المؤلفون: M.B. Dzhus, M.S. Kulyk, T.A. Karasevska, H.V. Mostbauer, O.I. Ivashkivskyi, R.A. Potomka, H.L. Novytska

المصدر: Bolʹ, Sustavy, Pozvonočnik, Vol 12, Iss 4, Pp 201-210 (2022)

مصطلحات موضوعية: sarcopenia, inflammation, rheumatic diseases, review, Medicine (General), R5-920

الوصف: Sarcopenia is characterized by a loss of skeletal muscle mass, a decrease in muscle strength and/or physical performance, and is one of the main causes for limiting daily activities in the elderly. This is associated with an increased incidence of many adverse events such as dysfunction, falls, frailty, hospitalization, disability, and mortality. Primary (considered as a part of the aging process) and secondary sarcopenia (due to malabsorption, immobility/bed rest, starvation, hypothyroidism, osteoporosis, immune-mediated rheumatic diseases) are united by a chronic inflammatory process of different degrees. Sarcopenia supports one of the most widely accepted theories that low-grade chro­nic inflammation is important in the pathogenesis of many di­seases. For a long time, sarcopenia was considered an age-related disease, but recently it has been reported to be more common in young subjects with autoimmune diseases. In particular, the relationship between sarcopenia and rheumatic diseases such as rheumatoid arthritis has been studied in detail. Although the pathogenesis of sarcopenia in autoimmune diseases is not fully understood, it is believed that a chronic inflammatory process contri­butes to the development of loss of muscle mass and strength, and is different depending on the underlying disease. The definition of sarcopenia varies between studies, which complicates and li­mits direct comparisons. Therefore, in this review, we demonstrate various diagnostic criteria for sarcopenia, focusing on its pre­valence in patients with rheumatic diseases, including rheumatoid arthritis, juvenile idiopathic arthritis, axial spondylitis, psoriatic arthritis, and systemic sclerosis. We developed a structured search strategy for English language publications in PubMed using the term “sarcopenia” in combination with the following keywords: “inflammation”, “diagnosis”, “criteria”, “muscle mass”, “strength”, “outcomes”, “disability”, “mortality”, “pathophysiology”, “rheumatoid arthritis”, “juvenile arthritis”, “axial spondylitis”, “psoriatic arthritis”, “systemic sclerosis”. We focused on clinical trials, meta-analyses and review articles. Articles published only after 2000 year were included, however, we did not include major contributions published before. The search was completed on October 8, 2022.

وصف الملف: electronic resource

العلاقة: https://pjs.zaslavsky.com.ua/index.php/journal/article/view/349Test; https://doaj.org/toc/2224-1507Test; https://doaj.org/toc/2307-1133Test

الوصول الحر: https://doaj.org/article/20e3e9185be14979a90373a774d7bf34Test

المؤلفون: H.V. Mostbauer, M.B. Dzhus

المصدر: Медична наука України, Vol 18, Iss 2, Pp 55-68 (2022)

مصطلحات موضوعية: nonspecific aortoarteritis, takayasu's disease, pulmonary artery, pulmonary artery arteritis, pulmonary hypertension, Medicine

الوصف: Relevance. Nonspecific aortoarteritis (NAA) or Takayasu's disease can exacerbate life-threatening arteritis of the pulmonary artery (LA), which is usually diagnosed with delay and lead to a poor prognosis. Objective: to review the literature data on LA lesions in NAA to improve the diagnosis and timely appointment of appropriate treatment for better the prognosis of the overall outcome. Methods. Review of scientific literature in international electronic databases PubMed, Google Scholar by keywords for the period 2007-2022. The search was conducted by two independent authors. 90 sources were selected for analysis, of which 43 were used, which were written in English and met the search criteria. Results. In NAA, LA lesions are not a rare pathology, which is observed in 5.7-66% of cases. LA arteritis can manifest itself in the form of stenosis, occlusion, dilatation, aneurysm, thrombosis in situ, and thickening of the arteries. When LA is involved in the pathological process, the risk of developing pulmonary hypertension (LH), heart failure, and lung parenchymal lesions increases, which worsens the prognosis of such patients. The pathology of LA is often diagnosed with a delay due to nonspecific symptoms. It should be noted that in NAA LH can develop not only due to LA arteritis but also due to the presence of pathology in the left heart. Conclusions. LA lesions are common in patients with NAA, however, are often diagnosed with a delay. Involvement of LA in the pathological process can lead to the development of LH, HF, and lung parenchymal lesions and worsen the prognosis, so early diagnosis and timely appropriate treatment are important to reduce morbidity and mortality due to LA lesions in NAA. In addition, pulmonary blood flow and intracardiac hemodynamics should be monitored regularly.

وصف الملف: electronic resource

العلاقة: https://msu-journal.com/index.php/journal/article/view/370Test; https://doaj.org/toc/2664-472XTest; https://doaj.org/toc/2664-4738Test

الوصول الحر: https://doaj.org/article/7362d48c3eaa48db9ae359139ac5a705Test

المؤلفون: O.I. Ivashkivskyi, T.A. Karasevska, M.B. Dzhus, H.L. Novytska

المصدر: Bolʹ, Sustavy, Pozvonočnik, Vol 10, Iss 4, Pp 181-185 (2020)

مصطلحات موضوعية: yersiniosis arthritis, reactive arthritis, Medicine (General), R5-920

الوصف: Reactive arthritis (ReA) remains an important problem in the practice of rheumatology, and is one of the most common types of acute arthritis in young people. The relevance of ReA is due to its high frequency, difficulties of diagnosis, a chronicity with an insufficiently effective treatment. The article discusses current literature data on Yersinia arthritis, features of pathogenesis, diagnosis and treatment. The occurrence of ReA is most often associated with gastrointestinal or urogenital infection, which precedes the development of joint syndrome. Among the ReAs associated with intestinal infection, Yersinia is quite common. Intestinal yersiniosis is severe, has a significant duration with a tendency to chronicity, involvement of various organs and systems in the pathological process. The features of Yersiniosis pathogens in combination with infectious conditions cause a wide variety of clinical manifestations. The disease has a frequent association with HLA-B27 antigen. Among the common clinical symptoms of ReA there are asymmetric arthritis of the lower extremities, sausage-like toe deformity, tendonitis, enthesitis (most commonly heel tendon enthesitis), and asymmetric sacroiliitis. The frequency and severity of extra-articular manifestations may be different: lesions of the eyes, skin, mucous membranes, urogenital or gastrointestinal tract. First-line drugs in the treatment of ReA are NSAIDs. Patients with an active source of infection also require a long-term treatment with antibacterial therapy, sulfosalazine is added in case of a chronic arthritis. The article presents a clinical case of Yersiniosis reactive arthritis, emphasizes the multidisciplinary approach in the management of the patient.

وصف الملف: electronic resource

العلاقة: http://pjs.zaslavsky.com.ua/article/view/220458Test; https://doaj.org/toc/2224-1507Test; https://doaj.org/toc/2307-1133Test

الوصول الحر: https://doaj.org/article/3ef655a10b39485ba54042e206549a55Test

المؤلفون: M.B. Dzhus, G.V. Mostbauer, T.A. Karasevska, M.I. Shevchuk, M.S. Kulik

المصدر: Медична наука України, Vol 15, Iss 3-4, Pp 24-31 (2019)

مصطلحات موضوعية: juvenile idiopathic arthritis, adults, polyarthritis, management tactics, Medicine

الوصف: Relevance. The polyarticular variant of juvenile idiopathic arthritis (JIA) is a disease that begins in childhood and leads to joint damage and disability in adulthood with significant social losses. At 18, patients go under the supervision of adult rheumatologists, often accompanied by loss of control of the disease due to insufficient compliance from both the patient and the physician. Today, there is no documented process for the transfer of patients from childhood to adulthood in Ukraine. Therefore, creating an algorithm for managing such patients is an urgent task.The polyarticular variant of JIA is a disease that begins in childhood and leads to joint damage and disability in adulthood with significant social losses. Objective of this study was to evaluate the clinical and laboratory status and to develop an algorithm for managing adult patients with polyarticular variant of JIA, depending on the detection of RF or/and A-CCP. Materials and methods. The study included 168 adult patients from different regions of Ukraine who were diagnosed with JIA in childhood between 1984 and 2014 without severe comorbidities. Inclusion criteria were: 16 to 60 years old; duration of the disease more than 3 years; the presence of documentary evidence of childhood diagnosis of JIA (ambulatory card, hospital records). Among patients with JIA were identified 53 patients with polyarticular variant, of whom 42 or 25% - with RF (-) polyarthritis and 11 or 6.5% - with RF (+) polyarthritis. The disease activity was evaluated by DAS28 and JADAS-10. The questionaries SF-36, HAQ, TAS-20, PHQ-9 were analyzed and remote articular JADI-A and extra-articular JADI-E damages were evaluated. Statistical studies were performed using IBM SPPS Statistics version 25.0.0.0 software, the results were considered to be reliable at 5% critical level (P

وصف الملف: electronic resource

العلاقة: https://msu-journal.com/index.php/journal/article/view/163Test; https://doaj.org/toc/2664-472XTest; https://doaj.org/toc/2664-4738Test

الوصول الحر: https://doaj.org/article/11735da6a68944fe8b5c287549d720f3Test

المؤلفون: M.B. Dzhus

المصدر: Медична наука України, Vol 14, Iss 1-2, Pp 24-33 (2018)

مصطلحات موضوعية: juvenile rheumatoid arthritis, adults, active disease, remission, treatment, Medicine

الوصف: Relevance. The study of the frequency of remission in adult patients with JRA treated in accordance with the "Unified clinical protocol for medical care for patients with juvenile rheumatoid arthritis" is relevant. Objective. The aim of our study was to evaluate the association of the clinical, psycho-emotional state and the pathogenetic therapy with the development of remission in adult patients with JRA. Materials and methods. 168 adult patients with JRA were examined at the transition period of the health care and adolescents. A retrospective analysis of medical records was performed to evaluate clinical symptoms and laboratory data in childhood and evaluated the clinical status, duration of the disease, activity on the JADAS and DAS-28 scales, quality of life, depression and alexithymia by scales SF-36, PHQ-9, TAS- 20, bone mineral density and methods of treatment in childhood and in adulthood. Results. All patients were divided into 2 groups: Group I - 138 patients (82.1%) with active disease at the time of examination, and II group - 30 patients (17.9%) who achieved remission. Patients who achieved remission did not differ by age at the time of the study, although the prevalence of women (58.1%) in the I group was determined, compared with 31.0% in the II group. Patients in both groups did not differ in height, however, patients with remission had a greater body weight (p 0.05). Patients with active disease had lower BMD in femoral neck and in ultradistal forearm area (all p 3 joints (p

وصف الملف: electronic resource

العلاقة: https://msu-journal.com/index.php/journal/article/view/6Test; https://doaj.org/toc/2664-472XTest; https://doaj.org/toc/2664-4738Test

الوصول الحر: https://doaj.org/article/b4e7cccc2e7d4c9992d434aaee7eb1f1Test

المؤلفون: M.B. Dzhus, T.V. Marushko, H.V. Mostbauer, О.І. Ivashkivsky, I.V. Kurylchyk, N.A. Yegorova, О.К. Nosovets

المصدر: Медична наука України, Vol 13, Iss 3-4, Pp 28-37 (2018)

مصطلحات موضوعية: juvenile idiopathic arthritis, polyarticular variant, adults, prognosis, long term damages, jadi, Medicine

الوصف: Relevance. It is known that the poly-articular variant of JIA is associated with significant articular and extra-articular damages with predominant lesions of small and medium joints with limitation of their function and the development of ankylosis, requiring surgical intervention in these patients. Objective. The aim of the study was to evaluate the risk factors of articular and extra-articular damages in adults with the poly-articular variant of the JIA and to work out a prognostic model for their development. Materials and methods. The study included 45 adult patients with poly-articular (RF+ and RF-) variant of the JIA. Retrospective analysis of medical records of patients with poly-articular variant of JIA was made, taking into account clinical manifestations in the onset of the disease, laboratory parameters and response to therapy. In adulthood, the integral index of articular (JADI-A) and extra-articular (JADI-E) damages was used to assess the long-term effects of JIA. Results. Unfavorable prognostic factors were revealed by method of binary logistic regression. Mathematical model for predicting the probability of long-term negative articular and extra-articular damages of poly-articular JIA was developed. Conclusions 1. The risk factors for the development of articular and extra-articular damages in adulthood in patients with a poly-articular variant of the JIA are female sex, the presence of lymphadenopathy and/or splenomegaly in childhood, the level of ESR during treatment in childhood, the activity of JADAS in childhood, the presence of symmetric arthritis in childhood, the RF positivity in the debut of the disease, the treatment with glucocorticoids, the cumulative dose of the DMARDs, and lack of therapy by DMARDs. 2. A prognostic model for the development of articular and extra-articular damages in adult patients with a poly-articular variant of the JIA is developed. This model is effective and allows determine the adverse course of the disease and can be the basis for personalized treatment for the prevention of the development of significant articular and extra-articular damages of JIA.

وصف الملف: electronic resource

العلاقة: https://msu-journal.com/index.php/journal/article/view/61Test; https://doaj.org/toc/2664-472XTest; https://doaj.org/toc/2664-4738Test

الوصول الحر: https://doaj.org/article/fc7122cf4b8541ca8357672e00a2a24cTest

المؤلفون: M.B. Dzhus

المصدر: Acta Medica Leopoliensia, Vol 23, Iss 4, Pp 4-11 (2017)

مصطلحات موضوعية: jia, adults, long term damages, jadi-a, jadi-e, quality of life, mental health, Medicine (General), R5-920

الوصف: Aim. The aim of our study was to evaluate the quality of life, psychological and physical health of patients with articular and extra-articular damages of JIA using SF-36, HAQ, PHQ-9, and JADI questionnaires in young adults with JIA during the transition healthcare in Ukraine. Materials and Methods. The cross-sectional study of 89 young adults aged 16 to 22 years with a history of JIA, regardless of the active inflammation presence at the time of the survey. The study was performed at the Oleksandrivsky Сentral Clinical Hospital in Kyiv, Ukraine in the period between April 2015 and February 2017. 25 age- and sex-matched controls (without rheumatic disease) were included. There was performed an evaluation of the age at disease onset, disease duration, JADAS, received therapy, quality of life by the Short-Form-36 questionnaire (SF36), the functional state of the HAQ, long-term JIA damage indices JADI-A and JADI-E, PHQ-9, and Beck depression scale. Results and Discussion. Juvenile idiopathic arthritis had a significant impact on the physical scales of quality of life. Patients with JIA had worse (p

وصف الملف: electronic resource

العلاقة: https://amljournal.com/index.php/journal/article/view/133Test; https://doaj.org/toc/1029-4244Test; https://doaj.org/toc/2415-3303Test

الوصول الحر: https://doaj.org/article/dc2d34c58a4a4fb2806f78a30889cf20Test

المؤلفون: M.B. Dzhus, H.V. Mostbauer, T.A. Karasevska, O.I. Ivashkivsky

المصدر: Медична наука України, Vol 13, Iss 1-2, Pp 12-20 (2017)

مصطلحات موضوعية: juvenile idiopathic arthritis, hla-b27, long-term consequences, adults, Medicine

الوصف: Relevance. The existence of associations between histocompatibility antigens and JIA variants has been proved. There is no consensus that the JIAs associated with HLA-B27 antigen are transformed in adulthood into other diseases for which it is necessary to revise the diagnosis, according to the adult classification of rheumatic diseases. Is this one process that began in childhood and continues into adulthood, and whether these two processes that begin in childhood and adulthood have common signs and differences? There is few data about the hallmarks of the disease and outcome in adulthood. Objective. – To investigate the frequency of HLA-B27 detection in adult patients with a history of JIA and to evaluate the clinical features of the course of arthritis in adulthood and the long-term articular and extra-articular consequences of JIA. Materials and methods. A survey of 132 young adult patients with different variants of JIA in the history (70 women, 62 males), aged – 24,3±8,3 years; disease duration – 13,6±9,3 years. We evaluated body mass index, anamnestic data, visual analogue scale, C-reactive protein quantitatively, HLA-B27, rheumatoid factor (RF), IgG-antibody to cyclic citrulline peptide (anti-CCP) and antinuclear antibody (АNА). Long-term effects JIA assessed by joint indices (JADI-A) and extraarticular (JADI-E) damage. Disease activity in childhood and adulthood was assessed on a scale JADAS (Juvenile Arthritis Disease Activity Score) and DAS 28. For statistic analises we use the Statistica 6.0 software packages Copyright © StatSoft, Inc. 1984-2001. Results. HLA-B27 was found in 38 patients with JIA (28,8 %), including 95 % of patients with enthesitis-related arthritis, 28,1 % – with persistent oligooarthritis and 36,8 % of patients with extended oligoarthritis, 8,3 % – with RF-positive JIA and 10,5 % – with the systemic onset JIA. According adult classification 61,5 % of patients with positive HLA-B27 antigen in adulthood developed ankylosing spondilitis or undifferentiated spondiloarthritis, in 22,7 % – undifferentiated arthritis, 100 % – psoriatic arthritis and 31,8 % – remission of the disease. In the childhood in HLA-B27 (+) patients, symmetrical joint damage (20,5 %, p

وصف الملف: electronic resource

العلاقة: https://msu-journal.com/index.php/journal/article/view/19Test; https://doaj.org/toc/2664-472XTest; https://doaj.org/toc/2664-4738Test

الوصول الحر: https://doaj.org/article/f37596ebb0aa45dbb44d4cd194fa911eTest

المؤلفون: V.V. Povoroznyuk, M.B. Dzhus

المصدر: Bolʹ, Sustavy, Pozvonočnik, Vol 7, Iss 4, Pp 146-151 (2017)

مصطلحات موضوعية: juvenile idiopathic arthritis, bone mineral density, young males, osteoporosis, osteopenia, T-score, Z-score, Medicine (General), R5-920

الوصف: Background. Juvenile Idiopathic Arthritis (JIA) is a term used to classify a group of heterogeneous pediatric rheumatic diseases. Many of these conditions persist through adulthood. Presence of chronic inflammatory disease along with a glucocorticoid treatment is the risk factor of osteoporosis in young adult males. The purpose was to study the bone mineral density (BMD), T- and Z-scores in young adult males with JIA. Materials and methods. The study included 50 patients aged 19–25 years, divided into two groups: I — 25 apparently healthy young males; ІІ — 25 young men from different regions of Ukraine with a history of JIA in childhood, regardless of the presence or absence of active inflammation at the time of the observation. Two-energy X-ray densitometry (Prodigy, GE Lunar, Madison, USA) was performed at the D.F. Chebotarev Institute of Ge­rontology, Ukrainian Scientific-Medical Centre for the Problems of Osteoporosis, together with analysis of BMD, T- and Z-scores at different skeletal areas. Results. Young men with JIA and healthy individuals did not differ in age, height, weight and body mass index. Four patients with JIA (16 %) had fractures, while in the control group, there were no fractures. Negative impact of the JIA on the BMD was found in group II compared to group I. Lumbar spine BMD in group II was lower (p < 0.01) than in healthy subjects, as well as the Z-score (p < 0.001) in the L1-L4 lumbar spine region. BMD, T- and Z-scores in femoral neck region were lower in group II than in group I (p < 0.001; p < 0.001; p < 0.01, respectively). Significant differences between the two groups were found in total body BMD (p < 0.001), T-score (p < 0.01), Z-score (p < 0.05). Patients with JIA had lower BMD (p < 0.01) and T-score (p < 0.05) of the ultradistal radius. Decrease of BMD up to the level of osteopenia (Z-score < –2 SD) was found in 20 % patients at the level of L1-L4 lumbar spine, in 8 % — at femoral neck, in 12 % — at total body and in 8 % patients at the level of ultradistal radius. Conclusions. Young men with JIA aged 19–25 years had reduced total body BMD, T- and Z-scores, which indicate the negative impact of the disease on the bone tissue compared with healthy men of the corresponding age.

وصف الملف: electronic resource

العلاقة: http://pjs.zaslavsky.com.ua/article/view/121225Test; https://doaj.org/toc/2224-1507Test; https://doaj.org/toc/2307-1133Test

الوصول الحر: https://doaj.org/article/98f09377dc54417180c4fac6b2caea33Test

المؤلفون: M.B. Dzhus

المصدر: Acta Medica Leopoliensia, Vol 23, Iss 1-2, Pp 44-51 (2017)

مصطلحات موضوعية: juvenile idiopathic arthritis, quality of life, depression, anxiety, prosthetics, Medicine (General), R5-920

الوصف: Aim. To determine emotional state in adults with juvenile idiopathic arthritis (JIA) using questionnaires/ Material and Methods. Patients diagnosed with JIA (N=106) aged over 18 years were examined on the basis of the Alexander Municipal Clinical Hospital, Kyiv, Ukraine. The diagnosis was verified according to the classification criteria of the International League of the Association of Rheumatologists. The study did not include patients with organic pathology of the brain, encephalopathy associated with hypertension, diabetes mellitus, and chronic renal failure. Clinical examination included count of swollen and painful joints; count of joints requiring prosthetics in consequence of destructive changes; assessment of disease activity with regard to administered anti-rheumatic drugs; assessment of quality of life and health with the questionnaires SF-36, HAQ, PHQ-9; evaluation of anxiety by Beck and Hamilton (HAM-A) questionnaires; evaluation of depression by Beck questionnaire surveys and Chaban questionnaire on self-evaluation of anxiety and depression; and determining the social factors that appear to affect health. Results and Discussion. All patients were divided into two groups, depending on the need for prosthetic joints regardless of JIA clinical variants. Group I included 20 patients aged 24,20±8,7 years, with the need of one or more prosthetics joints as a result of JIA. The second group included 86 patients who did not require prosthetic joints, with mean age 23,18±6,18 years. In group I, a longer disease duration (p=0.025), more deformed joints (p

وصف الملف: electronic resource

العلاقة: https://amljournal.com/index.php/journal/article/view/166Test; https://doaj.org/toc/1029-4244Test; https://doaj.org/toc/2415-3303Test

الوصول الحر: https://doaj.org/article/d7a8c57829f14dd99f088d483b475114Test