Background: fracture risks assessment and determination of bone mineral density are modern methods, generally accepted and widely used. However, they have limitations and disadvantages for the dynamic evaluation of bone remodeling processes in RA-patients with low BMD. The investigation of bone resorption markers is an important issue.
Aims: to compare the antiresorptive activity of denosumab and alendronic acid in patients with rheumatoid arthritis and osteoporosis using β-CTX and osteocalcin (OC).
Materials and methods: forty-two patients were included in the study (16 patients were treated with denosumab, 13 patients – with alendronic acid, 13 patients - control group without any osteoporosis treatment). The quantitative determination of β-CTX and OC as well as dual-energy X-ray absorptionometry (DXA) were carried out for all patients at the first visit with consecutive investigation of bone resorption markers 3 months after. The predictive capacity was determined using the ratio of observed fractures/expected fractures by FRAX.
Results: The level of β-CTX 16% (median 861.6 pg/ml vs. 724.6 pg/ml, p = 0.049) and OC 39% (median 13.9 ng/ml vs 8.5 ng/ml, p = 0.047) decreased significantly in 3 month in RA patients treated with denosumab. The decrease of β-CTX (median 858.9 pg/ml vs. 821.8 pg/ml) and OC (median 14.8 ng/ml vs. 13.9 ng/ml) was observed in the group of patients treated with alendronic acid, but not reached statistical significance.
Conclusions: denosumab had showed better antiresorptive activity compared with bisphosphonates, which was registered 3 month after the start of the treatment.
This article outlines the results of a study of transition of educational organizations training specialists at the higher education level from traditional contact methods of direct interaction with students (classroom lectures, practical (laboratory) classes, etc.) to distance, contactless forms of educational process in the context of the COVID-19 pandemic. The study considers specific problems that higher education institutions faced during the spread of the COVID-19 virus and proposes ways to address emerging ones. In addition, the article reflects the results of the educational process of one of the higher education institutions in the Krasnoyarsk region (the Institute of Land Surveying, Cadaster and Nature Management of the Krasnoyarsk State Agrarian University), on the basis of which the impact of the identified problems on the educational process is assessed. Positive aspects of "digitalization" of educational institutions, which allowed ensuring the continuity and accessibility of the educational process, are also indicated. The benefits of the distance mode of knowledge transfer and the prospects for the development of distance learning considering the threats of the COVID-19 virus have been identified and noted. Establishing problems of transition to a distance form of conducting the educational process allowed to determine the factors and conditions that should be taken into account to ensure that both teachers and students are as effective and efficient as possible.
The article presents a clinical case of a rare autoinflammatory disease – a family case of Muckle – Wells syndrome. The diversity of clinical manifestations and the impossibility of confirming the diagnosis without a genetic study by DNA sequencing determine the complexity of and delay in the diagnosis. The development of severe complications and, as a consequence, a fatal outcome necessitates early diagnosis. The described clinical case demonstrates the importance of DNA sequencing for the timely diagnosis of the disease, the features of the disease course, and the familial nature of the disease. The diagnosis of Mackle – Wells syndrome in young family members before the development of severe complications will allow to start adequate and timely treatment and prevent the development of amyloidosis.
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