Представлен обзор литературы, посвященной поражению опорно-двигательного аппарата при воспалительных заболеваниях ки-шечника (ВЗК). Описаны варианты поражения суставов и позвоночника при язвенном колите (ЯК) и болезни Крона (БК). The paper reviews literature on locomotor apparatus injury in inflammatory bowel disease (IBD). It describes the types of joint and spinal column involvement in ulcerative colitis (UC) and Crohn's disease (CD). The ratio of onset to the activity of IBD and articular syndrome is estimated. The most common type of articular syndrome is peripheral arthritis that involves mainly the knee and ankle joints and that is associated with IBD activity in most cases. Unlike peripheral arthritis, the course of axial spondyloarthritis manifesting as isolated sacroiliitis and ankylosing spondylitis (AS) is unrelated to IBD activity. There is evidence on isolated sacroiliitis that is rather common asymptomatic, that is diagnosed late, and that is a finding in a number of patients during examination. The paper provides the clinical and instrumental characteristics of AS in
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The Gleeble-3800 unit was used to simulate physically the upsetting of cast and hot rolled semi-finished products from aluminum-lithium alloy V-1461 over the temperature range of 400-460°C and the strain rates of 1-60 s-1. Following texture analysis of upset samples showed the most typical preferred crystallographic orientations and its formation features depending on the temperature-strain rate schedules. The formation of recrystallization type orientations at a strain rate of 60 s-1 is a distinctive feature of the cast samples’ behavior during deformation. In general, the established regularities of texture formation allow to produce a hot-rolled semi-finished products from V-1461 alloy with a given structure’s crystallography in compliance with requirements for blank’s forming and product’s operation.
Background:Objectives:To assess the bone mineral density (BMD) of the skeleton using the Hologic Discovery A DXA, determine the frequency of low-energy skeletal bone fractures among adult patients with alkaptonuria (AKU), and identibjectivefy factors that affect the occurrence of fractures.Methods:AKU is a rare genetic disease (1 case per 250,000) which occur to severe damage to the spine and large joints. Serious problem in this category of patients is a decrease in BMD. The study included 40 patients with a reliable diagnosis of AKU (23 men and 17 women) aged from 33 to 78 years (mean 60.32±9.1). Densitometry of the lumbar spine was performed in 40 patients; of the forearm bones in 34 patients; of the proximal femur in 32 patients (8 patients were not examined due to bilateral hip joint replacement).Results:Normal values of spinal BMD were found in 26 patients (65%), osteopenia – in 12 (30%) and osteoporosis – in 2 (5%) patients. In the proximal parts of the femur, osteoporosis was detected in 12 patients (30%), osteopenia in 13 (32.5%), and normal in 7 (17.5%) patients. In the bones of the forearm, osteoporosis was found in 22 patients (55%), osteopenia – in 8 (20%), and norm – in 4 (10%) patients. The BMD values (g / cm2) in the group were as follows:Table 2.Disease and treatment characteristics of 2 discrete phenotypes (Systemic and Chronic articular)Systemic formChronic articular formTotalPatients (n)10616Duration of follow-up (years), median (range)13 (3-24)14 (1-14)14 (1-24)Duration of disease prior to bDMARDs (months)7.5 (2-120)21 (3-36)10.5 (2-120)Number of cDMARDs prior to bDMARDs2 (1-2)1 (1-4)2 (1-4)Patients on concomittant cDMARDs, n (n/N%)10 (100%)6 (100%)16 (100%)Type of 1stbDMARD (n)3 TCZ, 2 anti-TNFa, 4 Anakinra, 1 Canakinumab4 anti-TNFa, 2 TCZPatients on bDMARD at the end of follow-up (n/N%)6 (60%)6 (100%)12 (75%)Time to steroids discontinuation after bDMARD initiation (months)7.5 (2-22)4.5 (3-36)6.5 (2-36)NMeanPercentiles25th75thBMD L1-L4401,060,881,25BMD Prox.Femur320,560,610,81BMD Forearm340,480,430,54Peripheral bone fractures were diagnosed in 15 (32.6%) patients – 9 men and 6 women; 25 (62.5%) patients had no fractures. For the first time, fractures were reported in patients aged from 33 to 69 years (mean 55.9±9.5). The localization of fractures was as follows: femur – in 8 patients (20%), forearm – in 6 (15%), shin bones – in 1 (2.5%) patients. Despite lower BMD rates in women, there were no significant differences in the frequency of fractures depending on sex. Correlation analysis (for Spearman) showed the relationship of fractures with age (r= -0.31, p<0.05), femur BMD in general (r= -0.53, p<0.01) and forearm BMD (r= -0.44, p<0.01).Conclusion:There is a high incidence of osteoporosis, mainly in the proximal femur and forearm in patients of the older age group with AKU. In the lumbar spine (due to the development of calcification of the intervertebral discs and ligamentous apparatus), osteoporosis is rarely detected, but the frequency of osteopenia is quite high. 32.6% patients had a history of skeletal bone fractures, and the sex of the patients did not affect the risk of fractures. The occurrence of fractures in patients with AKU is associated with low BMD values of the proximal femur.Disclosure of Interests:None declared
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