Darbo tikslas. Įvertinti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių gyvenimo kokybės sąsajas su sveikatos paslaugų prieinamumu Prienų rajone. Uždaviniai. Įvertinti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių klinikinę charakteristiką ir sąsajas su socialiniais – ekonominiais veiksniais. Ištirti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių savarankiško judėjimo ir apsitarnavimo galimybes. Įvertinti sergančiųjų reumatoidiniu artritu darbingo amžiaus žmonių gydymo įstaigos pasiekiamumo ir aptarnavimo galimybes. Įvertinti sergančiųjų reumatoidiniu artritu gyvenimo kokybės ir skausmo intensyvumo sąsajas su aptarnavimu ir sveikatos priežiūros paslaugų prieinamumo galimybėmis. Tyrimo metodika. Kiekybinis momentinis tyrimas. Anketinė apklausa, naudota SF – 36, DAS 28 ir paruoštas bendrojo pobūdžio klausimynas. Analizuojamosios imties dydis – 67 reumatoidiniu artritu sergantys asmenys. Atsako dažnis – 74,4 proc. Gautiems duomenims apdoroti naudota SPSS 22.0. Rezultatai. Tyrime dalyvavo 61,2 proc. moterų ir 38,8 proc. vyrų. Patenkinamai savo sveikatos būklę dažniau vertino dirbantys respondentai, gyvenantys santuokoje, kaime. Nustatyta, kad sąnarių skausmas dažnai vargina 50,7 proc. respondentų, sąnarių sutinimas – 40,3 proc. tiriamųjų, rytinis sąnarių sustingimas – 34,3 proc. apklaustųjų, sąnarių judesių ribotumas – 52,2 proc. Nedirbantys, gaunantys mažas pajamas respondentai dažniau teigė turintys daugiau sutinusių ir skausmingų sąnarių... [toliau žr. visą tekstą] / Aim of the study. To evaluate the quality of life and its links with accessibility to healthcare services for working age patients with rheumatoid arthritis in Prienai region. Objectives. To evaluate the clinical characteristics and their links to the social - economic factors for working age patients with rheumatoid arthritis. To analize the self-movement and the self-service capabilities for working age patients with rheumatoid arthritis. To evaluate the reach of medical institutions and the service capabilities for working age patients with rheumatoid arthritis. To evaluate the quality of life, the intensity of pain and their links with accessibility to healthcare services for working age patients with rheumatoid arthritis. Methods. Quantitative cross sectional research. The size of the sample under analysis – 67 patients with rheumatoid arthritis. The frequency of the response is 74,4 %. The statistical analysis of data was performed using statistical package SPSS Statistics 22.0. Results. 61,2% women and 38,8% man participated in the study. Working in, living in marriage, living in the village respondents their health evaluated satisfactory more often. The pain of joints more often suffer 50,7% of respondents, the swelling of joints – 40,3%, morning stiffness – 34,3%, limitation of joint movement – 52,2%. The unemployed, with low incomes respondents affirmed about the swollen and the painful joints more often. Respondents living in the village and the employed... [to full text]

Rheumatoid arthritis (RA) is an autoimmune disease, which causes joint inflammation. Different environmental and genetic factors such as smoking, anti-citrullinated protein antibody, rheumatoid factor, and certain MHC-alleles cause RA. It affects mostly women and it is characterised by joint swelling, pain, tiredness, and stiffness. Untreated RA can lead to disability and complications in different organs (brain, lung, heart,). The body develops tolerance against self-antigens using different mechanisms, including Tregs mediated, by increasing the expression of inhibitory receptors and through receptor modification/destruction of self-reactive cells.  Failure in the resistance development mechanism leads to autoimmune diseases. The most important cellular components of RA dependent inflammation are macrophages, T-cells, and B-cells. These cells contribute to the inflammations process by producing antibodies, cytokines, and through antigen presentation or immune cell activation. One of the cytokines, which are released by macrophages and T-cells is Tumour necrosis factor (TNF). It stimulates angiogenesis, activation of osteoclasts and the production of different cytokines by increasing the expression of NF-kB.  The diagnostic process of RA consists of serological, physical, and radiological examinations. These examinations together with other factors are utilized for calculating score (0-10), in order to decide if a patient have RA or not. The treatment of RA depends on disease activity and it is composed of NSAID, steroids, DMARDs, biological DMARDs and non-pharmacological treatment. The interventions can be given as a monotherapy or in combination. The disease activity of RA or the efficacy of a drug which is used to treat RA can be studied by ACR response, DAS-28, HAQ-DI score using joint progression score. The aim of the study was to investigate the efficacy and safety of adalimumab, as well as to compare it with other treatments, which are used to in RA. 5 scientific articles which were obtained from PubMed were used to perform the study. The keywords used to get the materials was” adalimumab rheumatoid arthritis”. It gave 172 results and 5 of the first 20 were selected. ACR 20 response and change in DAS-28 were studied as a primary efficacy endpoint. The result of the studies demonstrated that adalimumab had a moderate-god effect against RA according to the ACR/ EULAR criteria. However, adalimumab was less effective comparing to barcitinib, tocilizumab, sirukumab but it had a similar efficacy as ABP 501 as well as abatacept.   ACR response, change in DAS-28 and remission rate showed better results in patients who treated by sirukumab, tocilizumab or barcitinib. The studies have also proved that adalimumab leads to better outcomes when it is used in combination with methotrexate instead of monotherapy. Regarding safety, all the drugs showed similar patterns and nasopharyngitis as well as lung infections were the most common adverse events. More studies are required in order to find the perfect target molecule and combination therapy so that RA can be treated efficiently and at a lower cost.