Adenosine deaminase and C-reactive protein in diagnosing and monitoring of rheumatoid arthritis.

AIM: To determine of catalytic activities of adenosine deaminase (ADA) and values of C-reactive protein (CRP) concentration in serums of patients with rheumatoid arthritis (RA), who were and were not treated with Methotrexate (MTX), and identifying the possibilities of using these biochemical parameters in diagnosing and monitoring of treatment effects in RA. METHODS: The study involved 120 subjects (60 healthy ones, who are in accordance with examined groups concerning age and sex, 30 suffering from RA who were not treated with MTX and 30 suffering from RA who were treated by MTX). Catalytic activities of ADA in serum were determined by spectrophotometric method using adenosine as a substrate. CRP concentrations in serum were determined immunoturbidimetrically. RESULTS: A statistically significant correlation between values of ADA catalytic activities and values of CRP concentrations (r = 0.55, p < 0.01) in serums of subjects with RA without MTX treatment. At subjects with RA treated by MTX, correlation between values of ADA catalytic activities and values of CRP concentrations in serums was not statistically significant (r = 0.33, p > 0.01). CONCLUSION: Study results have shown that ADA catalytic activity in serum can be a useful biochemical marker of inflammatory process in RA.

Temptation of academic medicine: second alma mater and "shared employment' concepts as possible way out?

Apparently, in developing and in well-developed societies we are confronted with a crisis of academic medicine in all aspects: health care, teaching, and research. Health care providers in teaching hospitals are under pressure to generate revenues, academic research is pressed to keep pace with institutions devoted solely to research, and teaching is often understood not as privilege and honor but as burden and nuisance. The key problem and the principal cause of the crisis are low interest of the best young graduates to follow an academic career in a world where the benefits and values of the private sector are prevailing. Confronted with these circumstances and the continuous perils of permanent brain-drain, we developed an innovative concept of "shared employment' where two academic institutions (one in a developed and one in a developing country) will collaborate in development and support of fresh talents, building elite academic staff. Most academic exchange programs developed so far have proved to be ineffective and of poor vitality, in spite of loud exclamations, high expectations, and a huge amount of good will involved. In contrast, the suggested cooperation will be based exclusively on mutual interest and clearly defined benefits for all involved parties.