Ce-doped Li6Ln(BO3)3 (Ln = Y, Gd) Single crystals fibers grown by micro-pulling down method and luminescence properties

Ce3+-doped borate crystal fibers of Li6Gd(BO 3)3 (LGBO) and Li6Y(BO3)3 (LYBO) compositions are grown by the micro-pulling down (μ-PD) method for potential application in developing new neutron detectors. The ternary equilibrium diagram of Li2O-Gd2O3-B 2O3 is drawn and the preparations of homogeneous mixed LGBO and LYBO powders and growth conditions for single crystal fibers are discussed. Absorption, excitation and X-ray luminescence spectra are investigated. Absolute light yield derived from energy spectra and kinetic decay curves measured under α- and γ-scintillations of Ce 3+-doped LGBO and LYBO single crystal fibers is provided. © 2012 Elsevier B.V. All rights reserved

Достижение минимальной активности болезни при псориатическом артрите в зависимости от времени назначения синтетических базисных противовоспалительных препаратов, сравнительный анализ эффективности пероральной и подкожной форм метотрексата. Данные Общероссийского регистра пациентов с псориатическим артритом

The goal of psoriatic arthritis (PsA) therapy is to achieve remission or minimal disease activity (MDA). According to the EULAR guidelines, synthetic disease-modifying antirheumatic drugs (sDMARDs), methotrexate (MTX) in particular, are first-line therapy for PsA.Objective: to study the rate of MDA achievement after initiation of sDMARD therapy in patients with early- and late-stage PsA and the efficacy of oral and parenteral MTX.Patients and methods. The investigation enrolled 253 patients (93 men and 160 women) diagnosed with PsA who met the appropriate 2006 CASPAR (ClASsification criteria for Psoriatic ARthritis) criteria and were recorded in the All-Russian PsA Registry. The median (Me) age was 47 (Min 20 – Max 82) years. All the patients took sDMARDs: MTX (n=211) that was received orally (as tablets) (n=102) and parenterally (n=109); leflunomide (n=7); sulfasalazine (n=24); apremilast (n=10); and tofacitinib (n=1). According to the disease duration at sDMARD treatment initiation, the patients were divided into two groups. Group 1 included 165 patients with an early PsA duration of less than 2 years and Group 2 consisted of 88 patients with a disease duration of >2 years. The efficiency of oral and parenteral MTX was evaluated in 182 patients (68 men and 114 women). Every 6 months, the patients underwent a standard rheumatology examination that included PsA activity assessment. The efficiency of MTX therapy was evaluated from MDA achievement (5 out of the 7 criteria) in the patients.Results and discussion. After sDMARD prescription, MDA was achieved in 39 (24%) of the 165 patients with early PsA and in 4 (5%) of the 88 long-term patients. The patients who started sDMARD at an early stage of the disease were significantly more likely to achieve MDA than those with late-stage PsA (odds ratio (OR) 6.5; 95% confidence interval (CI) 2.2–18.9). At 11 years after sDMARD therapy initiation, the cumulative MDA achievement rate in the patients with late-stage disease was 5% (p<0.05). MDA was achieved by 16.5% of the 182 patients receiving oral or subcutaneous MTX. MDA was observed in 25 (31%) patients who received parenteral MTX and in only 5 (5%) patients who took oral MTX. The patients who received parenteral MTX were significantly more likely to achieve MDA than those who took oral MTX as tablets (OR 8.8; 95% CI 3.2–24.3). Following 27-month parenteral MTX therapy, the cumulative rate of MDA achievement was 48%, whereas after oral MTX treatment, that was 7% (p<0.05). In the patients who achieved MDA, the mean dose of parenteral MTX was 17 mg/week, and in those who failed, that was 15 mg/week. The mean dose of oral MTX was 15 mg/week, regardless of MDA achievement.Conclusion. The administration of sDMARD at an early stage of PsA lasting less than 2 years allows MDA to be achieved significantly more often and faster than at later stages of the disease. Among sDMARDs, preference is mostly given to the use of MTX in real clinical practice; the treatment with the latter enables 16.5% of patients to achieve MDA. Parenteral MTX significantly enhances the efficiency of therapy and can achieve MDA in almost one third (31%) of patients.Целью терапии псориатического артрита (ПсА) является достижение ремиссии или минимальной активности болезни (МАБ). В соответствии с рекомендациями EULAR синтетические базисные противовоспалительные препараты (сБПВП), в частности метотрексат (МТ), являются первой линией терапии (ПсА).Цель исследования – изучение частоты достижения МАБ после инициации терапии сБПВП у больных с ранней и поздней стадиями ПсА и эффективности перорального и парентерального применения МТ.Пациенты и методы. В исследование включено 253 пациента (93 мужчины и 160 женщин) с диагнозом ПсА, соответствующим критериям CASPAR (2006), наблюдающихся в Общероссийском регистре пациентов с ПсА. Медиана (Me) возраста составила 47 (Min 20 – Max 82) лет. Все пациенты получали сБПВП: МТ – 211 пациентов, из них 102 в таблетированной форме и 109 парентерально; лефлуномид – 7, сульфасалазин – 24, апремиласт – 10, тофацитиниб – 1. В зависимости от длительности болезни в момент инициации терапии cБПВП пациенты были разделены на две группы. В 1-ю группу вошли 165 больных ранним ПсА с длительностью болезни ≤2 года, во 2-ю группу – 88 пациентов с длительностью болезни >2 лет. У 182 пациентов (68 мужчин и 114 женщин) была оценена эффективность таблетированной и парентеральной форм МТ. Каждые 6 мес больным проводилось стандартное ревматологическое обследование, включавшее оценку активности ПсА. Эффективность терапии МТ оценивалась по достижению больными МАБ (5 критериев из 7).Результаты и обсуждение. МАБ после назначения сБПВП достигли 39 (24%) из 165 больных ранним ПсА и 4 (5%) из 88 длительно болеющих пациентов. Пациенты, начавшие принимать сБПВП на ранней стадии болезни, значимо чаще достигали MAБ, чем пациенты с поздней стадией ПсА (отношение шансов, OШ 6,5; 95% доверительный интервал, ДИ 2,2–18,9). Через 11 лет после начала терапии сБПВП у пациентов с поздней стадией заболевания кумулятивная частота достижения MAБ составила 5% (p<0,05). Из 182 больных, получавших МТ в пероральной или подкожной форме, 16,5% достигли МАБ. На фоне парентерального введения МТ МАБ отмечена у 25 (31%) пациентов, тогда как при пероральном применении МТ – только у 5 (5%). Пациенты, получавшие МТ парентерально, значимо чаще достигали МАБ, чем получавшие МТ в таблетированной форме (ОШ 8,8; 95% ДИ 3,2–24,3). За 27 мес терапии парентеральным МТ кумулятивная частота достижения МАБ составила 48%, тогда как при пероральном приеме – 7% (p<0,05). У пациентов, достигших МАБ, средняя доза парентерального МТ составила 17 мг/нед, а у не достигших МАБ – 15 мг/нед. Средняя доза пероральной формы МТ равнялась 15 мг/нед независимо от достижения МАБ.Заключение. Назначение сБПВП при раннем ПсА, длительностью ≤2 года, позволяет достигать МАБ значимо чаще и быстрее, чем на более поздних стадиях заболевания. В реальной клинической практике из сБПВП в большинстве случаев назначается МТ, на фоне лечения которым 16,5% больных достигают МАБ. Применение парентеральной формы МТ значимо повышает эффективность терапии и позволяет достичь МАБ практически у трети (31%) больных

RESEARCH OF IONIZING RADIATION INFLUENCE ON VIABILITY CELLS IN CULTURE

The effects of ionizing radiation on human dermal fibroblasts and rat tumor fibroblast line K-22 were studied. The samples were irradiated using beta-emitter 90Sr+90I. The results showed decrease in viability of human dermal fibroblasts in the exposure range from 5 to 10 Gy

Influence of the duration of psoriatic arthritis on the achievement of remission and minimal disease activity during therapy with genetically engineered biologic drugs. Data from the all-russian register of patients with psoriatic arthritis

Aim. To study the frequency and timing of the onset of remission and minimal disease activity after the administration of genetically engineered biologic drugs (GEBD) in patients with early and long-term psoriatic arthritis observed within the framework of the All-Russian register of patients with psoriatic arthritis.Material and methods. The study included 140 patients with psoriatic arthritis (77 men, 63 women) who met the CASPAR criteria, who took part in the All-Russian register and were followed up every 6 months. Previously, patients did not receive GEBD. The median age of the patients was 42 [19-73] years. All patients were divided into two groups depending on the duration of psoriatic arthritis before the appointment of GEBD: early psoriatic arthritis - ≤2 years (67 patients) and long-standing psoriatic arthritis - more than 2 years (73 patients). All patients were prescribed GEBD (37 - adalimumab, 26 - infliximab, 20 - etanercept, 19 - golimumab, 1 - certolizumab pegol, 33 - ustekinumab, 4 - secukinumab) in combination with or without methotrexate. All patients were assessed for the activity and efficacy of psoriatic arthritis therapy according to DAPSA and the criteria for minimal disease activity (number of painful joints - ≤1, number of swollen joints - ≤1, PASI - ≤1 or BSA - ≤3, pain score - ≤15, overall assessment of activity disease by the patient - ≤20 mm on a visual analogue scale, HAQ - ≤0.5, enthesitis -≤1) at the beginning of the study and every 6 months. The number of patients who achieved remission (DAPSA ≤4) or minimal disease activity (5 criteria out of 7) at least 1 time during therapy with GEBD was determined. The cumulative frequency and timing of achieving remission after the appointment of GEBD were calculated.Results. After the initiation of treatment with GEBD, DAPSA remission was achieved at least once in 24 out of 67 (36%) patients with early psoriatic arthritis and in 19 out of 73 (26%) patients with long-standing psoriatic arthritis. The minimum disease activity was achieved, respectively, in 33 of 67 (49%) and 23 of 73 (32%) patients. The time interval to achieve remission in early psoriatic arthritis was significantly less than in long-standing one. Its median was 48 months (95% CI: 11.75-84.25) and 139 months (95% CI not determined) (p<0.05), respectively. The time until the minimum activity of the disease was reached in patients with early psoriatic arthritis was significantly less than in patients with long-standing psoriatic arthritis. Its median was 21 months (95% CI: 13.1-28.9) and 58 months (95% CI: 0-118.1), respectively (p<0.05).Conclusion. In real clinical practice, after prescribing GEBD, patients with an early stage of psoriatic arthritis (no more than 2 years of illness) achieve remission and minimal disease activity significantly more often and faster than patients with long-term illness

Specific features of axial involvement in psoriatic arthritis: data from real clinical practice

Objective. To compare clinical features in psoriatic arthritis (PsA) patients with and without axial involvement. Subjects and methods. 385 PsA patients (172 males and 213 females) from National PsA Register were examined, their diagnosis verified according to CASPAR criteria. Patients’ median age was 45 [35; 54] years, median disease duration – 5,1 [0; 8] years. Pelvis X-ray and HLA-B27 levels in addition to physical examinations were obtained in all patients. Sacroiliitis (SI) was established based on radiographic findings (rSI) including bilateral changes corresponding to at least stage II, or unilateral – corresponding to at least stage III of Kellgren-Lawrence radiographic grading scale. Patients’ radiographs were evaluated by an independent radiologist. Disease activity was assessed using the DAS28 (Disease activity score 28), DAS (Disease activity in psoriatic arthritis) and BASDAI (Bath ankylosing spondylitis disease activity index) scales. 100 mm visual analog scale (VAS) was used for assessment of pain intensity (PI) and the Patient’s Global Assessment of Disease Activity (PtGA). Patients were distributed into two groups: Group 1 included rSI(+) patients, Group 2 – patients without radiologically confirmed SI – rSI (-). Results. Group 1 included 214 (55,6%) patients with axial involvement, 106 males and 108 females, Group 2 rSI (-) – 171 (44,4%) patients, 66 males and 105 females Proportion of men was significantly higher in RSi(+) group – 49,5% vs 38,6% in rSi(-) group (Odds Ratio, OR – 1,56, 95% CI 1,6-2,4; р = 0,0324). Patient’s median age was 45 [35; 54] and 46 [34; 56] years, respectively (p=0,911). Higher rates of HLA-В27 positivity were found in group rSI(+) patients, than in rSI(-), respectively in 62 out of 126 and in 26 out of 78 patients (OR 1,9, 95% CI 1,1-3,5). Patients from RSI(+) group had more severe erosive peripheral arthritis. Median tender joint counts (TJC) were 9 [14; 18] and 6 [3; 12] (р=0,02), while radiographic feet bone erosions were found in 58 (27,1%) and 29 (17%) patients, respectively (OR 1,8, 95% CI 1,1-3,0). Disease activity was higher in rSI(+) group. Median DAS28 score was 4,3 [3,3; 5,6] and 4,05 [3,03; 4,88] (р=0,02), DAPSA – 28,40 [15,65; 43,65] and 20,0 [12,45; 30,0], (р < 0,01), BASDAI – 1,6 [0; 5,1] and 0 [0; 4,5] (р < 0,01), C-reactive protein (CRP) – 0,9 [0,4; 2,2] mg/dl and 0,8 [0,3; 1,3] mg/dl, respectively (р=0,029). PtGA VAS values were 56,5 [42,3; 70,0] mm and 50,0 [30,0; 60,0] mm (р < 0,01); physicians global assessment (PGA) – 54,0 [40,0; 69,5] mm and 40,0 [25,5; 50,0] mm (р < 0,01); PI VAS values were 50,0 [40,0; 70,0] mm and 50,0 [20,5; 58,8] mm, respectively (р < 0,01). Higher rates of entheses involvement based on the Leeds Enthesitis Index (LEI) and dactylitis were documented in rSI(+) group. Median LEI score was 0 [0; 2] and 0 [0; 1] (p=0,02), while dactylitis was established in 71 (31,2%) and 32 (18,7%) patients, respectively (OR 2,2, 95% CI 1,3-3,5). More severe cutaneous involvement was also found in rSI(+) patients as compared to rSI (-). BSA (Body Surface Area) > 3% involvement was established in 94 (43,9%) and 57 (33,3%) patients, respectively (OR 1,7, 95% CI 1,03-2,4). Axial involvement was associated with more pronounced functional impairment. Median HAQ was 1,0 [0,6; 1,5] and 0 [0-2,2] (р=0,02). Conclusion. Axial involvement in PsA patients is associated with more severe articular damage, higher enthesitis and dactylitis rates, more severe psoriasis, which should be considered when planning treatment

OPTIMIZING THE DIAGNOSIS, A MONITORING AND TREATMENT SYSTEM FOR PSORIATIC ARTHRITIS IN REAL PRACTICE: GENERAL PRINCIPLES FOR ORGANIZING AN ALL-RUSSIAN REGISTER OF PATIENTS WITH PSORIATIC ARTHRITIS

The paper presents the design, general characteristics of and possibilities of data usage from the All-Russian register of patients with psoriatic arthritis (PsA).The purpose of creating and introducing the register into Russian healthcare practice is to evaluate the effectiveness of the diagnosis and treatment of PsA. The All-Russian register of PsA patients was created for the period 2016–2018 within the framework of the All-Russian register of patients with arthritis «OREL» on the basis of the V.A. Nasonova Research Institute of Rheumatology and with the support of the All-Russian public organization «Association of Rheumatologists of Russia». This system is an all-Russian population-based register that allows for the recording and monitoring of patients with PsA throughout the follow-up period. This enables healthcare specialists and organizers to obtain reliable information on the state of care for this category of patients in the region.The main purpose of the register is to provide necessary information support and automated technology for solving the problems of accounting, controlling, and monitoring of the status of PsA patients and to organize information interaction between specialists. The register is based on existing state regulatory legal acts. While developing and testing of the register, there were a number of tasks to be solved: to evaluate the efficiency of existing standard and promising targeted PsA therapies in real practice; to assess and improve the routing of patients with PsA. The use of the register allows an operational analysis of the following characteristics: demographic and socioeconomic parameters of patients with PsA; anamnestic data of patients with this condition; results of clinical examinations, instrumental and laboratory data.The geography of the register covers 27 regions of the Russian Federation; the register includes information on 460 patients with PsA.Creating a register permits one to track the dynamics of various parameters (social, demographic, and medical ones), to compare treatment options and the clinical and functional characteristics of patients with PsA, and to evaluate their performance, disability and changes in the social and labor status during the treatment performed. Thus, for the first time in the Russian Federation, the demographic, functional, and socioeconomic parameters of patients with PsA were comprehensively analyzed and the level of performance and impaired daily activities in PsA patients were studied using the WPAI questionnaire; moreover, the patients’ functional and psychological status was evaluated for the first time, by applying the PsAID-12, FACIT questionnaires (in the patients of the V.A. Nasonova Research Institute of Rheumatology).An analysis of the information available in the register makes it possible to compare the efficiency of different PsA treatment regimens, by estimating the rates of remission and/or minimal disease activity in real practice