[Sjögren's syndrome with juvenile onset].

Aim to analyze demographic data, clinical features and results of laboratory and instrumental examinations in children with primary and secondary Sjögren syndrome (SS). MATERIALS AND METHODS: The study included all consequently patients, who hospitalized to the pediatric department of V.A. Nasonova Scientific and Research Institute of Rheumatology from January 2013 to December 2018, which verified the diagnosis of the SS. RESULTS: The diagnosis of SS was established in 30 patients, among whom there were only 5 (16.7%) boys, the ratio of boys and girls was 1:5. According to the results of the examination, the following diagnoses were verified: 4 - primary SS, 9 - systemic lupus erythematosus with SS, 10 - juvenile rheumatoid arthritis with SS, 3 - mixed connective tissue disease, 3 - overlap syndrome, 1 - systemic sclerosis with SS. The median age of rheumatic disease onset was 10.4 (7.0; 13.75) years. The median of disease duration at the time of SS verification - 3.0 (0.85; 4.4) years. Recurrent parotitis were observed in 8 patients. 24 pts had isolated involvement of salivary glands, 6 - combined with lacrimal glands. Sicca syndrome was occurred in 8 patients. All patients had systemic manifestations: constitutional abnormalities - 50%, polyarthritis - 83.3%, lymphadenopathy - 73.3%, cutaneous involvement - 60%, pulmonary involvement - 23.3%. Of the hematological disorders, leuko/lymphopenia was more often recorded - in 30%, polyclonal hypergammaglobulinemia - in 26.7% of patients. ANA were detected in all cases, anti-Ro antibodies - 60%, a positive rheumatoid factor - 56.7% of patients. The most common combination of immunological disorders was the presence of ANA, RF and anti-Ro antibodies (40% of patients). The treatment for each patient was justified by the main manifestations and activity of rheumatic disease: 66.7% received nonsteroidal anti - inflammatory drugs, 80% - glucocorticoids, 46.7% - methotrexate, 20% - azathioprine, 43.3% - hydroxychloroquine, 10% - mycophenolatis mofetilum, 3.4% - cyclophosphamide. 66.7% of patients received the treatment of Biologics. CONCLUSIONS: Early diagnosis of SS in children with rheumatic diseases significantly affects to the choice of treatment and prognosis. In children the SS has no clinical manifestations for a long time. Such symptoms as a hypergammaglobulinemia, positive RF without persistant arthritis, nonspecific skin lesions, recurrent parotid swelling may help to diagnosis of SS.

[Parkinson's disease and glutamate excitotoxicity]. / Bolezn' Parkinsona i glutamatnaia éksaitotoksichnost'.

AIM: To measure the concentration of glutamate in the serum of patients with Parkinson's disease (PD) and determine its association with clinical variants of disease course. MATERIAL AND METHODS: One hundred and ten patients with PD and 90 healthy people were examined. Glutamate concentration in the blood serum was determined with a spectrophotometric method. RESULTS AND CONCLUSION: Patients with Parkinson's disease had significantly higher levels of serum glutamate compared with healthy subjects (p<0,0001). Patients with a tremor-dominant subtype had significantly higher levels of serum glutamate compared to those in patients with akinetic-rigid and mixed subtypes. The results obtained allow us to expand our understanding of the pathogenesis of this disease. Changes in the concentration of glutamate may reflect neurodegenerative process in PD.

[Parkinson's disease and glutamatergic system]. / Bolezn' Parkinsona i glutamatergicheskaia sistema.

Clinical variants of Parkinson's disease (PD) are not restricted to motor symptoms but include a wide spectrum of different non-motor symptoms: cognitive, psychotic, autonomic and sensory. These non-motor symptoms often occur long before classical motor features. Associated pathologic changes can now be identified at earliest stages using neuroimaging, pathomorphological and genetic studies. Therefore, PD is currently considered as a multifactorial, heterogenic systemic disease associated with involvement of multiple neurotransmitter systems. This leads to understanding that not only dopaminergic but also other neurotransmitter systems, including glutamatergic system, are involved in the pathogenesis of PD. This article aimed at investigating a role of glutamatergic system in the initiation of neurodegenerative process. The role of glutamate as a neurotransmitter and a neurotoxin in the pathogenesis of PD and progression of its clinical manifestations is discussed. The authors suggest that research into glutamate excitotoxicity in PD patients might allow the improvement of treatment tactics and correction of pathogenetic therapy.

Importance of trabecular anisotropy in finite element predictions of patellar strain after Total Knee Arthroplasty.

Patellar fracture and anterior knee pain remain major complications after Total Knee Arthroplasty (TKA). Patient-specific finite element (FE) models should help improve understanding of these complications through estimation of joint and bone mechanics. However, sensitivity of predictions on modeling techniques and approaches is not fully investigated. In particular, the importance of patellar bone anisotropy, usually omitted in FE models, on strain prediction is still unknown. The objective of this study was thus to estimate the influence of modeling patellar trabecular anisotropy on prediction of patellar strain in TKA models. We compared FE-derived strain predictions with isotopic and anisotropic material properties using 17 validated FE models of the patella after TKA. We considered both non-resurfaced and resurfaced patellae, in a load-bearing TKA joint. We evaluated and compared the bone volume above a strain threshold and, in addition, estimated if the difference in isotopic and anisotropic predictions was consistent between patellae of different average bone volume fraction. Compared to the anisotropic reference, the isotropic prediction of strained volume was 3.7±1.8 times higher for non-resurfaced patellae and 1.5±0.4 times for resurfaced patellae. This difference was higher for patellae with lower average bone volume fraction. This study indicates that strain predictions acquired via isotropic patellar FE models should be interpreted with caution, especially when patellae of different average bone volume fraction are compared.

[Correlation Between Emotional-Affective Disorders and Gut Microbiota Composition in Patients with Parkinson's Disease].

Background: Despite the efforts of scientific community the data available on the correlation between emotional-affective symptoms of Parkinson's disease and changes in microbiome is still scarce. Deeper studies of nonmotor symptoms evident in premotor stages of the disease and the reciprocal influence of microbiota may help to understand the etiology and pathogenesis of PD neurodegeneration better. Aim of the Study: Discover the relations between emotional-affective disorders prevalent in PD population and changes in gut microbiota composition. Methods: 51 patient diagnosed with PD participated in the study. Every participant's emotional-affective state was examined using Beck's Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS). Taxonomic richness of microbiome was studied using 16S ribosomal RNA gene sequencing, bioinformatics, and statistical analysis. Results: Anxiety and depression are prevalent affective disorders in patients with PD. In our study, most of the subjects demonstrated certain anxiety and depression. Taxonomic diversity of gut microbiota in BP was increasing with the increase in anxiety levels, reaching the maximum in the group with subclinical anxiety, and decreasing in the group with clinically significant anxiety disorder. At the species level, patients with clinically significant anxiety had higher abundance of Clostridium clariflavum compared to the anxiety-free patients. Patients with moderate depression were characterized by the higher prevalence of Christensenella minuta, Clostridium disporicum, and Oscillibacter valericigenes compared to subjects without depression or with mild depression. Conclusion: The data we received in our study allow better understanding of PD pathogenesis.

[A role of the gastrointestinal tract microbiota in the pathogenesis of Parkinson's disease]. / Vozmozhnaia rol' mikrobioty zheludochno-kishechnogotraktavpatogenezebolezniarkinsona.

Microbiota is a community of microorganisms, viruses, protozoa, colonizing the gut. There are tight phylogenetic relationships between the gut microbiota and the human body, the disturbance of which may lead to the CNS dysfunction as well as to the development of neurodegenerative diseases. This review focuses on general and specific aspects of the influence of gut microbiota on the pathogenesis of Parkinson's disease (PD). Current theories and models of the relationship between microbiota and brain structures in PD are presented with a specific focus on neurochemical and immunological aspects of the problem.