Psoriatic arthritis (PsA) is a chronic inflammatory disease of the joints, spine and enthesis from the group of spondyloarthritis that develops in patients with psoriasis. Guselkumab is a biologic disease-modifying antirheumatic drug, an inhibitor of interleukin 23, which has been shown to be effective in the treatment of plaque psoriasis and PsA.Objective: to evaluate the effectiveness of guselkumab treatment in PsA patients.Patients and methods. The study included 16 patients with PsA. All patients received 100 mg of guselkumab subcutaneously at weeks 0, 4, 12, 20. Disease activity and treatment efficacy were assessed at weeks 0, 12 and 24 using the DAS28, ASDAS, BASDAI, DAPSA activity indices, the index of the extent and severity of psoriasis PASI.Results and discussion. During treatment, patients with PsA showed a pronounced positive dynamics of the indices of disease activity and an improvement in the skin condition. Before the treatment with guselkumab, the mean value of the DAS28 index was 4.26±0.64, DAPSA – 37.94±9.45, ASDAS – 2.7±0.65, and BASDAI – 5.49±1.39, after 12 weeks of treatment these indicators decreased to 3.03±0.49; 17.06±4.58; 1.64±0.33 and 3.48±0.66, respectively, and after 24 weeks (after the 4th injection) – to 2.32±0.18; 11.31±2.18; 1.22±0.27 and 2.62±0.78, respectively (p<0.05 for all cases). Before treatment, the average PASI index reached 30.99±15.43, after 12 weeks – 4.55±4.82, and after 24 weeks – 1.05±1.46 (p<0.05). During treatment, a significant improvement in the main manifestations of the disease was noted: regression of peripheral arthritis, spondylitis, and skin rashes.The treatment was well tolerated during the 24 weeks of the study, and no serious adverse events were reported.Conclusion. The data from real clinical practice indicate that guselkumab is highly effective and safe in the treatment of PsA.
With age the state of health worsens, it is necessary to see doctors more often. Availability and quality of the provided medical care, a set of medical services can differ depending on the place of its rendering. The work purpose – to study a self-assessment of a zdorovyapatsiyentama of age 60+ of rural out-patient clinic of the Zelenograd district of the Kaliningrad region and their relation to the organization of the primary health care (PHC) and satisfaction with it. Survey among 211 patients of rural medical out-patient clinic aged from 60 up to 88 years, within the project of Partnership “Northern measurement” in the field of health care and social wellbeing is conducted (further in the text – the Project). The factors offered in the questionnaire having the greatest impact on health, according to patients, and satisfaction with the PHC organization are studied. The patients living in rural areas often visit the medical organizations with the medical and diagnostic and advisory purposes, pay attention to medical examination passing that can testify to an active position of the general practitioner working in the Project as in answers about the factors having the greatest impact on health, questions of prevention at poll got the last place. The satisfaction with the PHC organization made in general 3.6 points on a five-point system.
Распространенность табакокурения среди сотрудников медицинских организацийТ.Г. ЗАДОРКИНА ФГБУ «Центральный научно-исследовательский институт организации и информатизации здравоохранения» Минздрава России, Москва, Россия Цель исследования -выявить причины и степень распространенности табакокурения среди сотрудников медицинских организаций Калининграда. В одномоментное эпидемиологическое исследование методом анкетирования вошли 428 сотрудников 7 медицинских организаций города: врачи, средний и младший медицинский персонал, руководящий персонал, медицинские регистраторы, бухгалтеры, водители, операторы, педагоги-психологи, сторожа. Среди опрошенных были выделены группы лиц, пробовавших ранее курить (60%), в том числе курящих в настоящее время (31%), никогда не куривших (40%). Причинами первого опыта табакокурения были любопытство (42% мужчин и 60% женщин), пример товарища, начавшего курить (38% мужчин и 13% женщин), влияние моды (13% мужчин и 13% женщин). Преобладающий возраст начала курения среди мужчин -16-20 лет (56%), среди женщин -17 лет и старше (55%). Среди тех, кто пробовал курить ранее, в настоящее время курят 50% мужчин и 25% женщин, при этом доля курящих женщин среди работников немедицинских специальностей составляет 14%, среди врачей -18%, руководящего персонала -25%, среднего медицинского персонала -27%, младшего медицинского персонала -29%, медицинских регистраторов -50%; среди мужчин, представляющих руководящий персонал, курят 33%, средний медицинский персонал -33%, врачей -48%, младший медицинский персонал -63%, работников немедицинских специальностей -68%. Таким образом, проблема табакокурения среди сотрудников медицинских организаций остается актуальной, что в свою очередь снижает эффективность борьбы с табакокурением среди населения. Ключевые слова: табакокурение, распространенность табакокурения, сотрудники медицинских организаций. Prevalence of smoking among employees of healthcare facilities T.G. ZADORKINA Central Research Institute for Health Organization and Informatics, Ministry of Health of Russia, Moscow, RussiaObjective -to reveal smoking causes and prevalence among the employees of Kaliningrad healthcare facilities. Questionnaires were used to include 428 employees from seven healthcare facilities of the city, such as physicians, mid-level and junior medical staff, managerial staff, medical receptionists, accountants, drivers, operators, teachers/psychologists, and watchmen, into a crosssectional epidemiological survey. Groups of persons who had previously tried smoking (60%), including current smokers (31%), never-smokers (40%), were identified among the respondents. The causes of the first smoking experience were curiosity (42% of men and 60% of women); an example of the friend who had started smoking (38% of men and 13% of women); and the influence of fashion (13% of men and 13% of women). The predominant age of smoking initiation was 16-20 years among men (56%) and 17 years and older among women (55%). Among those who had previously tried smoking, there were current smokers (50% of ...
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