gene A and the level of antibodies to citrullinated proteins, which should be taken into account when choosing the therapeutic effect on H. pylori in this group.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":"26 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141815476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteopoikilia in the practice of a rheumatologist","authors":"N. Y. Tikhomirova, L. N. Eliseeva, N. Belozerova, E. S. Kameneva, V. A. Shkokov, T. I. Frolova","doi":"10.33667/2078-5631-2024-10-51-53","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-51-53","url":null,"abstract":"Osteopoikilia (OPC) is a rare, benign autosomal dominant disease characterized by sclerotic bone lesions, which usually proceeds asymptomatically. It is usually diagnosed by accident with conventional radiography. In most patients, the disease is asymptomatic, but some may complain of mild joint pain and swelling. Differential diagnoses of the disease include osteoblastic metastases, primary bone tumor, mastocytosis, tuberous sclerosis, synovial chondromatosis and melanostasis. In the literature, we have found reports of the coexistence of OPC with rheumatological diseases such as fibromyalgia, reactive arthritis, familial Mediterranean fever, psoriatic arthritis, rheumatoid arthritis, seronegative spondyloarthritis. Thus, the clinical case we observed is interesting not only from the standpoint of the importance of establishing a clinical diagnosis, but also the timeliness of starting treatment, which affects the prognosis of the disease.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":"25 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141814523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal nature of pain syndrome in patients with rheumatoid arthritis in relation to the course of the disease and clinical characteristics","authors":"K. R. Zagretdinova, Z. Gabdullina, E. Sukhorukova, E. S. Zamanova, R. Z. Abdrakipov, S. A. Lapshina","doi":"10.33667/2078-5631-2024-10-37-42","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-37-42","url":null,"abstract":"Purpose of the study. To evaluate the character of pain syndrome in patients with rheumatoid arthritis in correlation with the course of the disease and comorbid pathology.Material and methods. Sixty-six patients with a verified diagnosis of RA were examined. Of them 84.9% were women (n=56) and 15.1% men (n=10). The median age was 59 [52; 63] years. Disease activity was assessed by DAS28-CRP, with a median of 5.2 [4.54; 6.0]. Patients with moderate (31.8%) and high activity (57.5%) predominated. Disease duration averaged Me 156 [93; 246] months. Seropositive RA was suffered by 89.3% of patients. The distribution by radiological stage was as follows: 2 radiological stage – 36.3% (n=24), 3 radiological stage – 30.3% (n=20), 4 radiological stage – 33.4% (n=22). Baseline anti-inflammatory therapy was taken by 84.8% of patients (n=56), genetically engineered biological drugs were received by 28.7% (n=16). To assess the multicomponent nature of pain syndrome, the following were used: Pain Detect questionnaire — to verify neuropathic pain (NP), CSI questionnaire — to verify central sensitisation (CS). The EQ-5D-3L questionnaire was used to assess quality of life, and the Charlson index was used to assess comorbid pathology. Structural changes were assessed by modified Sharpe method on hand and foot radiographs, synovium vascularisation was assessed by joint ultrasound.Results. 84.8% of patients had pain syndrome of mixed nature. NP correlated with pain intensity by VAS (rSp=0.458, p<0.001), DAS28-CRP (rSp=0.509, p<0.001), number of peripheral arthritis (rSp=0, 414, p<0.001), number of comorbidities (rSp=0.337, p=0.006), Charlson index (rSp=0.323, p=0.009), EQ-5D-3L (rSp= –0.268, p=0.031). CS–with VAS pain intensity (rSp=0.250, p=0.045), DAS28-CRP (rSp=0.251, p=0.044), number of painful joints (rSp=0.353, p=0.004), number of comorbidities (rSp=0.368, p=0.003), BMI (rSp=0.266, p=0.032), systolic blood pressure level (rSp=0.403, p<0.001), number of erosions on hand and foot radiographs (rSp= –0.299, p=0.016), EQ-5D-3L (rCp= –0.408, p<0.001). Patients with the presence of synovial vascularization by ultrasound had three-component pain in more than half of cases, and the combination of inflammatory pain and CS did not occur in them.Conclusions. 84.8% of patients had multicomponent pain, with pain associated only with clinical parameters of disease activity. Associated pathology and local chronic inflammation in the joint potentiate the development of other types of pain and have a mutual negative influence.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":"25 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141816977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney autotransplantation with renal arteries injury in a patient with Takayasu arteritis","authors":"I. Borodina, A. A. Popov, B. Fadin, V. V. Rzhannikov, A. N. Ageev, L. Shardina","doi":"10.33667/2078-5631-2024-10-43-47","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-43-47","url":null,"abstract":"Takayasu arteritis (AT) is a systemic vasculitis of large vessels. As a rule, AT develops in patients under 50 years of age and is characterized by vasculitis, often granulomatous, with a predominant lesion of the aorta and/or its main branches. The article describes a clinical case of a patient with bilateral lesions of the renal arteries caused by AT, who underwent kidney autotransplantation. The first manifestations of psoriasis in the patient occurred after psychological stress 15 years after surgery. The described clinical observation of multi-stage surgical treatment of Takayasu arteritis, which ended favorably, is presented by us in order to demonstrate the capabilities of modern medical technologies in both diagnosis and surgical treatment of multi-vessel lesions in Takayasu arteritis. The combination of AT and psoriasis is a rare pathology, the problems of diagnosis and treatment of which require further study.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":"28 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141814501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Современные маркеры диагностики сочетания анкилозирующего спондилита и воспалительных заболеваний кишечника","authors":"D. Tarasova, L. N. Shilova","doi":"10.33667/2078-5631-2024-10-47-50","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-47-50","url":null,"abstract":"The problem of the combination of ankylosing spondylitis (AS) and inflammatory bowel diseases (IBD) is interdisciplinary. Modern approaches to studying this issue among rheumatologists and gastroenterologists are somewhat different. The combination of these two pathologies is a potential factor for a more severe course of these diseases. The article provides an overview of some markers that have shown high specificity in the diagnosis of AS and IBD","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":"48 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141815055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative characteristics of the effectiveness of drugs for the treatment of alopecia areata in childhood","authors":"N. Murashkin, A. M. Dogov","doi":"10.33667/2078-5631-2024-9-66-69","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-9-66-69","url":null,"abstract":"Alopecia areata (АА) is an autoimmune inflammatory disease with an established genetic predisposition, which is based on the lesion of hair follicles, leading to persistent or temporary hair loss. To date, treatment of АA in children, is limited to the use in most cases of external hormonal therapy in the form сream or the prescription of intradermal injections of GCS in outpatient conditions. However, data on the effectiveness of this group of drugs in severe forms of AA flow are not fully studied. There is an open question of the choice of the most preferred drug in patients simultaneously with a severe flow of AA and a severe form of atopic dermatitis. Another interesting variant of treatment of AA is the drug Dupilumab. (blocker IL-4 and IL-13). The mechanism of action of dupilumab at АA remains unknown, and its effect on TH-type 2 is assumed.Purpose of the study. To conduct a comparative performance characterization of: external GCS (Clobetazole) and injectable GCS (Betamethazone) for treatment of AA in children; Tofacitinib treatment for children with alopecia and the presence or absence of atopic dermatitis in the form of a concomitant disease; use of Dupilumaba to treat children with AA.Materials and methods. The research sample includes 420 patients. By the nature of the lesion, we considered three types of alopecia: spotted, total and universal. Patient data is taken from the register of AA patients in children. [13]. The effectiveness of the treatment was assessed on the scale SALT [14]. Patients were monitored for six months.Results. Use of intradermal injections GKS (Betamethazone), more effective than outdoor GKS (Clobetazole). In patients with atopic dermatitis, the efficacy of Tofacitinib for AA treatment is reliably higher than in patients without atopic dermatitis. Dupilumab may be a drug of choice for treating patients with a total and universal form of AA.Conclusion. Additional randomized controlled trials are needed to assess the long-term efficacy of drugs such as Tofacitinib and Dupilumab.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":"36 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience in using laser to correct periorbital and temporal veins","authors":"A. S. Popova, N. Gryazeva, A. G. Stenko","doi":"10.33667/2078-5631-2024-9-95-96","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-9-95-96","url":null,"abstract":"This article presents the experience of using laser for the correction of periorbital and temporal veins. Clinical cases are presented indicating the treatment parameters used. Mono mode and multiplex modes were used.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":"88 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proinflammatory cytokines in rheumatoid arthritis: dynamics against therapy with Janus kinase and interleukin 6 inhibitors","authors":"A. A. Baranov, N. Lapkina, E. A. Leontyeva, A. Karateev, A. A. Kolinyko, A. P. Pavluchkov, A. Artyuhov, I. A. Gorohov","doi":"10.33667/2078-5631-2024-10-31-36","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-31-36","url":null,"abstract":"Increased production of proinflammatory cytokines in serum and synovial fluid plays an important role in the pathogenesis of RA. JAK inhibitors and bDMARD are aimed at suppressing various pathological reactions caused by them.The aim of the study. To determine the effect of therapy with JAK and IL-6 inhibitors on the concentration of proinflammatory cytokines in RA patients in real clinical practice.Materials and methods. The study included 30 patients with a reliable diagnosis of RA, advanced stage of disease, with moderate or high RA activity and ineffectiveness of previous therapy with csDMARD or bDMARD for at least 6 months. 10 patients received TOFA at a dose of 5 mg twice daily 10 received UPA at a dose of 15 mg once daily and 10 were on OKZ therapy at a dose of 64 mg subcutaneously every 4 weeks. Studies were performed before treatment, after 3 and 6 months of therapy. The levels of IL-1β, IL-6, IL-17A, IL-17F, IL-23, IL-31, IL-33, INF-γ, TNF-α in serum were investigated using multiplex xMAR technology on Bio-PlexTM 200 System analyser (BIO-RAD, USA).Results. In all groups of patients after 3 and 6 months from the start of therapy, there was a significant decrease in the RA activity index compared to baseline values. The concentration of IL-1β, IL-17A, IL-17F and IL-23 did not change significantly during treatment with any of the drugs. IL-6 values on TOFA background significantly decreased after 3 and 6 months of follow-up compared to the baseline level. UPA therapy had no effect on IL-6 level during the whole observation period, and against the background of OKZ application its values significantly increased after 3 months, and after 6 months – decreased, remaining higher than the initial values. The concentration of IL-31 after 3 months of TOFA treatment significantly decreased (respectively: 6.95 (3.85; 17.72) pg/ml and 3.00 (1.50; 3.85) pg/ml, p<0.05), and after 6 months – increased, but remained lower than baseline (5.09 (3.85; 6.33) pg/ml, p<0.05). IL-33 level on the background of UPA decreased and after 6 months was significantly lower than baseline (1.11 (0.86; 3.95) pg/ ml; 1.05 (0.37; 3.95) and 0.37 (0.12; 1.23) pg/ml, p<0.05). The concentration of INF-γ after 3 and 6 months of TOFA administration decreased significantly compared to the start of therapy (2.05 (1.48; 3.19) pg/ml; 0.99 (0.49; 2.05) pg/ml and 0.99 (0.49; 2.62) pg/ml, p<0.05). Treatment with OKZ resulted in increased TNF-α levels after 6 months compared to baseline values of 0.79 (0.41; 0.98) pg/ml and 1.23 (0.67; 2.06) pg/ml, p<0.05.Conclusions. The use of TOFA, UPA and OKZ in RA patients has a positive effect on disease activity, but has different effects on the level of proinflammatory cytokines in serum.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":"17 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern approaches to acne therapy: review of clinical recommendations and analysis of clinical cases","authors":"L. S. Kruglova, N. Gryazeva","doi":"10.33667/2078-5631-2024-9-61-65","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-9-61-65","url":null,"abstract":"This article provides an overview of modern guidelines for acne treatment. The issues of prescribing both topical and systemic acne therapy are discussed. Particular attention is paid to systemic isotretinoin therapy. Clinical examples of the use of the drug Erase for acne of moderate and severe severity are discussed.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":"64 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141817720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}