Objective. To evaluate the functional status of patients with rheumatoid arthritis (RA) in Russia, to compare the distribution and associations
between functional insufficiency (FI) and functional class (FC), as well as disability groups (DG), and to consider their impact of a
number of the patients' demographic, social, and clinic characteristics.
Methods. Rheumatologists from 27 cities and towns of Russia (a total of 30 centers) participated in the cross-sectional epidemiological study.
The study included all patients with valid rheumatoid arthritis, who had consecutively turned to a polyclinic rheumatologist or who had
been treated at hospital for 3 months. The demographic and social characteristics of a patient, his/her occupation, the onset and duration
of RA, DG and a reason for its receiving, and the patient's clinicofunctional status at the study were recorded.
Results. A total of 1504 patients, including 1271 women, were examined; their mean age was 53 years; the mean duration of the disease
was 10.5 years; 80.4% were seropositive for rheumatoid factor; 94.3% patients had erosive arthritis (X-ray stages II-IV RA). High disease
activity scores (DAS) were found; the mean DAS [Mean (SD)] was 5.44±1.18. Severe extraarticular manifestations were identified in 10%
of cases. 63% of the RA patients were in FC III and IV; 67% had grades 2 and 3 FI, and 44.5% had DGs I and II. An association was
found between FC and FI (r = 0.43; p < 0.0001), DG (r = -0.396; p<0.0001) and DAS28 (r = 0.42; p < 0.0001).
Conclusion. In the Russian population of patients with RA, half had high FC (III or IV). To determine the functional status and capabilities
of RA patients, it is expedient to use the rating methods Health Assessment Questionnaire (HAQ) and global functional status (in scores)
signifying the respective FC, which have acquired a high reputation among rheumatologists all over the world.

The paper presents the long-term outcomes of rheumatoid arthritis (RA) according to the data of a 15-year prospective follow-up and treatment
in 240 patients with the disease. Disease activity resistance (stable remission of more than 2 years, a recurring course with druginduced
remissions of 6-18 months, or no remissions), the degree of joint destruction progression, the functional state of patients and their
survival were assessed in relation to the time of use of basic anti-inflammatory drugs (BAIDs). In groups 1, 2, and 3, BAID therapy was
initiated within the first 5 months of RA, 6-11 and 12-36 months after its onset, respectively. The treatment was monitored, by estimating
clinical and X-ray parameters, the functional state of the locomotor apparatus and by correcting the therapy at its stages in the absence of
reliable suppression of RA activity and/or with the continuing emergence of new erosions in small joints. The early use of BAIDs under
meticulous control of the degree of RA activity suppression and RA progression were shown to frequently achieve clinical and laboratory
remissions and to improve functional and life prognosis in the patients.

Subjects and methods. Thirty patients, including 9 (30.0%) men and 21 (70.0%) women, with signs of radiculopathy (RP) in late-stages
Lyme borreliosis (LB) were examined. A control group comprised 30 patients with vertebrogenic RP in the presence of dystrophic changes
in the vertebral column.
Results. 56.7% of the patients with LB were observed to have its primary chronic course in the absence of the acute period of LB. The latter
with the signs of RP showed a topic association between the pain location and the tick bite site in 43.3% of the patients. A gradual disease
development was more frequently (63.3%) observed in LB while the periods of remission and exacerbation were more typical (56.7%) in
vertebrogenic RP. In the patients with LB, pain syndrome depended on posture and physical exercise less frequently (30.0%) than in those
with vertebrogenic RP (96.7%). Bilateral pain irradiation was more characteristic of RP in LB than in dystrophic lesions of the vertebral
column. The symptoms of tonic muscle tension and limited movement volume in the afflicted part of the vertebral column were significantly
less common in the patients with LB than in those with vertebrogenic RP. LB was marked by a concomitance of radicular and polyneuritic
disorders (83.3%) and vertebrogenic RP was characterized by a preponderance of the radicular-type of sensitivity disorder (100%).
Systemic inflammatory syndrome and polysystemacy of manifestations were more characteristic of LB. The benefits of nonsteriodal antiinflammatory
drugs in LB patients with RP were significantly worse than in those with vertebrogenic RP; regression of symptoms in LB was
seen only after a course of specific antibiotic therapy.

Vascular dysfunction and inflammation in psoriatic arthritis (PsA) share the same pathogenetic mechanism wherein the proinflammatory
cytokine tumor necrosis factor- (TNF-) plays a key role. Treatment with anti-TNF- agents is effective in inhibiting inflammation in
PsA; however, their effect on the wall of large arteries has not been studied.
Objective. To evaluate the effect of Adalimumab (ADA) on the arterial wall and blood rheological properties in PsA.
Subjects and methods. Eighteen patients with PsA [12 women and 6 men; mean age 43.1±10.2 years; disease activity scores (DAS), 4.78 (4.0;
5.45)] were subcutaneously injected ADA, 40 mg/every two weeks, for 12 weeks. The investigators assessed the vascular wall, by measuring the
mean and maximum common carotid intima-media thickness (IMT) by ultrasound duplex scanning, and arterial rigidity (AR), by determining
the refraction index (RI,%) and the rigidity index by digital volume photoplethysmography and Doppler study measuring the aortic pulse wave
velocity (PWV) in the carotid-femoral segment (Micromedical, UK), before and after treatment. Erythrocyte aggregation (EA) parameters [Т1
(sec), Kt (c.u.); (sec-1), I2,5 (%)] were measured recording the rate of inverse light scattering and the levels of blood lipids [total cholesterol (TC),
low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG)], and atherogenicity coefficient
(AC) by routine methods on an automated Express plus analyzer (Bayer, Germany) at baseline, 4, and 12 weeks. The median and the interquartile
range [Me (Q25; Q75)] were calculated; the changes in the parameters were estimated by the Wilcoxon test (Wt) and the Friedman test (Ft)
for dependent samples; p<0.05 was considered statistically significant.
Results. Along with a significant reduction in PsA activity [DAS from 4.79 (4.0; 5.45) tо 1.6 (1.3; 2.03), Ft.; p < 0.05], there was a considerable
improvement in the arterial wall (the mean IMT decreased from 0.78 (0.74; 0.84) to 0.73 (0.61; 0.74), Wt.; p < 0.028) and most AR
parameters (there were reductions in RI from 69.5 (58; 74) to 49.5 (44; 64), Wt; p < 0.005) and aortic PWV from 9.9 (7.7; 17.7)
to 9.2 (7.4; 10.6), Wt; p < 0.05). The baseline EA values [T1 = 5.98 (5.42; 6.99), Kt = 0.39 (0.33; 0.53), = 58.32 (47; 77.3),
I2,5 = -8 (-9; -7) significantly improved at just 4 weeks of treatment [Т1 = 8.77 (7.9; 10.1); Кt = 0.22 (0.17; 0.28); = 32.46 (20.7; 42.49),
I2,5= -26 (-29; -20)] and preserved their positive changes at 12 weeks [Т1 = 9.2 (8.4; 11.4); Кt = 0.22 (0.2; 0.27); = 34 (26.5; 41.9),
I2,5 = -27.5 (-32; -22)] (Ft; p < 0.002 for all EA parameters). ADA treatment caused a significant increase in TC and TG from 4.9 (4.1; 5.8)
to 5.5 (4.9; 6) and from 0.85 (0.75; 1.26) to 1.09 (0.94; 1.43), respectively; Wt; p < 0.007/0.021). AC remained unchanged.
Conclusion. ADA lowers PsA activity, normalizes blood rheological properties, and improves the wall of large arteries as reductions in
carotid IMT and AR parameters associated with the vessels of the microcirculatory bed.

Objective. To compare disease history data and clinical and laboratory parameters in patients with scleroderma systematica (SDS) with high-resolution
computed tomography (HRCT)-verified interstitial lung lesion (ILL) versus those without lung involvement.
Subjects and methods. An examination was made in 138 patients with SDS who had been consecutively admitted in 2006-2008, female/male ratio, 124 :
14; limited : diffuse : mixed forms, 78 : 40 : 20; mean age, 47±13 years; median disease duration, 6 (2.5 11) years. The history data (occupational hazards,
smoking, respiratory diseases) and clinical manifestations of SDS and laboratory data were studied. The diagnosis of ILL was established on the basis of
chest HRCT.
Results. According to HRCT data, the signs of varying ILL were found in 82% of the patients with SDS. The duration of SDS was similar in the patients with
and without lung involvement; but the latter were younger at the time of disease onset. There were no significant differences between the groups compared in
history data, clinical forms of SDS, the frequency of involvement of visceral organs and systems. Crepitation was heard only in the patients with ILL. The
frequency of respiratory manifestations increased with a larger number of the involved lung segments. The prevalence of ILL was found to be positively correlated
with age at the onset of SDS (r=0.29; p<0.0005), SDS activity index (r=0.24; p<0.005), lactate dehydrogenase (r=0.39; p<0.0004), erythrocyte sedimentation
rate (r = 0.2; p<0.02) and C-reactive protein (r=0.23; p<0.01). Anticentromere antibodies (ACAb) were significantly more frequently detectable
in the patients without lung involvement.
Conclusion. The clinical and X-ray pattern of ILL does not depend on history data, gender, and the subtype of SDS. The frequency of respiratory manifestations
increases with a larger number of the involved lung segments. Crepitation is an important physical sign of ILL, which is indicative of the extensive
nature of changes. The large extent of lung parenchymal involvement was associated with higher inflammatory activity. In patients without lung involvement,
SDS occurred at a younger age and was more frequently associated with ACAb.

Objective. To evaluated effect of adalimumab treatment on activity of arthritis, enthesitis, psoriasis and functional status in PsA patients (pts).
Subjects and methods. 18 pts with active PsA (12 female, 6 male), median age 43,1±10,2 years (yrs) (range 24-56), median duration of
psoriasis 16,7±9,6 yrs (range 4-33), median duration of PsA 9,2±6,7 yrs (range 1,5-23) received Adalimumab 40 mg subcutaneously
every other week (wk) for 12 wks in open-label study. Evaluations of treatment effects were conducted by the PSARC, ACR 20, 50 and 70,
LEI, PASI, BSA, HAQ and CRP at wks 4 and 12.
Results. The sings of activity of PsA at baseline were: DAS=4,8 (4,0; 5,45), LEI=4,25 (0,25; 8,05), PASI=10,5 (7,2; 12,1), BSA=1,75
(1; 2), HAQ=1,125 (0,875; 1,5), СRР=27,9 (11,4; 34,6). After 4 wks all parameters significantly improved: DAS=2,85 (2,1; 3,1),
LEI=1,86 (0; 3,97), PASI=6,4 (2,8; 8), BSA=0,75 (0,15; 1), HAQ=0,375 (0,125; 0,625), СRP=1,7 (1,4; 3,2) and were maintained
after 12 wks: DAS=1,6 (1,3; 2,03), LEI=0,38 (0; 0,89), PASI=1,1 (0,4; 2,2), BSA=0 (0; 0,9), HAQ=0,312 (0; 0,625), СRР=1,75 (0,7;
3,6); p<0,05. 100% pts achieved PSARC at the 4 and 12 wks 55,6; 11,1 and 27,8% PsA pts achieved ACR 20, 50 and 70 at 4 wks and
11,1; 33,3 and 55,6% at 12 wks respectively. Adalimumab was well tolerated throughout the study.
Conclusion. Adalimumab therapy significantly reduced the main clinical symptoms of PsA: arthritis, enthesitis, psoriasis. Additionally it
improved quality of life PsA patients and was well tolerated.

The authors describe their case of leukocytoclastic vasculitis developing in a patient with ankylosing spondylitis after the second injection of
adalimumab and give references to cases of vasculitis induced by anti-tumor necrosis factor- agents.