60 research outputs found

    Indicators of the osteoclastogenesis system in men with different clinical types of ankylosing spondylitis

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    Objective: to evaluate the osteoclastogenesis regulatory system – osteoprotegerin/receptor activator of nuclear factor-κβ ligand (OPG/RANKL) system – in men with different clinical types of ankylosing spondylitis (AS).Subjects and methods. The osteoclastogenesis regulatory system was studied in 60 men, including 40 patients diagnosed with AS complying with the 1984 New York criteria and 20 men without AS. RANKL, a major stimulant of osteoclastogenesis, and OPG, a decoy receptor that binds RANKL and, accordingly, blocks osteoclastogenesis, were investigated.Results. It was shown that in the patients with AS, RANKL concentrations were normal and the content of OPG and OPG/RANKL ratio proved to be significantly higher than those in the men without AS. The highest OPG concentrations were recorded in patients with the axial form of this disease, its moderate activity and early X-ray stage. No relationship was found between the level of RANKL and the clinical characteristics of AS; however, there was a tendency to a slight increase in its concentration in patients with extraskeletal manifestations of AS, its high activity, high functional class, and late X-ray stage.Conclusion. The considerable increase in OPG levels and OPG/RANKL ratio was ascertained to be associated to the fact that 94% of the patients with late-stage AS characterized by the presence of numerous syndesmophytes. These changes must be compensatory in response to modestly increased RANKL level and enhanced bone resorption

    Показатели системы остеокластогенеза у мужчин с различными клиническими вариантами анкилозирующего спондилита

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    Objective: to evaluate the osteoclastogenesis regulatory system – osteoprotegerin/receptor activator of nuclear factor-κβ ligand (OPG/RANKL) system – in men with different clinical types of ankylosing spondylitis (AS).Subjects and methods. The osteoclastogenesis regulatory system was studied in 60 men, including 40 patients diagnosed with AS complying with the 1984 New York criteria and 20 men without AS. RANKL, a major stimulant of osteoclastogenesis, and OPG, a decoy receptor that binds RANKL and, accordingly, blocks osteoclastogenesis, were investigated.Results. It was shown that in the patients with AS, RANKL concentrations were normal and the content of OPG and OPG/RANKL ratio proved to be significantly higher than those in the men without AS. The highest OPG concentrations were recorded in patients with the axial form of this disease, its moderate activity and early X-ray stage. No relationship was found between the level of RANKL and the clinical characteristics of AS; however, there was a tendency to a slight increase in its concentration in patients with extraskeletal manifestations of AS, its high activity, high functional class, and late X-ray stage.Conclusion. The considerable increase in OPG levels and OPG/RANKL ratio was ascertained to be associated to the fact that 94% of the patients with late-stage AS characterized by the presence of numerous syndesmophytes. These changes must be compensatory in response to modestly increased RANKL level and enhanced bone resorption.Цель исследования – оценить состояние системы регуляции остеокластогенеза – остеопротегерин/лиганд рецептора активатора нуклеарного фактора κβ (OPG/RANKL) – у мужчин с различными клиническими вариантами анкилозирующего спондилита (АС).Материал и методы. Система регуляции остеокластогенеза изучалась у 60 мужчин: 40 больных с диагнозом АС, соответствующим модифицированным Нью-Йоркским критериям (1984 г.) и 20 мужчин без АС. Исследовали RANKL – основной стимулятор остеокластогенеза и OPG – «рецептор-ловушку», связывающий RANKL и, соответственно, блокирующий остеокластогенез.Результаты исследования. Показано, что у больных АС концентрация RANKL была нормальной, а содержание OPG и отношение OPG/RANKL оказалось достоверно выше, чем у мужчин без АС. Наибольшая концентрация OPG зарегистрирована у пациентов с аксиальной формой заболевания, умеренной степенью активности и ранней рентгенологической стадией. Не выявлено зависимости уровня RANKL от клинических характеристик АС, однако отмечена тенденция к незначительному повышению его концентрации у пациентов с наличием внескелетных проявлений АС, высокой степенью активности, высоким функциональным классом и поздней рентгенологической стадией АС.Заключение. Установлено, что значительное повышение уровня OPG и отношения OPG/RANKL может быть связано с тем, что 94% пациентов имели позднюю стадию АС, характеризующуюся наличием множественных синдесмофитов. Данные изменения, вероятно, могут носить компенсаторный характер в ответ на незначительное повышение уровня RANKL и усиление костной резорбции

    Динамика минеральной плотности кости на фоне 4-летней терапии ритуксимабом у женщин в постменопаузе, страдающих ревматоидным артритом

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    Objective: to estimate the time course of bone mineral density (BMD) changes during 4-year rituximab (RTM) therapy in postmenopausal women with rheumatoid arthritis (RA).Subjects and methods. Seventy-nine postmenopausal women with a valid diagnosis of RA were followed up. According to the basic therapy option, all the patients were allocated into two groups: 1) 44 patients who received combination therapy with RTM and methotrexate (MT); 2) 35 patients who had MT monotherapy. BMD was estimated by dual-energy X-ray absorptiometry using an Excell XR-46 stationary dualenergy X-ray bone densitometer (Norland, USA).Results. There was a statistically significant increase in femoral neck BMD and T score as compared to the baseline values in the RTM group after 3 years of follow-up. The MT monotherapy group showed no statistically significant densitometric changes in the femoral neck. The similar positive BMD changes were observed 4 years following RTM and MT therapy.Conclusion. Following 2 therapy cycles, femoral neck BMD parameters were noted to be stabilized in the patients with RA. After 3 therapy cycles, there was a positive densitometric change that remained by the fourth therapy cycle.Цель исследования – оценка динамики минеральной плотности кости (МПК) шейки бедра на фоне 4-летней терапии ритуксимабом (РТМ) у женщин в постменопаузе, страдающих ревматоидным артритом (РА).Материал и методы. Под наблюдением находилось 79 женщин в постменопаузе с достоверным диагнозом РА. Все больные были распределены в две группы в зависимости от варианта базисной терапии: 1-я группа (n=44) получала комбинированную терапию РТМ и метотрексатом (МТ); 2-я группа (n=35) – монотерапию МТ. МПК определяли методом двухэнергетической рентгеновской абсорбциометрии с помощью стационарного двухэнергетического рентгеновского костного денситометра Exceell XR-46 (Norland, США).Результаты. Установлено статистически значимое повышение показателей МПК и Т-критерия шейки бедра по сравнению с исходными показателями через 3 года наблюдения в группе больных, получавших РТМ. В группе пациенток, получавших монотерапию МТ, статистически значимого изменения денситометрических показателей шейки бедра не отмечено. Аналогичная положительная динамика МПК наблюдалась через 4 года терапии РТМ и МТ.Выводы. После 2 курсов терапии отмечена стабилизация показателей МПК шейки бедра у больных РА. После 3 курсов лечения определялась положительная динамика денситометрических показателей, которая сохранялась и к 4-му курсу терапии

    Post COVID-19 Conditions and the Cardiovascular System

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    One out of four patients affected by COVID-19 will experience persistent (>3-4 weeks) signs and symptoms (Post COVID-19 conditions or Post-Acute Sequelae of SARS-CoV-2 – PASC) and this fact will have a major significance for the healthcare and economic systems in the upcoming years. The cardiovascular system is one of the key targets for the Post COVID-19 syndrome, given the pathogenesis of the virus and prevalence of ACE-2 receptors. According to our initial personal experience via the campaign “Life after COVID” of the Bulgarian Cardiac Institute, a substantial proportion of patients having suffered from COVID-19 develop long-term cardiovascular consequences. They could range from rhythm disorder and blood pressure variation, through impairment of myocardial mechanics and heart failure, and to acute vascular manifestations of Post COVID-19 conditions, such as acute coronary syndrome, acute pulmonary embolism, and acute limb ischemia. These cardiovascular complications require special and dedicated medical attention, and we could share our personal experience on the matter

    On the Dark Side of Therapies with Immunoglobulin Concentrates: The Adverse Events

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    Therapy by human immunoglobulin G (IgG) concentrates is a success story ongoing for decades with an ever increasing demand for this plasma product. The success of IgG concentrates on a clinical level is documented by the slowly increasing number of registered indication and the more rapid increase of the off-label uses, a topic dealt with in another contribution to this special issue of Frontiers in Immunology. A part of the success is the adverse event (AE) profile of IgG concentrates which is, even at life-long need for therapy, excellent. Transmission of pathogens in the last decade could be entirely controlled through the antecedent introduction by authorities of a regulatory network and installing quality standards by the plasma fractionation industry. The cornerstone of the regulatory network is current good manufacturing practice. Non-infectious AEs occur rarely and mainly are mild to moderate. However, in recent times, the increase in frequency of hemolytic and thrombotic AEs raised worrying questions on the possible background for these AEs. Below, we review elements of non-infectious AEs, and particularly focus on hemolysis and thrombosis. We discuss how the introduction of plasma fractionation by ion-exchange chromatography and polishing by immunoaffinity chromatographic steps might alter repertoire of specificities and influence AE profiles and efficacy of IgG concentrates

    Transformation of Statehood - Palestine Case Study

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    Cílem této práce je analyzovat proměnu státnosti Palestiny. Zkoumané období je od roku 1947 do roku 2015. Práce je rozdělena na dvě části - teoretickou a empirickou. Teoretická část se zaměřuje na čtyři základní prvky moderního státu - území, obyvatelstvo, vnitřní a vnější suverenita a aplikuje je na případ Palestiny. V empirické části práce se zaměřuji na vývoj Palestiny od Britského mandátu Palestina až do roku 2015, aby má práce byla co nejaktuálnější.ObhájenoThe aim of this thesis is to analyze the transformation of Palestine's statehood towards obtaining the status of a sovereign state from 1947 to 2015. I have chosen one research question: How has been the Palestine' s statehood transforming in the period 1947-2015? The thesis is divided into two parts. In the theoretical part I discuss a sovereign state and its attributes, and the empirical part is focused on the development of Palestinian statehood and whether or not it is able to fulfil the conditions to be recognised as a sovereign state

    Transformation of Statehood - Palestine Case Study

    No full text
    Cílem této práce je analyzovat proměnu státnosti Palestiny. Zkoumané období je od roku 1947 do roku 2015. Práce je rozdělena na dvě části - teoretickou a empirickou. Teoretická část se zaměřuje na čtyři základní prvky moderního státu - území, obyvatelstvo, vnitřní a vnější suverenita a aplikuje je na případ Palestiny. V empirické části práce se zaměřuji na vývoj Palestiny od Britského mandátu Palestina až do roku 2015, aby má práce byla co nejaktuálnější.ObhájenoThe aim of this thesis is to analyze the transformation of Palestine's statehood towards obtaining the status of a sovereign state from 1947 to 2015. I have chosen one research question: How has been the Palestine' s statehood transforming in the period 1947-2015? The thesis is divided into two parts. In the theoretical part I discuss a sovereign state and its attributes, and the empirical part is focused on the development of Palestinian statehood and whether or not it is able to fulfil the conditions to be recognised as a sovereign state

    Characteristics of the patient population.

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    <p>Characteristics of the patient population.</p

    VTE: Ages of cohorts with and without VTE.

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    <p>VTE: Ages of cohorts with and without VTE.</p
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