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OBJECTIVES: To analyse clinical severity/activity of rheumatoid arthritis (RA) according to smoking status. METHODS: The QUEST-RA multinational database reviews patients for Core Data Set measures including 28 swollen and tender joint count, physician global estimate, erythrocyte sedimentation rate (ESR), HAQ-function, pain, and patient global estimate, as well as DAS28, rheumatoid factor (RF), nodules, erosions and number of DMARDs were recorded. Smoking status was assessed by self-report as 'never smoked', 'currently smoking' and 'former smokers'. Patient groups with different smoking status were compared for demographic and RA measures. RESULTS: Among the 7,307 patients with smoking data available, status as 'never smoked,' 'current smoker' and 'former smoker' were reported by 65%, 15% and 20%. Ever smokers were more likely to be RF-positive (OR 1.32;1.17-1.48, p<0.001). Rheumatoid nodules were more frequent in ever smokers (OR 1.41;1.24-1.59, p<0.001). The percentage of patients with erosive arthritis and extra-articular disease was similar in all smoking categories. Mean DAS28 was 4.4 (SD 1.6) in non-smokers vs. 4.0 (SD 1.6) in those who had ever smoked. However, when adjusted by age, sex, disease duration, and country gross domestic product, only ESR remained significantly different among Core Data Set measures (mean 31.7mm in non-smokers vs. 26.8mm in ever smoked category). CONCLUSIONS: RA patients who had ever smoked were more likely to have RF and nodules, but values for other clinical status measures were similar in all smoking categories (never smoked, current smokers and former smokers).

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OBJECTIVE: To assess the prevalence of rheumatoid arthritis (RA) and spondyloarthropathy (SpA) in two Lithuanian cities, Vilnius and Kaunas. METHODS: The first step in this study involved the translation and validation of a telephone questionnaire developed by rheumatologists and epidemiologists in France. The second step comprised the prevalence survey. To detect RA and SpA cases in the populations of Vilnius and Kaunas, 6542 subjects selected randomly (every 50th) from the latest telephone book were interviewed by telephone using a validated case detection questionnaire (the screening phase). All subjects with rheumatic symptoms but an uncertain diagnosis were contacted by a rheumatologist (confirmation phase) by telephone. If the diagnosis remained uncertain, the subjects were invited for a rheumatological examination. RESULTS: We attempted to contact 3370 telephone numbers in Vilnius and 3172 in Kaunas, and had a response rate of 62.5% and 67.7%, respectively. Over the course of all the study phases (telephone interview, rheumatologist's interview, and clinical examination), 39 RA cases and 27 SpA cases were detected, resulting in a crude prevalence of 0.92% for RA (95% CI 0.65-1.25) and 0.64% (95% CI 0.42-0.92) for SpA. The standardized prevalence rate according to age and sex in the Lithuanian population showed an RA prevalence of 0.55 (95% CI 0.39-0.74) and a SpA prevalence of 0.84 (95% CI 0.53-1.21). CONCLUSIONS: The prevalence of RA and SpA in Lithuania was found to be one of the higher rates in Europe. A telephone interview using a validated short questionnaire enabled a cost- and time-saving epidemiological survey to be conducted to detect RA and SpA cases in the community.

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A total of 196 rifampicin (RMP) resistant Mycobacterium tuberculosis isolates were searched for mutations in the cluster I region of the rpoB gene. Seventeen different types of mutations were observed in 184 (93.9%) isolates. The remaining isolates searched also had no mutations in the N-terminal region of this gene. Mutations were most frequently detected at single codons Ser531 (47.4%), His526 (20.9%), and Asp516 (20.4%). Our data indicate that genotypic drug susceptibility assays based on detection of mutations at the specific codons of the rpoB gene should be effective for predicting resistance to RMP and rifabutin and multidrug resistance in Lithuania.

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Sixty patients with systemic lupus erythematosus (SLE) were examined: 40 patients with cryoglobulinemia and 20 patients without it. Cryoglobulinemia was observed in patients with SLE, as a rule, in the acute course of the disease ending in renal affection. Cryoglobulinemia in SLE was accompanied by the phenomenon of generalized vasculitis in the form of skin and mucosa lesions with ulcero-necrotic changes and affections of the central and peripheral nervous system and the kidneys. The clinical picture of SLE accompanied by cryoglobulinemia was characterized by a polysyndrome phenomenon and infrequent presence of the ARA criteria. Cryoglobulinemia was accompanied by high titres of anti-DNA. Thus, cryoglobulinemia can be regarded as one of the important factors of immunocomplex damage in SLE.

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EIA was used to measure the concentration of fibronectin in plasma and cryoprecipitates of 37 patients suffering from systemic lupus erythematosus coupled with cryoglobulinemia. A definite relationship was discovered between the level of cryoglobulins and the activity of SLE, the concentration of fibronectin in plasma and liver damage. A tendency was revealed towards increase of the fibronectin content in plasma of patients with a high level of antibodies to native DNA and CIC as was a significant correlation between the concentration of cryoglobulin protein and the concentration of fibronectin in cryoprecipitates.

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