56 research outputs found

    Muons with E_th >= 1 Gev and Mass Composition in the Energy Range 10^{18}-10^{20} ev Observed by Yakutsk Eas Array

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    The ratio of the muon flux density to charged particle flux density at distances of 300 and 600 m from the shower axis (\rhom(300)/\rhos(300) and \rhom(600)/\rhos(600)) is measured. In addition, the energy dependence of \rhom(1000) is analysed for showers with energies above 101810^{18} eV. A comparison between the experimental data and calculations performed with the QGSJET model is given for the cases of primary proton, iron nucleus and gamma- ray. We conclude that the showers with \E\ge3\times10^{18} eV can be formed by light nuclei with a pronounced fraction of protons and helium nuclei. It is not excluded however that a small part of showers with energies above 101910^{19} eV could be initiated by primary gamma-rays.Comment: 19th European Cosmic Ray Symposium, Aug 30 - Sep 3 2004, Florence, Italy. 3 pages, 1 figure. Submitted for publication in International Journal of Modern Physics

    PReS-FINAL-2041: Macrophage activation syndrome in the children with systemic juvenile idiopathic arthritis during the course of tocilizumab

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    Background Trauma exposure and posttraumatic stress disorder (PTSD) are common among individuals with a mental disorder, but symptoms often go undetected and untreated. Methods The aim of this study was to determine the prevalence of PTSD among a large sample of adults with psychiatric diagnoses and to establish factors associated with symptoms going undetected. Participants were 1,946 adults recruited by the National Centre for Mental Health. Structured interviews and validated self-report questionnaires were used to ascertain clinical and demographic information for analysis. Results The prevalence of participants screening positive for PTSD that had not been detected by clinical services was 13.9% [12.4–15.5%, 95% confidence interval]). Factors associated with undetected PTSD were female gender, younger age of first contact with psychiatric services, and lower household income. Especially, poor rates of detection were observed after traumatic events, such as child abuse and sexual assault. Conclusions Our findings demonstrate the need for routine assessment of trauma histories and symptoms of PTSD among individuals with anymental disorder

    Experience of the successful treatment with canakinumab of a patient with NLPC4-associated autoinflammatory syndrome with enterocolitis

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    The article shows the observation of rare NLPC4-associated autoinflammatory syndrome with enterocolitis and familial cold urticaria.Β Diagnosis is confirmed molecularly-genetically: previously not described mutation c.928C>T in the heterozygous state in NLRC4 gene isΒ discovered by a method of the new generation sequencing. The use of a monoclonal antibody to the interleukin 1 canakinumabΒ provided complete relief of fever and skin and intestinal symptoms in just 1 week of treatment. Later the signs of inflammation haveΒ disappeared completely; the patient’s quality of life improved and life-threatening complications were prevented. The above exampleΒ demonstrates the high clinical efficacy of canakinumab in the patient with NLRC4-associated autoinflammatory syndrome and suggestsΒ promising therapeutic use of interleukin 1 blockers in such patients. There were no adverse events during canakinumab therapy

    High Efficiency of Kanakinumabum for a Patient with a Late Diagnosed Chronic Infantile Neurological Cutaneous Articular Syndrome (CINCA)

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    The article presents the monitoring of a severe course of CINCA/NOMID syndrome diagnosed at late stages. The use of monoclonalΒ antibodies to IL 1 β€” kanakinumabum β€” in a patient with chronic neurological cutaneous and articular syndrome was successful:Β fever, cutaneous and pain syndromes were completely stopped, joint contractures decreased after one week of therapy. LaboratoryΒ parameters of the child’s disease activity (ESR and CRP) became normal after 8 weeks of treatment. Movements in the affected jointsΒ recovered completely after 24 weeks; the audiologist noted an improvement in hearing. The above clinical example demonstrates theΒ high efficiency of kanakinumabum for a patient with chronic neurological cutaneous and articular syndrome, and shows the perspectiveΒ of therapeutic application of IL 1 blocker for patients with CINCA syndrome including advanced stages of the disease. No adverseΒ effects were noted during kanakinumabum therapy

    ΠžΠΏΡ‹Ρ‚ примСнСния Ρ‚ΠΎΡ†ΠΈΠ»ΠΈΠ·ΡƒΠΌΠ°Π±Π° Ρƒ больной полиартикулярным Π²Π°Ρ€ΠΈΠ°Π½Ρ‚ΠΎΠΌ ювСнильного идиопатичСского Π°Ρ€Ρ‚Ρ€ΠΈΡ‚Π° с ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ шСйного ΠΎΡ‚Π΄Π΅Π»Π° ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡ‡Π½ΠΈΠΊΠ°

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    The article describes a case of polyarticular juvenile idiopathic arthritis lesions of the cervical spine. This clinical example demonstratesΒ the high efficiency of tocilizumab in a patient with polyarticular juvenile idiopathic arthritis with lesions of the cervical spine. After theΒ first injection of tocilizumab a decrease in the following was observed: pain in the cervical spine and affected joints, severity of functionalΒ disorders in the temporomandibular joint and the interphalangeal joints, cervical spine; a 30% improvement in the JADAS, ACRpedi30 wasΒ achieved. By the 8th week of therapy the proliferative changes in the joints of the hands and arthralgia decreased, as well as the durationΒ of morning stiffness. After 3 months there was a decrease in the activity of Jia (DAS28), and the erythrocyte sedimentation rate and serumΒ concentrations of C-reactive protein. Adverse effects during therapy with tocilizumab were not observed. The disease activity decreased,Β (assessed using the visual analog scale (VAS)), as well as the functional impairment (assessed using the Children Health AssessmentΒ Questionnaire (CHAQ)). The emotional status and quality of life of the child and her family improved significantly.Π’ ΡΡ‚Π°Ρ‚ΡŒΠ΅ описан случай полиартикулярного Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Π° ювСнильного идиопатичСского Π°Ρ€Ρ‚Ρ€ΠΈΡ‚Π° с ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ суставов шСи и височно-Π½ΠΈΠΆΠ½Π΅Ρ‡Π΅Π»ΡŽΡΡ‚Π½Ρ‹Ρ… суставов, Ρ€Π΅Ρ„Ρ€Π°ΠΊΡ‚Π΅Ρ€Π½ΠΎΠ³ΠΎ ΠΊ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ классичСским иммунодСпрСссантом. ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½Π½Ρ‹ΠΉΒ ΠΊΠ»ΠΈΠ½ΠΈΡ‡Π΅ΡΠΊΠΈΠΉ ΠΏΡ€ΠΈΠΌΠ΅Ρ€ дСмонстрируСт Π²Ρ‹ΡΠΎΠΊΡƒΡŽ ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ Ρ‚ΠΎΡ†ΠΈΠ»ΠΈΠ·ΡƒΠΌΠ°Π±Π° Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠΈ с полиартикулярным ΡŽΠ²Π΅Π½ΠΈΠ»ΡŒΠ½Ρ‹ΠΌ идиопатичСским Π°Ρ€Ρ‚Ρ€ΠΈΡ‚ΠΎΠΌ, ΡΠΎΠΏΡ€ΠΎΠ²ΠΎΠΆΠ΄Π°ΡŽΡ‰ΠΈΠΌΡΡ ΠΏΠΎΡ€Π°ΠΆΠ΅Π½ΠΈΠ΅ΠΌ осСвого скСлСта. Π£ΠΆΠ΅ послС ΠΏΠ΅Ρ€Π²ΠΎΠ³ΠΎ ввСдСния Ρ‚ΠΎΡ†ΠΈΠ»ΠΈΠ·ΡƒΠΌΠ°Π±Π° ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½ΠΎ ΡƒΠΌΠ΅Π½ΡŒΡˆΠ΅Π½ΠΈΠ΅ Π±ΠΎΠ»ΠΈ Π² шСйном ΠΎΡ‚Π΄Π΅Π»Π΅ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡ‡Π½ΠΈΠΊΠ° ΠΈ ΠΏΠΎΡ€Π°ΠΆΠ΅Π½Π½Ρ‹Ρ… суставах, сниТСниС Π²Ρ‹Ρ€Π°ΠΆΠ΅Π½Π½ΠΎΡΡ‚ΠΈΒ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½Ρ‹Ρ… Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΠΉ Π² височно-Π½ΠΈΠΆΠ½Π΅Ρ‡Π΅Π»ΡŽΡΡ‚Π½Ρ‹Ρ… ΠΈ ΠΌΠ΅ΠΆΡ„Π°Π»Π°Π½Π³ΠΎΠ²Ρ‹Ρ… суставах, шСйном ΠΎΡ‚Π΄Π΅Π»Π΅ ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡ‡Π½ΠΈΠΊΠ°; достигнуто 30% ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΠ΅ ΠΏΠΎ индСксам JADAS, АмСриканской ΠΊΠΎΠ»Π»Π΅Π³ΠΈΠΈ Ρ€Π΅Π²ΠΌΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΎΠ² (ACRpedi30). К 8-ΠΉ Π½Π΅Π΄ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈΒ Ρƒ Π΄Π΅Π²ΠΎΡ‡ΠΊΠΈ ΡƒΠΌΠ΅Π½ΡŒΡˆΠΈΠ»ΠΈΡΡŒ ΠΏΡ€ΠΎΠ»ΠΈΡ„Π΅Ρ€Π°Ρ‚ΠΈΠ²Π½Ρ‹Π΅ измСнСния Π² суставах кистСй, Π°Ρ€Ρ‚Ρ€Π°Π»Π³ΠΈΠΈ, ΡΠΎΠΊΡ€Π°Ρ‚ΠΈΠ»Π°ΡΡŒ Π΄Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ утрСннСй скованности. Π§Π΅Ρ€Π΅Π· 3 мСс ΠΎΡ‚ΠΌΠ΅Ρ‡Π°Π»ΠΎΡΡŒ сниТСниС активности ювСнильного идиопатичСского Π°Ρ€Ρ‚Ρ€ΠΈΡ‚Π° ΠΏΠΎ индСксу DAS28,Β Π° Ρ‚Π°ΠΊΠΆΠ΅ скорости осСдания эритроцитов ΠΈ cΡ‹Π²ΠΎΡ€ΠΎΡ‚ΠΎΡ‡Π½ΠΎΠΉ ΠΊΠΎΠ½Ρ†Π΅Π½Ρ‚Ρ€Π°Ρ†ΠΈΠΈ Π‘-Ρ€Π΅Π°ΠΊΡ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ Π±Π΅Π»ΠΊΠ°. ΠΠ΅ΠΆΠ΅Π»Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… явлСний Π½Π° Ρ„ΠΎΠ½Π΅ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ‚ΠΎΡ†ΠΈΠ»ΠΈΠ·ΡƒΠΌΠ°Π±ΠΎΠΌ Π½Π΅ ΠΎΡ‚ΠΌΠ΅Ρ‡Π΅Π½ΠΎ. Бнизилась Π°ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ Π±ΠΎΠ»Π΅Π·Π½ΠΈ (ΠΏΠΎ Π²ΠΈΠ·ΡƒΠ°Π»ΡŒΠ½ΠΎ-Π°Π½Π°Π»ΠΎΠ³ΠΎΠ²ΠΎΠΉ шкалС),Β ΡƒΠΌΠ΅Π½ΡŒΡˆΠΈΠ»Π°ΡΡŒ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½Π°Ρ Π½Π΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒ (ΠΏΠΎ опроснику Children Health Assessment Questionnaire). Π—Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΒ ΡƒΠ»ΡƒΡ‡ΡˆΠΈΠ»ΠΎΡΡŒ ΡΠΌΠΎΡ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠ΅ состояниС ΠΈ качСство ΠΆΠΈΠ·Π½ΠΈ Ρ€Π΅Π±Π΅Π½ΠΊΠ° ΠΈ Π΅Π³ΠΎ сСмьи

    ΠžΠΏΡ‹Ρ‚ ΡƒΡΠΏΠ΅ΡˆΠ½ΠΎΠ³ΠΎ лСчСния ΠΊΠ°Π½Π°ΠΊΠΈΠ½ΡƒΠΌΠ°Π±ΠΎΠΌ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° с TRAPS- синдромом с Ρ€Π°Π½Π΅Π΅ Π½Π΅ описанной ΠΌΡƒΡ‚Π°Ρ†ΠΈΠ΅ΠΉ Π² Π³Π΅Π½Π΅ Ρ€Π΅Ρ†Π΅ΠΏΡ‚ΠΎΡ€Π° TNF Ξ±

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    The article presents an observation of one of the most common autoinflammatory syndromes β€” TRAPS (periodic syndrome associated with a mutation in the TNFΒ Ξ±Β receptor gene). During a molecular-genetic examination of a 9-year-old child, a c.337_339del deletion in the heterozygous state of the TNFRSF1A gene exon 04, leading to a p.Glu113del amino acid deletion, was found. This mutation has not been described previously in TRAPS patients, and according to computer analysis (Alamut Visual) the issue is pathogenic. This observation indicates the presence of families with TRAPS in the Russian population, who can have Β«atypicalΒ» TNFRSF1A gene mutations. A successful use of monoclonal antibodies to interleukin 1 β€” canakinumab β€” in the patient is described. As a result, fever and abdominal syndromes have completely stopped, while knee joints pain decreased a day later. After a week of treatment, the child’s disease activity laboratory indices returned to normal (ESR, C-reactive protein). No exacerbations were fixed over the next 32 weeks. No adverse effects were registered during canakinumab therapy. Thus, canakinumab has demonstrated a high level of effectiveness and safety for the patient suffering from a periodic syndrome associated with a mutation in the TNFΒ Ξ±Β Β gene receptor. This indicates therapeutic use prospects for the interleukin 1Β Ξ²Β blocker in TRAPS syndrome patients.ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½ΠΎ наблюдСниС пСриодичСского синдрома, ассоциированного с ΠΌΡƒΡ‚Π°Ρ†ΠΈΠ΅ΠΉ Π² Π³Π΅Π½Π΅ Ρ€Π΅Ρ†Π΅ΠΏΡ‚ΠΎΡ€Π° TNFΒ Ξ±Β Β (TRAPS), β€” ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΈΠ· Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ часто Π²ΡΡ‚Ρ€Π΅Ρ‡Π°ΡŽΡ‰ΠΈΡ…ΡΡ Π°ΡƒΡ‚ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… состояний. ΠŸΡ€ΠΈ молСкулярно-гСнСтичСском обслСдовании Ρ€Π΅Π±Π΅Π½ΠΊΠ° Π² возрастС 9 Π»Π΅Ρ‚ Π±Ρ‹Π»Π° выявлСна дСлСция c.337_339del Π² Π³Π΅Ρ‚Π΅Ρ€ΠΎΠ·ΠΈΠ³ΠΎΡ‚Π½ΠΎΠΌ состоянии Π² экзонС 04 Π³Π΅Π½Π° TNFRSF1A, приводящая ΠΊ Π΄Π΅Π»Π΅Ρ†ΠΈΠΈ аминокислоты p.Glu113del. Подобная мутация Ρ€Π°Π½Π΅Π΅ Π½Π΅ описана Π² рСгистрах ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с TRAPS ΠΈ ΠΏΠΎ Π΄Π°Π½Π½Ρ‹ΠΌ ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½ΠΎΠ³ΠΎ Π°Π½Π°Π»ΠΈΠ·Π° (Alamut visual) являСтся ΠΏΠ°Ρ‚ΠΎΠ³Π΅Π½Π½ΠΎΠΉ. ΠŸΡ€ΠΈΠ²Π΅Π΄Π΅Π½Π½Ρ‹ΠΉ клиничСский ΠΏΡ€ΠΈΠΌΠ΅Ρ€ ΡƒΠΊΠ°Π·Ρ‹Π²Π°Π΅Ρ‚ Π½Π° Π½Π°Π»ΠΈΡ‡ΠΈΠ΅ Π² российской популяции сСмСй с TRAPS, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ ΠΌΠΎΠ³ΡƒΡ‚ ΠΈΠΌΠ΅Ρ‚ΡŒ Β«Π½Π΅Ρ‚ΠΈΠΏΠΈΡ‡Π½Ρ‹Π΅Β» ΠΌΡƒΡ‚Π°Ρ†ΠΈΠΈ Π³Π΅Π½Π° TNFRSF1A. Описано ΡƒΡΠΏΠ΅ΡˆΠ½ΠΎΠ΅ ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° моноклонального Π°Π½Ρ‚ΠΈΡ‚Π΅Π»Π° ΠΊ ΠΈΠ½Ρ‚Π΅Ρ€Π»Π΅ΠΉΠΊΠΈΠ½Ρƒ 1 ΠΊΠ°Π½Π°ΠΊΠΈΠ½ΡƒΠΌΠ°Π±Π°. Π’ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Π΅, ΡƒΠΆΠ΅ Ρ‡Π΅Ρ€Π΅Π· дСнь ΠΏΠΎΠ»Π½ΠΎΡΡ‚ΡŒΡŽ ΠΊΡƒΠΏΠΈΡ€ΠΎΠ²Π°Π»ΠΈΡΡŒ Π»ΠΈΡ…ΠΎΡ€Π°Π΄ΠΊΠ° ΠΈ Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡŒΠ½Ρ‹ΠΉ синдром, ΡƒΠΌΠ΅Π½ΡŒΡˆΠΈΠ»Π°ΡΡŒ боль Π² ΠΊΠΎΠ»Π΅Π½Π½Ρ‹Ρ… суставах. Π§Π΅Ρ€Π΅Π· 1 Π½Π΅Π΄ лСчСния Ρƒ Ρ€Π΅Π±Π΅Π½ΠΊΠ° Π½ΠΎΡ€ΠΌΠ°Π»ΠΈΠ·ΠΎΠ²Π°Π»ΠΈΡΡŒ Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½Ρ‹Π΅ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ активности Π±ΠΎΠ»Π΅Π·Π½ΠΈ (ΡΠΊΠΎΡ€ΠΎΡΡ‚ΡŒ осСдания эритроцитов, Π‘-Ρ€Π΅Π°ΠΊΡ‚ΠΈΠ²Π½Ρ‹ΠΉ Π±Π΅Π»ΠΎΠΊ). Π’ Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ ΠΏΠΎΡΠ»Π΅Π΄ΡƒΡŽΡ‰ΠΈΡ… 32 Π½Π΅Π΄ обострСний основного заболСвания Π½Π΅ зафиксировано. ΠΠ΅ΠΆΠ΅Π»Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… явлСний Π½Π° Ρ„ΠΎΠ½Π΅ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΠΊΠ°Π½Π°ΠΊΠΈΠ½ΡƒΠΌΠ°Π±ΠΎΠΌ Π½Π΅ ΠΎΡ‚ΠΌΠ΅Ρ‡Π°Π»ΠΎΡΡŒ. Π’Π°ΠΊΠΈΠΌ ΠΎΠ±Ρ€Π°Π·ΠΎΠΌ, ΠΏΠΎΠΊΠ°Π·Π°Π½Π° высокая ΡΡ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡ‚ΡŒ ΠΊΠ°Π½Π°ΠΊΠΈΠ½ΡƒΠΌΠ°Π±Π° Ρƒ больного с пСриодичСским синдромом, ассоциированным с ΠΌΡƒΡ‚Π°Ρ†ΠΈΠ΅ΠΉ Π² Π³Π΅Π½Π΅ Ρ€Π΅Ρ†Π΅ΠΏΡ‚ΠΎΡ€Π° TNFΒ Ξ±, Ρ‡Ρ‚ΠΎ ΡƒΠΊΠ°Π·Ρ‹Π²Π°Π΅Ρ‚ Π½Π° ΠΏΠ΅Ρ€ΡΠΏΠ΅ΠΊΡ‚ΠΈΠ²Π½ΠΎΡΡ‚ΡŒ тСрапСвтичСского примСнСния Π±Π»ΠΎΠΊΠ°Ρ‚ΠΎΡ€Π° ΠΈΠ½Ρ‚Π΅Ρ€Π»Π΅ΠΉΠΊΠΈΠ½Π° 1Β Ξ²Β Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с TRAPS-синдромом

    ΠšΠ»ΠΈΠ½ΠΈΡ‡Π΅ΡΠΊΠΈΠΉ случай примСнСния Ρ‚ΠΎΡ†ΠΈΠ»ΠΈΠ·ΡƒΠΌΠ°Π±Π° Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° с систСмным ΡŽΠ²Π΅Π½ΠΈΠ»ΡŒΠ½Ρ‹ΠΌ идиопатичСским Π°Ρ€Ρ‚Ρ€ΠΈΡ‚ΠΎΠΌ

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    This article describes a case of successfully used tocilizumab (interleukin 6 receptors monoclonal antibodies) in a two-year patient with severe systemic juvenile idiopathic arthritis resistant to oral and parenteral glucocorticoids, nonsteroidal anti-inflammatory drugs, and methotrexate. Just after the first injection of tocilizumab, fever and pain ceased, morning stiffness decreased significantly; laboratory disease activity indices normalized by the 4th week of drug use; by the 16th week inflammatory changes in the joints regressed completely, the disease entered its inactive phase. After using tocilizumab, remission duration was 20 months for articular syndrome and systemic manifestations. No adverse reactions have been registered.Π’ ΡΡ‚Π°Ρ‚ΡŒΠ΅ описан случай ΡƒΡΠΏΠ΅ΡˆΠ½ΠΎΠ³ΠΎ примСнСния ΠΌΠΎΠ½ΠΎΠΊΠ»ΠΎΠ½Π°Π»ΡŒΠ½Ρ‹Ρ… Π°Π½Ρ‚ΠΈΡ‚Π΅Π» ΠΊ Ρ€Π΅Ρ†Π΅ΠΏΡ‚ΠΎΡ€Π°ΠΌ ΠΈΠ½Ρ‚Π΅Ρ€Π»Π΅ΠΉΠΊΠΈΠ½Π° 6 Ρ‚ΠΎΡ†ΠΈΠ»ΠΈΠ·ΡƒΠΌΠ°Π±Π° Ρƒ Π΄Π²ΡƒΡ…Π»Π΅Ρ‚Π½Π΅Π³ΠΎ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° с тяТСлым Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ΠΌ систСмного ювСнильного идиопатичСского Π°Ρ€Ρ‚Ρ€ΠΈΡ‚Π°, рСзистСнтного ΠΊ ΠΏΠ΅Ρ€ΠΎΡ€Π°Π»ΡŒΠ½Ρ‹ΠΌ ΠΈ ΠΏΠ°Ρ€Π΅Π½Ρ‚Π΅Ρ€Π°Π»ΡŒΠ½Ρ‹ΠΌ Π³Π»ΡŽΠΊΠΎΠΊΠΎΡ€Ρ‚ΠΈΠΊΠΎΡΡ‚Π΅Ρ€ΠΎΠΈΠ΄Π°ΠΌ, нСстСроидным ΠΏΡ€ΠΎΡ‚ΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΌ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Π°ΠΌ, мСтотрСксату. Π£ΠΆΠ΅ послС ΠΏΠ΅Ρ€Π²ΠΎΠ³ΠΎ ввСдСния Ρ‚ΠΎΡ†ΠΈΠ»ΠΈΠ·ΡƒΠΌΠ°Π±Π° ΠΊΡƒΠΏΠΈΡ€ΠΎΠ²Π°Π»ΠΈΡΡŒ Π»ΠΈΡ…ΠΎΡ€Π°Π΄ΠΊΠ° ΠΈ Π±ΠΎΠ»Π΅Π²ΠΎΠΉ синдром, Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ ΡƒΠΌΠ΅Π½ΡŒΡˆΠΈΠ»Π°ΡΡŒ утрСнняя ΡΠΊΠΎΠ²Π°Π½Π½ΠΎΡΡ‚ΡŒ, ΠΊ 4-ΠΉ Π½Π΅Π΄ ввСдСния ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Π° Π½ΠΎΡ€ΠΌΠ°Π»ΠΈΠ·ΠΎΠ²Π°Π»ΠΈΡΡŒ Π»Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€Π½Ρ‹Π΅ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ активности Π±ΠΎΠ»Π΅Π·Π½ΠΈ, ΠΊ 16-ΠΉ Π½Π΅Π΄ ΠΏΠΎΠ»Π½ΠΎΡΡ‚ΡŒΡŽ рСгрСссировали Π²ΠΎΡΠΏΠ°Π»ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Π΅ измСнСния Π² суставах, Π±Ρ‹Π»Π° констатирована Ρ„Π°Π·Π° Π½Π΅Π°ΠΊΡ‚ΠΈΠ²Π½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ. Π”Π»ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ рСмиссии суставного синдрома ΠΈ систСмных проявлСний послС примСнСния Ρ‚ΠΎΡ†ΠΈΠ»ΠΈΠ·ΡƒΠΌΠ°Π±Π° составила 20 мСс. ΠΠ΅ΠΆΠ΅Π»Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… Ρ€Π΅Π°ΠΊΡ†ΠΈΠΉ Π½Π° Ρ„ΠΎΠ½Π΅ ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠΌΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π½Π΅ зарСгистрировано
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