ACHIEVEMENT OF CLINICAL REMISSION IN PATIENTS WITH RHEUMATOID ARTHRITIS DEPENDING ON THE ACCP- AND RF-SEROLOGICAL STATUS.

In this clinical study, the effect of serological status of rheumatoid arthritis (RA) on the possibility and timing of clinical remission while taking the main non-biological disease modifying anti-rheumatic drugs (DMARD) was analyzed. The relationship between presence and levels of antibodies to cyclic citrullinated peptide (ACCP) and/or rheumatoid factor (RF) and remission in RA has also been studied. It was found that the frequency of remission, including early one (during the first 6 months of treatment), is three times higher in ACCP negative patients with RA. The rate of remission (ratio of early to total remission) does not depend on the serological status: about two thirds of patients in all analyzed groups achieve remission in the first 6 months of DMARD therapy. ACCP and RF titers in the onset of the disease do not influence the possibility of remission achievement.

Systemic lupus erythematosus and associated healthcare resource consumption in selected cities from the Russian Federation, Republic of Kazakhstan and Ukraine: the ESSENCE study.

OBJECTIVES: To evaluate healthcare resource (HR) consumption associated with Systemic Lupus Erythematosus (SLE) management in adult patients with active autoantibody positive disease in the Russian Federation, Republic of Kazakhstan, and Ukraine. METHODS: The ESSENCE was a retrospective, observational study, and included data on patients' clinical characteristics and SLE-related HR use (laboratory, biopsy, imaging tests, medications, visits to specialists, outpatient visits, hospitalizations) during 2010 from the 12 specialized rheumatologic centers. RESULTS: A total of 436 SLE patients were included in the analyses, with 232 patients being enrolled in Russia, 110 in Kazakhstan, and 94 in Ukraine. The mean age was 36-42 years and median SLE duration was 3-6.8 years across the countries. Extrapolation to total country population showed that, in 2010, visits to specialists (who assign treatment for organs involved/damaged by SLE) were the most frequently used HR (from 13,439 visits in Kazakhstan to 23,510 in Russia), followed by hospitalizations (from 2,950 in Kazakhstan to 6,267 in Russia) and outpatient visits (from 1,654 visits in Russia to 8,064 in Kazakhstan). Compared to chronic active patients (SLE persistent during last year), patients with relapsing-remitting SLE (at least one flare alternated by one remission per year) had a higher rate of visits to specialists (100% vs 60.8%, p < .001) and hospitalizations (98.9% vs 60.8%, p < .001). Compared to patients without flares, patients experiencing flares had a higher rate of unplanned visits to specialists (86.2% vs 6.3%, p < .001), were more often hospitalized (both ICU and non-ICU) (100.0% vs 50.0%, p < .001), and had a longer duration of ICU hospitalization (25.9 days vs 17.5 days, p < .001). CONCLUSIONS: Specialist visits are the most frequently consumed SLE-related healthcare recourse in the Commonwealth of Independent States (CIS) countries. A relapsing-remitting SLE profile and the occurrence of flares significantly raise healthcare resource consumption.

Standard medical care of patients with systemic lupus erythematosus (SLE) in large specialised centres: data from the Russian Federation, Ukraine and Republic of Kazakhstan (ESSENCE).

OBJECTIVES: To describe disease characteristics and treatment regimens for adult patients with systemic lupus erythematosus (SLE) with autoantibody positive disease in three countries (the Russian Federation, Ukraine and Republic of Kazakhstan). METHODS: The Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q wave Coronary Events (ESSENCE) study was a 1-year, retrospective, multicentre, observational study. Data included patients' characteristics, disease activity and severity, and healthcare resource use in 2010. RESULTS: Twelve centres enrolled 436 eligible patients: 232 in Russia, 110 in Kazakhstan and 94 in Ukraine. Mean age ranged from 36 to 42 years and median SLE duration from 3 to 6.8 years. According to study definitions, 69.2% of patients in Russia, 72.7% in Kazakhstan and 55.4% in Ukraine had severe disease at diagnosis. SLE activity (Nasonova classification, 1972) decreased from diagnosis to the last visit in 2010 in all countries. At the last visit, mean (SD) Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index score was 13.8 (10.5) in Russia, 19.4 (16.9) in Kazakhstan and 7.2 (6.8) in Ukraine, and Systemic Lupus International Collaborative Clinics/American College of Rheumatology damage index was 2.0 (2.2), 3.3 (3.2) and 2.2 (2.0), respectively. Treatment regimens included predominantly glucocorticoids (96.7-99.1%), immunosuppressants or cytotoxic drugs, for example, azathioprine and cyclophosphamide (20.7-53.2%), and antimalarial drugs (18.3-40.8%). CONCLUSIONS: The study provides reliable insight into the SLE clinical profiles in the referenced countries. Patients were 4-10 years younger in the study and had 3-7 years shorter SLE duration than in Western European countries and both SLE activity and severity were higher with higher rate of hospitalisations, but decreased during treatment. Local and international scales demonstrated correlation in SLE activity and organ damage evaluation. There were differences in clinical characteristics and healthcare features across the countries.

The prevalence and incidence of systemic lupus erythematosus (SLE) in selected cities from three Commonwealth of Independent States countries (the Russian Federation, Ukraine and Kazakhstan).

We assessed the prevalence and incidence of Systemic Lupus Erythematosus (SLE) in 2010 in adults from four cities in Russia, Kazakhstan and Ukraine. Individuals with SLE were identified retrospectively from the medical records of specialized centers. Prevalent SLE patients were nondeceased city residents, diagnosed prior to December 31, 2010; incident patients were residents newly diagnosed between January 1 and December 31, 2010. Population size was obtained from official census data. The observed prevalence rates (per 100,000, 95% CI) were 9.0 (7.1-11.2) in Kursk and Yaroslavl, Russian Federation; 20.6 (15.4-27.0) in Semey, Kazakhstan; and 14.9 (10.9-19.9) in Vinnitsa, Ukraine. The cumulative incidence rates (per 100,000, 95% CI) were 1.4 (0.7-2.4); 1.6 (0.4-4.1) and 0.3 (0.0-1.8), correspondingly. All rates were higher among females compared to males, and incidence peaked in the population aged 25-44. These rates appear slightly lower than those reported from Western Europe and the USA. This could be because of study design (case-ascertainment), local health care practices or true differences in disease risk. Case age and sex distribution was similar to the known epidemiology of SLE. The rates were highest in Kazakhstan, likely because of a predominantly ethnic Asian population.

[The fatty acid composition of the venous and arterial blood lipids in the complications in the acute period of myocardial infarct]. / Zhirnokislotnyi sostav lipidov venoznoi i arterial'noi krovi pri nekotorykh oslozhneniiakh ostrogo perioda infarkta miokarda.

Lipid fatty-acid composition was determined as was the level of free cholesterol in serum and red cells of venous and arterial blood in patients with myocardial infarction presenting with certain complications. The most significant changes in fatty-acid composition of blood serum lipids were in pulmonary edema and pneumonia, with those in the cell lipid complex being recordable in cardiogenic shock and ventricular fibrillation. Fatty-acid composition of the arterial blood lipids is more balanced compared to the venous blood in pulmonary edema, cardiogenic shock, ventricular fibrillation; the opposite tendency is observed during the development of pneumonia.

[A comparative evaluation of the efficacy of peroral and intravenous pulse therapy with methylprednisolone in rheumatic diseases]. / Porivnial'na otsinka efektyvnosti peroral'noï i vnutrishn'ovennoï pul's-terapiï metylprednizolonom pry revmatychnykh zakhvoriuvanniakh.

Pulse therapy with methylprednisolone (Solu-Medrol, Upjohn), 1000 mg daily over three successive days, was administered to patients in two randomized groups of 14 patients in each (23 patients with systemic lupus erythematosus, 5 with rheumatoid arthritis). In one of the groups the drug was taken per os, the other received it intravenously. There was no significant difference between the two groups in terms of clinical effectiveness and incidence of side effects However, the time-related course of such indices as erythrocyte sedimentation rate, the level of leukocytes, of total protein, urea, the blood antioxidant potential, permeability of erythrocytic membranes and capillary and tissue barrier proteinuria as well as the content of immune complexes in the arterial and venous blood was more striking with per os intake. Of the 14 patients, 11 demonstrated short-continued asymptomatic 35% rise in the activity of alaninaminotransferase.

[The sorption kinetics in an immunosorbent of circulating immune reactants in the blood of patients with systemic lupus erythematosus]. / Kinetyka sorbtsiï na imunosorbenti tsyrkuliuiuchykh imunnykh reaktantiv z krovi khvorykh na systemnyi chervonyi vovchak.

In a double-blind trial blood content was studied of antibodies to nDNA and dDNA (AB-nDNA and AB-dDNA) using methods of solid-phase and liquid-phase immunoassay, of circulating immune complexes (CIC), beta 2-microglobulin (beta 2-MG), Ig G, M, and A during the time-related run of two sessions of immunosorption (IS) or nonselective hemosorption (NHS) in 22 patients with systemic lupus erythematosus. In eleven patients there was employed for IS DNA-containing active carbon, in other eleven patients carbon was used for NHS. Throughout the whole IS session high- and low-avid AB-nDNA and CIC were getting fixed with the sorbent followed by AB-dDNA, with the concentration gradient for these substances in the column being greater at minute 30 than it was at minute 15. The control carbon fixed AB-nDNA and AB-dDNA as measured by ELISA but at the start of the session it did so also with low-avid AB-at minute 30. At minute 15 of perfusion the blood level of low-avid AB-nDNA and AB-dDNA following the column procedure tended to significantly increase both in NHS and, to a lesser extent, in IS. Neither of the sorbents adsorbed IG. Decline in beta 2-MG concentration in columns with engrafted and matrix carbon at the start of the perfusion and its rise during the second half of the session might be caused by blood cells structural and functional condition as a result of their interaction with the sorbent in question.

[Efficacy of immunosorption in patients with systemic lupus erythematosus: double blind controlled trial]. / Effektivnost' immunosorbtsii u bol'nykh sistemnoi krasnoi volchankoi: dvoinoe slepoe kontroliruemoe issledovanie.

Efficacy of immunosorption (IS) employing perfusion of whole blood through activated charcoal containing DNA was studied in 11 patients with systemic lupus erythematosus (SLE). 11 SLE patients exposed to hemosorption on charcoal free from DNA served as controls. When used in combination with intensive therapy (corticosteroids and cytostatic immunosuppressant), IS produced a positive effect on lupus nephritis symptoms in 8 out of 10 patients with kidney affection. AntiDNA antibodies blood level decreased by 53.6% after two IS procedures, while only by 36.4% after nonselective hemosorption. Reduced count and functional activity of B-cells recorded after IS contribute much to final outcome of the treatment.

[Changes of biochemical blood parameters under conditions of treatment with vaulen and polysorb enterosorbents]. / Zmina biokhimichnykh pokaznykiv krovi za umov vykoristannia enterosorbentiv vaulenu ta polisorbu.

Alteration of the biochemical blood indices has been studied in patients with rheumatoid arthritis and lupus erythematosus that were treated with vaulen (V) and polysorb (P) enterosorbents. It was determined that alanine aminotransferase activity grew and albumin, urea, uric acid levels enhanced after the V treatment. Glucose level and alanine-, asparagine aminotransferases activities decreased after the P treatment. It is necessary to take into consideration these results when choosing an enterosorbent for treatment of patients with the immunocomplex rheumatic diseases accompanied by the liver parenchyma lesion and hyperuricemia.

[The body oxygen allowance in myocardial infarct patients with progressive forms of acute circulatory failure]. / Kislorodnoe obespechenie organizma bol'nykh infarktom miokarda pri progressiruiushchikh formakh ostroi nedostatochnosti krovoobrashcheniia.

Oxygen supply of the body was studied in 172 patients with macrofocal myocardial infarction with a varying course of acute circulatory insufficiency. It was found that most patients with acute circulatory insufficiency developing during onset of the disease showed latent cardiac insufficiency that can be detected determination of the coefficient of oxygen transport function of the left ventricle. These patients also showed a pronounced shift of oxyhemoglobin dissociation curve to the right and an increase of the peripheral blood flow.

[The effect of ceruloplasmin on metabolic processes in the liver of mice during neutron exposure]. / Vliianie tseruloplazmina na metabolicheskie protsessy v pecheni myshei pri neitronnom vozdeistvii.

A single intraperitoneal administration of human ceruloplasmin to BALB/c mice 60 min before fast neutron irradiation normalizes lipid content and cAMP/cGMP index, and increases catalase activity in the liver of irradiated animals.

[The hemodynamic effect of Capoten in patients with myocardial infarct complicated by heart failure]. / Gemodinamicheskii éffekt kapotena u bol'nykh infarktom miokarda, oslozhnennym serdechnoi nedostatochnost'iu.

Capoten was used in the treatment of 28 patients with macrofocal myocardial infarction associated with marked acute cardiac insufficiency. 1.5 hours following intake of 6.25 mg of Capoten the arterial pressure reduced, the general peripheral vascular resistance, left ventricle filling pressure also reduced and this was accompanied by a reduction of rate of cardiac contractions, increase of cardiac ejection. No side effects related to Capoten treatment were observed.