Number Of Adverse Effects Research Articles

Gene expression profiling analysis of keloids with and without hydrocortisone treatment

The present study aimed to investigate the genetic effects of hydrocortisone (HC) treatment on keloids and screen medicines to be used in a combination therapy of keloids with HC. The dataset GSE7890 was downloaded from Gene Expression Omnibus. It contained data regarding 4 fibroblast samples from normal scar tissue and 5 samples from keloid tissue with HC treatment, as well as 5 samples from normal scar and 5 samples from keloids without HC treatment. Following the identification of differentially expressed genes (DEGs), the functions of these DEGs were analyzed by Gene Ontology (GO) and pathway enrichment analyses. Furthermore, adverse effects of HC were identified using WebGestalt. Additionally, candidate small molecule drugs associated with keloids were selected from a connectivity map database. A total of 166 and 41 DEGs, with and without HC treatment respectively, were only present in dermal fibroblasts from keloids (termed genesets A and B, respectively). A set of 26 DEGs was present following both treatments (geneset C). A number of DEGs in geneset B (COL18A1 and JAG1) were associated with endothelial cell differentiation. However, in genesets A and C, certain genes (CCNB1 and CCNB2) were involved in the cell cycle and p53 signaling pathways, and a number of genes (IL1R1 and COL1A1) were associated with bone loss. Additionally, numerous small molecule drugs (including acemetacin) were associated with keloids. Thus, it has been determined that HC may treat keloids by targeting genes associated to endothelial cell differentiation (COL18A1 and JAG1). However, HC has a number of adverse effects, including bone loss. Acemetacin may be applied in a combination therapy, along with HC, to treat keloids.

Strategic Evaluation Tool for Surface Water Quality Management Remedies in Drinking Water Catchments

Drinking water catchments (DWC) are under pressure from point and nonpoint source pollution due to the growing human activities. This worldwide challenge is causing number of adverse effects, such as degradation in water quality, ecosystem health, and other economic and social pressures. Different evaluation tools have been developed to achieve sustainable and healthy drinking water catchments. However, a holistic and strategic framework is still required to adequately consider the uncertainty associated with feasible management remedies of surface water quality in drinking water catchments. A strategic framework was developed to adequately consider the uncertainty associated with management remedies for surface water quality in drinking water catchments. A Fuzzy Multiple Criteria Decision Analysis (FMCDA) approach was embedded into a strategic decision support framework to evaluate and rank water quality remediation options within a typical fixed budget constraint faced by bulk water providers. The evaluation framework consists of four core aspects; namely, water quality, environmental, economic and social, and number of associated quantitative and qualitative criteria and sub-criteria. Final remediation strategy ranking was achieved through the application of the Euclidean Distance by the In-center of Centroids (EDIC).

Concentrations and human health risk assessment of DDT and its metabolites in free-range and commercial chicken products from KwaZulu-Natal, South Africa

ABSTRACTOrganochlorine pesticides such as dichlorodiphenyltrichloroethane (DDT) have been used in agriculture and for disease control purposes over many decades. Reports suggest that DDT exposure may result in a number of adverse effects in humans. In the KwaZulu-Natal Province of South Africa, DDT is sprayed annually in homes (indoor residual spraying) to control the mosquito vector of malaria. In the northern part of the Province, samples of free-range chicken meat (n = 48) and eggs (n = 13), and commercially produced chicken meat (n = 6) and eggs (n = 11), were collected and analysed. Of the free-range chicken meat samples, 94% (45/48) contained DDTs (ΣDDTs median 6.1 ng/g wet weight [ww], maximum 79.1 ng/g ww). Chicken egg contents were also contaminated (ΣDDTs in free-range eggs median 9544 ng/g ww, maximum 96.666 ng/g ww; and in commercial eggs median 1.3 ng/g ww, maximum 4.6 ng/g ww). The predominant DDT congener detected was p,pʹ-DDE in both free-range meat (>63%) and eggs (>66%), followed by p,pʹ-DDT and then p,pʹ-DDD. Based on estimated daily intake values, calculated human risk ratio (carcinogenic) values were >1 for DDTs detected in both free-range chicken products. Consumption of free-range eggs poses a particularly high health risk.

Frequency of analgesic drugs use and patients’ awareness of their possible interactions with antiplatelet therapy in coronary heart disease

Aim: The aim of the study was to assess the prevalence and frequency of analgesic drug use in patients with coronary heart disease, as well as to assess patients knowledge about possible interactions of these drugs with conventional cardiac therapy. Introduction: Nonsteroidal antiinflammatory drugs (NSAIDs) are commonly used in the management of pain in a variety of conditions. Available data clearly indicate that the NSAIDs use is associated with a number of adverse effects especially in patients with cardiovascular disease. Methods: The study group consists 93 patients hospitalized in the tertiary cardiology center (mean age 67±11 years,30% females). Thirty nine subjects were hospitalized with diagnosis of acute coronary syndrome and 54 underwent elective coronary intervention. Self-prepared questionnaire was used to collect data. Results: In the examined group 56 patients (60%) declared the use of analgesic drugs with regular use (defined as at least 3 times per week) reported by 25 subjects (27%). The most frequently used analgesics were NSAIDs (n=37), paracetamol (n=36), less commonly patients reported the use of tramadol (n=6) or metamizol (n=9). The majority of patients using analgesic are not aware about possible interactions with antiplatelet therapy (the answer “yes” for the question about knowledge of possible interactions of analgesic with cardiac treatment gave only 21% of responders, while majority answered “do not know” (72%)). Only 20% of patients admitted that they received the information about analgesics from their doctor. Majority of patients do not consult the use of analgesics with the physician (72%). Conclusion: The regular use of NSAIDs/analgesic by 27% of hospitalized patients with coronary heart disease is a significant concern. Patients with coronary heart disease should be provided with detailed information and recommendation about safe analgesic therapy and alternatives for NSAIDs. Acknowledgements: The authors thank Prof. Danuta Czarnecka, head of the 1st Department of Cardiology, Interventional Electrocardiology and Hypertension Collegium Medicum Jagiellonian University and Agnieszka Olszanecka Ph.D. for substantive supervision over the study.

Leidos and MD&A: Seeing MD&A through the Eyes of the SEC

The Supreme Court has never agreed to decide whether an item in Regulation S-K, like MD&A, creates a duty to disclose that is actionable under Rule 10b-5. By taking cert on Leidos, Inc. v. Indiana Public Retirement System, the Court may be doing just that. If the Court decides that a violation of Item 303 of Regulation S-K creates an independent cause of action for private plaintiffs under Rule 10b-5, the Court must then decide whether violating Item 303 leads “automatically” to a violation of Rule 10b-5 or if additional factors are required. These factors may include the materiality of any omitted disclosure, scienter or the ability of the company to predict the outcome of a trend or uncertainty at the time the omitted disclosure should have been made. Contrary to the Second Circuit’s decision, the Third and Ninth Circuits held that Item 303 does not create a cause of action under Rule 10b-5 in part because of the different materiality standard the SEC has applied to Item 303 in 1989 as compared to the materiality standard articulated in Basic v. Levinson in 1988. In resolving this conflict between the circuits, the Court is not just deciding a discrete and limited issue under Item 303, but may also be determining whether a violation of every one of the SEC’s disclosure rules creates an independent cause of action under Rule 10b-5. Deciding that Item 303 creates a duty to disclose that is actionable under Rule 10b-5 could lead to an implied right of action under Rule 10b-5 with respect to the rules adopted under Sections 13(a) and 15(d) and perhaps Section 14(a)of the Exchange Act. Creating a duty to speak would increase the likelihood of private actions under Rule 10b-5 alleging omitted disclosure in periodic reports against public companies which previously were not subject to Rule 10b-5 liability that did not cause a statement made to be materially misleading. A decision affirming Leidos could have a number of adverse effects: The SEC may need to revisit the trade-off made in 1980 of giving companies a general and flexible rule to foster the exercise of management judgment in providing meaningful disclosure in MDA Companies drafting defensive MDA Defensive disclosure can defeat the SEC’s ongoing effort to make documents readable and make already lengthy documents even longer and more forbidding to read; Voluminous defensive MDA MDA Faced with increased liability exposure and costs of compliance, the trend of companies ceasing to report to the SEC and going private may accelerate. Companies that would have made initial public offerings may decide to stay private.

Overeducation in the labour market

Motivation: Many new phenomena which the Polish economy had never seen before transition manifested themselves. The society showed greater interest in higher education and the market for education services expanded, increasing the number of colleges and universities. This helped the spread of higher education, which for years determined the level of human capital represented by the supply of labour. Today’s labour market in Poland is showing signs of imbalance. One of the reasons involves overeducation. The phenomenon has been known since the 1970s. It was then described for the first time in pertinent literature, with the US where overeducation occurred on a large scale and where it had a number of adverse effects across the entire economy having been used as an example. It seems important to understand and analyse the reasons for the emergence and perpetuation of this phenomenon on the Polish labour market and to indicate its implication. Aim: The paper aims to present and discuss overeducation in terms of selected economic theories, identify its causes in Poland and further to determine the economic and social implications of the persistence of the phenomenon in the long run. Results: Based on the author’s analysis, it can be concluded that overeducation is a complex phenomenon. It is possible to identify several reasons for its occurrence and long-drawn persistence on the Polish labour market. Some of the reasons have to do with the dynamic growth of the labour market and the educational services sector, society’s desire to gain higher education, structural mismatches in the labour market and a common education policy at the EU level. Overedutaion has far-reaching consequences, both for the entire economy and the single participant of the labour market alike. The fact of its occurrence determines the processes taking place in the labour market.

Glucocorticoid-induced abnormality in bone remodeling.

Glucocorticoid(GC)is widely used to treat a variety of autoimmune, inflammatory and allergic diseases. GC causes a number of adverse effects and among them osteoporosis and degenerative bone fracture are major complications of GC therapy. GC inhibits differentiation of mesenchymal stem cells to osteoblasts, induces apoptosis of osteoblasts and osteocytes and prolongs lifespan of osteoclast, resulting in low bone mass and micro-architectural deterioration of bone tissue, which leads to severe osteoporosis, increased bone fragility and susceptibility to bone fracture. Physicians who prescribe GC have to manage patients according to guidelines on the management and treatment of GC-induced osteoporosis.

The clinical importance of quantifying body fat distribution during androgen deprivation therapy for prostate cancer.

Androgen deprivation therapy (ADT) is now considered a mainstay in the treatment of metastatic and locally advanced prostate cancer (PCa). Despite well-established benefits of ADT in relation to overall survival, this treatment has been associated with a number of adverse effects, particularly with regard to key cardiometabolic risk factors including the development of insulin resistance, dyslipidemia and increases in total and regional fat mass. In non-ADT populations, increased levels of visceral adipose tissue (VAT) are thought to be a key mediator of the increased cardiometabolic risk associated with weight gain, but this has received limited attention in men treated with ADT. VAT is best assessed using tools such as computed tomography or magnetic resonance imaging; however, these tools are not readily accessible for the majority of researchers or clinicians. Recent advances allow for a method of estimating VAT using a whole-body dual-energy X-ray absorptiometry (DXA) scan that shows promise as a practical tool for researchers to evaluate changes in body fat distribution during ADT. The aim of this narrative review is to (1) review the available evidence with regard to the relationship between ADT and cardiometabolic risk; (2) discuss the role of body fat distribution on cardiometabolic risk in non-ADT populations, with a particular emphasis on the importance of visceral adiposity; (3) examine the potential influence of ADT on body fat distribution and visceral adiposity and (4) provide an overview of current tools used to measure changes in body fat distribution in men treated with ADT, highlighting the potential utility of a recently developed DXA-derived measure of VAT.

Rituximab and intravenous immunoglobulin as alternatives to long-term systemic corticosteroids in the treatment of pemphigus: a single center case series of 63 patients

Rituximab and intravenous immunoglobulin [IVIg] have recently emerged as effective treatments for pemphigus refractory to corticosteroids [CS]. This case series sought to compare the clinical, serologic,and adverse effects of CS, IVIg, and rituximab in patients with pemphigus. A retrospective review of 63 patients with pemphigus vulgaris (PV), pemphigus foliaceus (PF), or paraneoplastic pemphigus (PNP)was performed. Clinical remission (CR), serologic remission (SR), and adverse effects were evaluated. Three study groups were compared: patients treated with systemic CS, refractory patients treated withIVIg, and refractory patients treated with rituximab. The overall number of adverse effects was not significantly different between the groups but those observed in patients treated with systemic CS weremore severe. CR was less likely in the patients treated with systemic CS than in patients treated with IVIg or rituximab, P-value = 0.000467. SR was more likely in patients treated with systemic CS or rituximab thanin patients treated with IVIg, P-value = 0.002118. These results suggest that the clinical efficacy of IVIg is not correlated with an expected concomitant SR. Frequently reserved for refractory pemphigus,IVIg and rituximab are significantly more likely to produce clinical remission than systemic CS therapy, suggesting their utility as first-line treatments.

Urban Solid Waste Management in Itanagar Municipal Area of Arunachal Pradesh – An Application of Contingent Valuation Method

Urbanisation is a phenomenon which is a part and parcel of economic development. Simon Kuznets (1966) in his Nobel Prize winning work on measurement and analysis of historical growth of national income of developed countries identified high rate structural transformation as one of the six basic characteristics of modern economic growth. Urban development is no doubt a natural outcome of economic development but it has a number of adverse effects. For example, the rapid urbanization may lead to the rapid growth of slum settlements, informal sectors as well as environmental problems like solid waste accumulation etc. The management of Municipal Solid Wastes (MSW) in most of the urban areas is a serious concern for many of the developing countries which requires immediate attention of both Government and the public. The paper attempted to estimate the per capita waste generated in Itanagar municipality area based on primary data. Itanagar, The capital of Arunachal Pradesh is a newly growing town in hilly area. This paper also attempted to estimate the willingness to pay among the respondents of Itanagar municipality area. A contingent valuation method (CVM) was used to identify the determinants of willingness to pay (WTP). Interestingly, the result showed that educational attainment of the respondents, income of the households, years of living in the place and environmental awareness were positively and significant affects the maximum willingness to pay (WTP) for an improved solid waste management in the study area. Finally, the paper suggests a few policy measures based on field survey.

Evaluation of analgesic activity of simvastatin and atorvastatin in Wistar rats: An experimental study

Background: The statins are a group of hypolipidemic drugs that are commonly prescribed in cases of altered lipid profile mainly raised low-density lipoprotein levels. They stabilize atherosclerotic plaques and are useful in preventing coronary and cerebrovascular accidents. In addition to these effects, few studies have shown that statins such as atorvastatin and simvastatin have analgesic and anti-inflammatory activities. Aims and Objectives: This study has been undertaken to confirm the analgesic activity of these statins which might prove to be better-tolerated alternatives to the non-steroidal anti-inflammatory drugs which though are efficient in reducing pain but lead to a large number of adverse effects on the long term and injudicious use. Materials and Methods: Atorvastatin and simvastatin, in doses of 10 mg/kg each, were administered orally to two groups (n = 6) of rats (experimental groups) against a control group receiving normal saline (n = 6) and a standard group receiving aspirin (n = 6). The animals were then subjected to tail-flick test at 0, 30, 60, 90, and 120 min after drug administration, and the parameters were recorded. Results: Both the experimental groups receiving atorvastatin and simvastatin showed a significant increase in mean reaction time in the tail-flick test as compared to the control group receiving normal saline (P < 0.05). The increase in reaction time for the group receiving simvastatin was comparable with that of aspirin, a well-known analgesic. Conclusion: Both atorvastatin and simvastatin are found to have analgesic activities in Wistar rats, and the analgesic activity of simvastatin is comparable to that of aspirin.

We No Longer Need to Stress Ulcer Prophylaxis in the Critically Ill

Preventing stress gastropathy has been a mainstay in the management of critically ill patients for decades. A landmark trial in 1994 identified the most significant risk factors for stress gastropathy as mechanical ventilation for greater than 48 h and primary coagulopathy. Since this study's publication more than two decades ago, the incidence of clinically significant gastrointestinal bleeding secondary to stress gastropathy has significantly declined. In addition, the most widely used agents for prophylaxis have been associated with an increasing number of adverse effects, including myocardial infarction, Clostridium difficile infection, osteoporosis and ventilator associated pneumonia. As the incidence of significant bleeding decreases and the knowledge about prophylaxis-related adverse events increases, it is necessary to revisit current clinical practice. Major practice changes, including early aggressive fluid resuscitation and development of dynamic markers for volume status, have reduced the likelihood for prolonged hypoperfusion states. Additionally, the recognition of the important of enteral nutrition early in the ICU stay encourages mesenteric perfusion and reduces risk for development of ischemic damage. Contemporary studies have failed to replicate significant rates of gastrointestinal bleeding, likely in part due to these advances in care. Recent studies, including a pilot randomized trial, are questioning the necessity of pharmacologic prophylaxis in the modern era, with undetectable rates of gastrointestinal bleeding in enrolled patients. Patients with risk factors for stress gastropathy who demonstrate no evidence of splanchnic hypoperfusion may not benefit from receiving stress ulcer prophylaxis and tolerance of enteral nutrition may be used as a surrogate marker for adequate perfusion. Overall there is a lack of high quality data supporting stress ulcer prophylaxis in the modern era.

TREATMENTS OF HEPATITIS C VIRUS LIVER CIRRHOSIS WITH PEGYLAT INTERFERON-RIBAVIRIN AND INTERFERON FREE – COMPARATIVE STUDY

The article describes the adverse effects and efficiency of hepatitis C virus liver cirrhosis treatments available through the National Health Insurance Services, on a population of patients hospitalized at Victor Babes Infectious and Tropical Diseases Hospital, from 2012 to 2016. The population of patients was split into two distinct groups, for which we’ve recorded and comparatively analyzed demographic, clinical and paraclinical characteristics in a database. An evident success was recorded, from the point of view of hitting a clinical SVR index, in the DAA therapy group A, 87% percent compared to 2% in group B for the traditional standard therapy of PegInterferon + Ribavirin. Likewise, the number of adverse effects was lower in Group B versus Group A. Some side effects remained specific to the current cirrhosis treatment, which should be closely monitored.

International Real Estate Review

Incineration plants and derelict industrial sites can have a number of adverse effects on the local environment and social welfare, including the diminution of property values. Although there are many incineration plants in China, there has been relatively little research done to quantify their negative externality effects. This study therefore considers the effects of three municipal incineration plants in Hangzhou city on residential property values. Hedonic pricing modeling of 2,200 residential transactions in over 70 multifamily buildings within ten kilometers of the incineration plants over a one year period including 2014 and 2015 is carried out. Generally, the results show that the neighboring properties show decreases in the initial listing price of up to 25%, declining until the effect is gone about three kilometers from the incinerator. The most consistent losses are approximately 10% between 1-2 kilometers from the nearest incinerator. These results are comparable to similar situations in the United States and Canada.

Evidence for Biocompatible Peritoneal Dialysis Solutions.

Glucose-based peritoneal dialysis (PD) solutions are the mainstay of therapy for PD patients, yet are accompanied by a number of adverse effects and potential complications. The high glucose content can cause both systemic effects, such as hyperglycaemia, as well as local effects on the peritoneal membrane, which can interfere with its function. In addition, glucose degradation products (GDPs) generated during heat sterilization of the solutions and the acidic pH at which these solutions are kept have been shown to cause peritoneal membrane injury and precipitate inflow pain, respectively. As a result, biocompatible PD solutions, characterized by neutral pH and low GDP concentrations, have been developed. However, the published evidence supporting their use has often been conflicting and of variable methodological quality. This review aims to discuss the relevant literature and up-to-date evidence for the use of biocompatible PD solutions.

Phytochemicals in the treatment of hyperpigmentation

Phytochemicals in the treatment of hyperpigmentation Ashley K Clark,1 Raja K Sivamani2 1University of California, Davis School of Medicine, 2Department of Dermatology, University of California &ndash; Davis, Sacramento, CA, USA Abstract: Treating hyperpigmentation can be challenging and an expanded arsenal is needed to aid in the improvement of topical treatments. The current gold standard treatment is hydroquinone. However, it has been associated with a number of adverse effects, including skin irritation, contact dermatitis, and exogenous ochronosis in people of darker complexion. Cosmeceuticals are topical cosmetic-pharmaceutical hybrids containing biologically active ingredients that may improve the appearance of skin and are increasingly popular alternatives to standard agents. Among cosmeceuticals, plant derived compounds, known as phytochemicals, have been shown to have a multitude of cellular actions for various dermatological diseases. This review examines the latest clinical studies using plant-derived compounds and their effectiveness in the management of hyperpigmentation disorders. Keywords: phytochemicals, botanical, hyperpigmentation, melasma, lentigines

Engaging Critically Ill Patients in Symptom Management: Thinking Outside the Box!

Caring for critically ill patients receiving mechanical ventilation in the intensive care unit (ICU) is an immense challenge for clinicians. Interventions to maintain physiological stability and life itself can cause a number of adverse effects that have a marked impact on patients beyond the period of critical illness or injury. These ICU-acquired conditions include but are not limited to weakness, depression, and post-intensive care syndrome, all of which markedly affect patients' quality of life after they leave the unit. How best to manage the many symptoms experienced by patients undergoing mechanical ventilation without contributing to adverse ICU-acquired sequelae remains a daunting charge for clinicians and requires innovative "out of the box" approaches to address these complex issues. Systematic, cutting-edge research is needed to challenge the "usual" way of managing ICU patients in order to provide the best available evidence for practice integration that minimizes adverse, ICU-acquired sequelae and improves outcomes for the most vulnerable patients. This article highlights a program of research focused on interventions for managing symptoms in critically ill patients receiving mechanical ventilatory support, including the appropriate empowerment of symptom self-management by patients undergoing mechanical ventilation. Development and testing of innovative, nontraditional interventions specifically tailored for ICU patients receiving mechanical ventilatory support are presented. Music listening is highlighted as a nonpharmacological, adjunctive intervention to reduce anxiety associated with mechanical ventilation. Patient-controlled sedation is discussed as an alternative method to meet patients' highly individual needs for sedative therapy to promote comfort.

QT interval prolongation and torsade de pointes: Synergistic effect of flecainide and H1 receptor antagonists

A high percentage of patients having atrial fibrillation (AF) presents with paroxysmal AF. Flecainide, the prototypic class Ic anti-arrhythmic drug is the most effective drug to maintain sinus rhythm in this subgroup of patients, though the drug has potential pro-arrhythmic effects. Furthermore, the H1 receptor antagonists are the most commonly prescribed drugs for the symptomatic treatment of pruritus. Despite having low number of adverse effects, the H1 receptor antagonists have cardiotoxic effects. Flecainide and H1 receptor antagonists present arrhythmic complications including QT interval prolongation and torsade de pointes (TdP). The case presented here is a 65-year-old female who was diagnosed of atrial fibrillation and presented with rashes in lower extremities. The patient was treated using flecainide and H1 receptor antagonists (loratadine and hydroxyzine) that prolonged QT interval and induced TdP. The concomitant administration of flecainide and H1 receptor antagonists seems to have a synergistic effect in QT interval prolongation and subsequent TdP. The concurrent administration of H1 receptor antagonists to patients receiving class Ic anti-arrhythmic drugs should be avoided in order to reduce arrhythmic risk in this population.

Boosting or Hindering Aid Effectiveness? An Assessment of Systems for Measuring Donor Agency Results

SummaryAmid rising criticism of aid effectiveness coupled with tight budgets in many donor countries at a time of economic crisis, donor agencies are under pressure to deliver value for money and to demonstrate development results. In response to these pressures, more and more donor agencies are adopting standard indicators, which allow for results to be aggregated across interventions and countries, in order to report agency‐wide results. This article analyses the reporting practices of eleven bilateral and multilateral donor agencies and assesses the implications of agency‐wide results measurement systems for aid effectiveness. The analysis shows that the data on aggregate results provided by donor agencies is only of limited informational value and does not provide an adequate basis for holding donor agencies to account. Moreover, reporting on agency‐wide results may have a number of adverse effects. Given the various limitations and risks identified in this article, I suggest that donor agencies should explore complementary options or alternatives to standard indicators in order to meet their reporting requirements. Donor agencies are advised to invest more in rigorous impact evaluations and to raise the transparency of individual interventions. © 2016 The Authors. Public Administration and Development published by John Wiley &amp; Sons Ltd.

The Efficacy of Combination Therapy by Adalimumab with Methotrexate and of Monotherapy by Methotrexate for Children Suffering from Polyarticular Juvenile Idiopathic Arthritis

Background : The use of genetically engineered biological agents in patients with juvenile idiopathic arthritis (JIA) allows to achieve good results in treatment. However, their efficacy in patients refractory to basic antirheumatic drugs, requires further analysis. Objective : To study the efficacy and safety of the combination therapy by adalimumab with methotrexate and of the monotherapy by methotrexate in children with JIA. Methods : It was conducted a perspective (annual) comparative research with the analysis of the results of treating children with polyarticular seronegative JIA refractory to basic immunosuppressive therapy. The efficacy was assessed by ACRpedi criteria and by dynamics of values of cellular and humoral immunity indicators. Safety was determined by the number of adverse effects. Results : The combination therapy by methotrexate with adalimumab for children with JIA (n = 14) in a shorter time than the monotherapy by methotrexate (n = 17) induced arthritis remission. After 46 weeks of treatment, the remission of arthritis and the normalization of laboratory findings were reported in 6 (43%) patients treated by adalimumab with methotrexate, and in 3 (18%) children — methotrexate (p = 0.233); adverse effects — in 4 (29%) and 14 (82%) cases (p = 0.004), respectively. No serious adverse effects have been registered. Conclusion : The prescription of adalimumab in combination with methotrexate in children with JIA, refractory to basic immunosuppressive therapy, allows to achieve rapid remission of the disease while preserving the effect in a significant number of patients within 46 weeks of therapy.