Comparative analysis of anxiety-depressive spectrum disorders in patients with rheumatic diseases

Research objective - comparative analysis of incidence and structure of anxiety-depressive spectrum disorders (ADD) in patients with various rheumatic diseases (RD). Materials and methods. 613 patients with RD were enrolled in the study: 180 with a reliable diagnosis of systemic lupus erythematosus (SLE), 128 with rheumatoid arthritis (RA), 110 with systemic sclerosis (SSc), 115 with Behcet's disease (BD), 80 with primary Sjögren's syndrome (pSS). Female prevailed in all groups (95% of patients with pSS, 88,2% - SSc, 87,2% - RA, 85,5% of SLE) except BD patients (70% male). The mean age was 42.3±1.54 years and was lower in patients with BD (33.3±0.98 years) and SLE (34.6±0.93 years) compared to patients with SSc (49.9±2.47 years), RA (47.4±0.99 years) and pSS (46.2±2.3 years). The mean RD duration was 130,0±8,65 months and was more at BD - 148,5±10,4 months, pSS - 141,6±8,92 months, RA - 138,4±10,1months, and less at SLE - 134,9±8,8 months and SSc - 87,0±5,04 months. The mean SLE activity index SLEDAI was 9,13±0,63 points (high), RA (DAS28) - 5,26±0,17 points (high), BD (BDCAF) - 3,79±0,2 points (moderate) and SSc by G. Valentini - 1,1±0,20 points (moderate). Glucocorticoids took 100% of patients with pSS, 91,1% - SLE, 90% - SSc, 87% - BD and 67,2% - RA patients; conventional disease modifying anti-rheumatic drugs (cDMARDs) took 90% of patients with SSc, 84% - BD, 79,6% - RA, 68% - pSS, 40,6% - SLE. Biologic DMARDs took 32% of patients with RA, 17,4% - BD, 7,3% - SSc and 7,2% - SLE. Mental disorders were diagnosed by psychiatrist as a result of screening by the hospital anxiety and depression scale (HADS) and in semi-structured interview in accordance with the ICD-10/ DSM-IV. The severity of depression was evaluated by Montgomery-Asberg Depression Rating Scale (MADRS) and anxiety - by Hamilton Anxiety Rating Scale (HAM-A). Projective psychological methods were used for cognitive impairment detection. Results. Screening of depressive disorders (HADS-D≥8) was positive in 180 (29,4%) patients with RD, including 74 (41%) patients with SLE, 38 (35%) - SSc, 29 (23%) - RA, 23 (20%) - BD and 16 (20%) - pSS; anxiety disorders (HADS-A≥8) - in 272 (44,4%) patients, including 66 (52%) patients with RA, 40 (50%) - pSS, 77 (43%) - SLE, 45 (41%) - SSc and 44 (38%) - BD. In accordance with the ICD-10/ DSM-IV depressive disorders have been identified in 389 (63%) patients, including 94 (73%) patients with RA, 71 (64,5%) - SSc, 69 (60%) - BD, 90 (50%) - SLE and 39 (49%) - pSS; anxiety disorders - in 377 (61,5%) patients, including 20 (25%) patients with pSS, 44 (24,5%) - SLE, 29 (23%) - RA, 20 (17%) - BD and 7 (6,4%) - SSc. Conclusion. Anxiety-depressive spectrum disorders are typical for most patients with RA, SLE, SSc, pSS and BD. ADDs diagnosis in RD patients with the use of the HADS did not reveal a significant proportion. To obtain objective data on the frequency and structure of ADDs, psychopathological and clinical psychological diagnosis is necessary

ХЛОРИДЫ ПОЛИОРГАНОСИЛОКСАНОВ С 1-МЕТИЛДИАЗОЛИЛ-МЕТИЛЕНОВЫМИ ГРУППАМИ. СИНТЕЗ И СВОЙСТВА

Chlorides of polyorganosiloxanes with 1-methyldiazolylmethylene groups were synthesized using the reaction of quaternization of poly(chloromethyl)organosiloxanes with 1-methylimidazole. The degree of completeness of this reaction was determined, and the products were characterized by the data of elemental analysis, NMR spectroscopy (1H and 29Si), TGA and DTA. The possibility in principle of obtaining statistical polyorganosiloxanes with the [1-(methyl)imidazolyl]methyl substituent in the frame of the siloxane macromolecule by quaternization of the corresponding chloromethyl-substituted organosilicon polymers with 1-methylimidazole is shown. By the method of TGA and DTA, it was found that the destruction of the obtained ionic liquids occurs when heating them in air above 265 °C. The possibility of fixing the formation of an imidazolium salt by the appearance of a chemical shift in the region ~10 ppm in the 1Н-NMR spectrum has been established.Реакцией кватернизации поли(хлорметил)органосилоксанов с 1-метилимидазолом синтезированы хлориды полиорганосилоксанов с 1-метилдиазолилметиленовыми группами. Определена степень завершенности данной реакции и продукты охарактеризованы данными элементного анализа, ЯМР-спектроскопии (1H и 29Si), ТГА и ДТА. Показана принципиальная возможность получения статистических полиорганосилоксанов с [1-(метил)-имидазолил]-метильным заместителем в обрамлении силоксановой макромолекулы реакцией кватернизации соответствующих хлорметилзамещенных кремнийорганических полимеров 1-метилимидазолом. Методом ТГА и ДТА обнаружено, что деструкция полученных ионных жидкостей наступает при нагревании на воздухе выше 265 °С. Установлена возможность фиксировать образование соли имидазолия по появлению химсдвига в области ~10 м.д. в 1Н-ЯМР-спектре

VIRAL HEPATITIS B AND C AS COMORBIDITY IN RHEUMATIC DISEASES: ANALYSIS OF THE DATA OF THE V.A. NASONOVA RESEARCH INSTITUTE OF RHEUMATOLOGY CLINIC OVER 4 YEARS

<p>Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is a serious problem that substantially hinders the treatment of patients with rheumatic diseases (RD) particular when there is a need for using cytotoxic and biological agents (BAs).</p><p><strong>Objective:</strong> to estimate the rate of HBV and HCV infection in RD patients followed up at the V.A. Nasonova Research Institute of Rheumatology Clinic in 2011 to 2014.</p><p><strong>Subjects and methods.</strong> All case histories of the RD patients hospitalized in the given period were analyzed. Infection with HBV and HCV was assessed from the presence of HBsAg and anti-HCV, respectively.</p><p><strong>Results and discussion.</strong> There were a total of 16,553 admissions to the V.A. Nasonova Research Institute of Rheumatology Clinic over 4 years. HBV and HCV were detected in 0.33 and 0.74%, respectively; their combination was found in 0.03% (a total of 1.1%) of the patients. About half of the patients took cytotoxic agents and glucocorticoids; 29.8% received BAs, mainly rituximab. Moderate and high chronic hepatitis activity was noted in 4.9% of the patients; liver cirrhosis was observed in 2.7%. Over the follow-up period, alanine aminotransferase and aspartate aminotransferase levels were not elevated in the vast majority of patients.</p><p><strong>Conclusion.</strong> HBV and HCV infection is often detected in patients with RD. The infected patients and persons with chronic viral hepatitis require careful follow-up and the decision whether to perform prophylactic antiviral therapy when using cytotoxic agents and BAs.</p

CHLORIDES OF POLYORGANOSILOXANES WITH 1-METHYLDIAZOLYLMETHYLENIC GROUPS. SYNTHESIS AND PROPERTIES

Chlorides of polyorganosiloxanes with 1-methyldiazolylmethylene groups were synthesized using the reaction of quaternization of poly(chloromethyl)organosiloxanes with 1-methylimidazole. The degree of completeness of this reaction was determined, and the products were characterized by the data of elemental analysis, NMR spectroscopy (1H and 29Si), TGA and DTA. The possibility in principle of obtaining statistical polyorganosiloxanes with the [1-(methyl)imidazolyl]methyl substituent in the frame of the siloxane macromolecule by quaternization of the corresponding chloromethyl-substituted organosilicon polymers with 1-methylimidazole is shown. By the method of TGA and DTA, it was found that the destruction of the obtained ionic liquids occurs when heating them in air above 265 °C. The possibility of fixing the formation of an imidazolium salt by the appearance of a chemical shift in the region ~10 ppm in the 1Н-NMR spectrum has been established