63 research outputs found
Mapping of the Samara city by definition of areas with hydrogen degassing using Raman spectroscopy
No full textAnalysis of cell-tissue grafts under weightless conditions using confocal fluorescence microscopy
No full textAutoimmunity and autoinflammation — the key to understanding the pathogenesis of osteoarthritis and developing new ways for its prevention and therapy
Get PDFThe review considers the full spectrum of currently known autoantigens in osteoarthritis (OA) and discusses their role in the development and/or persistence of synovitis and the initiation of subsequent destruction of articular cartilage with the development of an autoimmune response and auto-inflammation. Of great interest are methods of drug prevention of OA considering autoimmunity responses and associated auto-inflammation, including the use of pharmaconutraceuticals.Preclinical and clinical studies of the safety and efficacy of pharmaconutraceuticals containing native type II collagen are presented. A clear relationship between the composition/chemical structure of the collagen components and its mechanism of action and efficacy is discussed. Taking into account the autoimmune pathogenesis of OA, new combined pharmaconutraceuticals aimed at reducing the manifestations of autoinflammation (chondroitin sulfate, glucosamine sulfate) are developed. They have an optimal ratio of active ingredients with a sufficient level of evidence, which allows enhancing their beneficial pharmacological effects
Degenerative and inflammatory hand joint changes in osteoarthritis according to magnetic resonance imaging
Get PDFErosive osteoarthritis (EOA) of the hand is an osteoarthritis (OA) phenotype that is characterized by central and marginal erosions of the articular surfaces in the distal and proximal interphalangeal (DIP and PIP) joints and in some cases by a fairly aggressive course with obvious pain syndrome and a high level of functional impairment. Diagnostic criteria and management tactics for EOA patients are still under investigation.Objective: to evaluate the nature of the changes detected by hand joint magnetic resonance imaging (MRI) in patients with EOA and non-erosive OA (NEOA) of the hand.Subjects and methods. Examinations were made in 61 females meeting the American College of Rheumatology (ACR) diagnostic criteria for hand OA; the patients' mean age was 66.34+5.79 years; the median age at disease onset was 50 [45; 56] years; the duration of pain was 15 [11; 20] years. All the patients underwent MRI of the second-fifth DIP, PIP, and metacarpophalangeal (MCP) joints of the right hand. The patients also filled out the AUSCAN questionnaire. EOA and NEOA were detected in 30 and 31 patients, respectively.Results and discussion. The patients with EOA and those with NEOA were matched for gender, age, and disease duration. The DIP joints in patients with EOA were found to have significantly more frequently and a greater number of large osteophytes (OPs), (53 and 16%, respectively), joint space narrowing (JSN) (73 and 35%), degenerative collateral ligament changes (DCLCs) (93 and 55%), subluxations (47 and 13%), and bone marrow edema (BME) (57 and 19%) than in those with NEOA. Synovitides and subchondral cysts occurred with approximately the same frequency in EOA and NEOA. The PIP joints in patients with EOA significantly more frequently showed BME (37%) and DCLCs (97%) than in those with NEOA. Subluxations in the PIP joint of the right hand were encountered exclusively in patients with EOA. Their incidence was 17%. Degenerative symptoms (small, less often moderate sizes of OPs, JSN, and DCLCs) were identified with approximately the same frequency in both groups (p>0.05). The PIP joints in patients with EOA were significantly more often found to have BME (53 and 26%, respectively; (p<0.05), cortical defects (CDs) of the metacarpal head (73 and 45%) than in those with NEOA. The incidence of subchondral cysts, OPs, JSN, and DCLCs was not significantly different in both groups (p>0.05). Large OPs in the PIP joint were found relatively rarely. Subluxations in the PIP joints were undetected in both groups.Conclusion. The symptoms of active inflammation are predominant and degenerative changes are more pronounced in patients with EOA unlike those with NEOA. Articular surface defects in the PIP joints in patients with hand OA differ from erosions in those with rheumatoid arthritis. These CDs in EOA are much more common than those in NEOA; however, the nature of their occurrence is unclear; therefore, the patients in whom they have been found need dynamic monitoring
Radiographic diagnosis of erosive hand osteoarthritis
Get PDFOsteoarthritis (OA) is one of the most common diseases of the musculoskeletal system in the world. Some researchers call the small joints of the hands as being one of the most common sites of involvement in OA. Its most severe phenotype is considered to be inflammatory, or erosive, OA (EOA). Nevertheless, the radiographic pattern of this disease has not yet been sufficiently studied, and whether EOA is an independent form of OA, a regular later stage of the disease or an individual nosological entity, has not yet been resolved.Objective: to assess the location, frequency, and severity of radiographic symptoms and pain in patients with EOA and non-erosive OA (NEOA), to study the involvement of carpometacarpal (CMC), wrist, metacarpophalangeal (MCP) and radiocarpal (RC) joints in the pathological process in patients with EOA and NEOA of the hands.Subjects and methods. The investigation enrolled 64 women with hand OA who met the American College of Rheumatology (ACR) OA criteria. Hand joint images in the anteroposterior projection were first performed in all the patients. Each patient completed the AUSCAN questionnaire. The images were described according to the Kellgren and Lawrence classification. The mean age of the patients was 65.28+6.82 years; the age at onset of the disease was 48.81+7.73 years; its median OA duration was 15.0 [10.0; 19.5] years. According to the presence of erosions in the interphalangeal joints (IPJ) of the hand, the patients were divided into two groups: 1) EOA (n=23); 2) NEOA (n=37). Both groups were matched for age and disease duration (the mean age of patients with EOA was 68+6.15 years, the mean disease duration was 18.34+7.11 years; these in the NEOA group were 65.13+5.43 and 16.56+8.4 years, respectively). For age matching, 4 patients were excluded from Group 2.Results and discussion. Kellgren and Lawrence Stage II hand OA was detected most frequently (49%) and the most common radiographic symptoms of OA in the distal IPJ (DIPJ), proximal IPJ (PIPJ) and MCP joints were joint space narrowing (JSN) (100%, 100%, and 95%, respectively) and osteophytes (OPs) (88%, 70%, and 45% respectively). The least common conditions were subchondral osteosclerosis (SCOS) (5%), erosions (8%), and subluxations (3%) in the MCP joints, as well as subluxations in the PIPJ (6%). In the wrist, the most frequent sites of involvement was first CMCJ and scaphoid-trapezium-trapezoid joint (STTJ); their JSN was identified in 86 and 69% of patients, respectively; OPs were found respectively in 81 and 50% of cases. Changes in the RC joint (RCJ) were least common.EOA of the DIPJ and PIPJ was found in 15 (23%) patients with radiographic changes corresponding to Stages III—IV OA of the hand and in 8 (12%) patients with Stage II according to the Kellgren and Lawrence classification. The DIPJ in EOA versus NEOA showed significantly higher frequency of OPs (100 and 78%), SCOS (74 and 11%), cysts (61 and 24%), and subluxations (43 and 14%); the PIPJ — SCOS (43 and 5%), cysts (52 and 27%), and subluxations (17 and 0%; p <0.05); the first CMCJ — JSN (96 and 68%), SCOS (61 and 22%), erosions (26 and 3%), and subluxations (39 and 14%), the STTJ, — SCOS (22 and 3%) and erosions (62 and 16%, respectively; p <0.05). According to the AUSCAN questionnaire, a significantly greater pain severity was recorded in patients with EOA than in those with NEOA (65 and 30%; p=0.008).Conclusion. DIPJs are most frequently affected by hand OA. The most common radiographic symptoms are JSN and OPs. In the wrists, first CMCJ and STTJ are most often involved; there are practically no changes in the RCJ. In EOA versus in NEOA, there are significantly more common OPs, cysts, SCOS, and subluxations in the DIPJs, SCOS, cysts, and subluxations in the PIPJs; first CMCJ and STTJ are significantly more often involved in the pathological process. EOA compared with NEOA is characterized by more severe pain, as evidenced by the AUSCAN questionnaire
FAKTORY, OPREDELYaYuShchIE RISK VOZNIKNOVENIYa OSTEOPOROZA ShEYKI BEDRA, U BOL'NYKh REVMATOIDNYM ARTRITOM
Get PDFУ больных ревматоидным артритом (РА) остеопороз (ОП) в 2-3 раза чаще диагностируется, чем в популяции, а риск переломов увеличен в 1,5-2,5 раза. Наиболее опасными в отношении дальнейшего качества и прогноза жизни больных являются переломы шейки бедренной кости. Цель. Выделить основные факторы риска развития ОП в шейке бедренной кости у женщин с РА. Материал и методы. В исследование включено 206 женщин с РА (по критериям АCR 1987 г.) в возрасте от 20 до 75 лет (средний возраст - 56,6±11,2 лет). На каждую больную была заполнена индивидуальная тематическая карта, включающая в себя социально-демографические, антропометрические, анамнестические и клинико-лабораторные данные, традиционные факторы риска ОП, суставной статус, коморбидные заболевания. Всем пациенткам была выполнена рентгенография кистей и дистальных отделов стоп. Счет эрозий и сужения суставных щелей произведен по методу Sharp (Шарпа) в модификации Van der Heijde. Оценка минеральной плотности кости (МПК) в осевом скелете осуществлялась методом двухэнергетической рентгеновской денситометрии. Для женщин, находящихся в постменопаузальном периоде, учитывался Т-критерий, у женщин с сохраненным менструальным циклом - Z-критерий. Результаты. ОП в шейке бедренной кости был диагностирован у 68 женщин (33%), у 138 (67%) - ОП выявлен не был. Больные с ОП и без него были сопоставимы по возрасту (58,7 ± 12,3 и 55,5 ± 10,2 лет, р=0,06), однако различались по длительности РА (12 (7-22) и 11 (7-15) лет, р=0,04) и суммарному индексу Шарпа (181,5 (92-267) и 112 (59173) баллов, p = 0,006). Пациентки с ОП имели большую среднесуточную дозу глюкокортикоидов (ГК) за прошедший год (5 (2,5-7,5) и 2,5 (1,3-5) мг/сут, р = 0,03) и большее суммарное количество внутрисуставных введений ГК по сравнению с пациентками без ОП (8 (3-18) и 6 (2-10), р=0,04, соответственно). Оценка традиционных факторов риска ОП показала, что больные с ОП имели меньший вес (62,8 ± 11,4 и 69,6 ± 12,4 кг, р < 0,001) и большинство из них находились в постменопаузальном периоде (89,7% и 74,6%, ОР = 1,2, 95% ДИ 1,06-1,36, р = 0,007). У больных с ОП чаще имелись родственники первой степени родства c переломами шейки бедра в анамнезе (16,4 и 2,9%, ОР = 5,57, 95% ДИ 1,82-17,07, р = 0,001). На основании дискриминантного анализа выделены наиболее значимые факторы риска развития ОП в шейке бедренной кости: суммарный индекс Шарпа, среднесуточная доза ГК за прошедший год, суммарное количество внутрисуставных введений ГК и менопауза; определен вклад этих переменных в развитие ОП (коэффициенты дискриминантной функции: 0,006; 0,37; 0,07; 2,91 соответственно) и создана формула, позволяющая с высокой точностью (площадь под ROC-кривой = 0,926) прогнозировать развитие ОП в шейке бедренной кости. Точность модели - 89,7%. Заключение: эрозивно-деструктивные изменения суставов кистей и стоп (по данным суммарного индекса Шарпа), среднесуточная доза ГК за прошедший год, суммарное количество внутрисуставных введений ГК и менопауза являются основными факторами риска развития ОП в шейке бедренной кости у женщин, страдающих РА
EFFEKTIVNOST' DINAMIChESKOY ELEKTRONEYROSTIMULYaTsII (DENS) V LEChENII OSTEOARTROZA KOLENNYKh SUSTAVOV (REZUL'TATY MNOGOTsENTROVOGO RANDOMIZIROVANNOGO ISSLEDOVANIYa)
Get PDF- …
