There were analysed bone mineral density (BMD) and spine roentgenograms in 15 candidates to heart transplantation and 24 recipients of heart transplantation in early (till 1 year) as far as late (till 12 years) period following operation. BMD showed axial osteopenia in terminal heart failure and early period after heart transplantation. There was progressive fail of axial and hip BMD in late period following heart transplantation to the degree of osteoporosis (axial osteoporosis was 3 times more often in late then in early period after operation while femur osteoporosis was only in late period). Femur BMD in neck, trochanter and Ward triangle inverse correlated with cumulated prednisolone dose. Ward triangle BMD inverse correlated with cumulative cyclosporine dose while axial BMD did not correlate any immunosuppressive drug. Vertebra fractures arised in terminal heart failure and did not progress after heart transplantation.
The aim of this study was to assess the effectiveness of the combined treatment with calcium and middle (400 mg daily) or high doses (800 mg daily) of vitamin D for prevention of osteoporosis in postmenopausal women with osteopenia in spine. Thirty patients, 45-70 years old, were divided into 3 equal groups: the women in the group 1 were treated with vitamin D3 400 IU. and calcium 1000 mg daily; the women in the group 2 received vitamin D3 800 IU and calcium 1000 mg daily; the patients from the group 3 did not receive any supplementation - the control 1 group. A significant increase in BMD was found at lumbar spine (+1.9 % after 6 months, p
The aim of study was tolerability and causes of discontinuation to alendronate 70 mg OW therapy in nonresearch real world setting. We prospectively analyzed 427 female patients (67+8,2years) newly prescribed with alendronate 70mg OW for postmenopausal osteoporosis and followed up during a year. The background of GI diseases was reported in 64% of patients, while 36% were receiving three or more concomitant medications. 30% of patients discontinued therapy throughout the year. The most frequent reasons for treatment discontinuation were unaffordable price of alendronate (20% of all patients; 68% of all discontinuation cases) and GI complaints (9%;29,6%), despite most cases were not assumed to be related to the drug. There were only 3 cases of intolerance to alendronate (0,7%;2,3%). In persistent patients alendornate was overall well tolerated; in 22% of them minor or mild dyspepsia was reported. The incidence of dyspepsia was not associated with the presence of GI diseases (p=0,953). The study suggests that a large proportion of GI adverse experiences seen on aledronate treatment may not have causal relationship to therapy. The high rate of GI diseases and concomitant drugs in osteoporosis patients are underestimated in clinical practice.
It is well known that clinical signs of endogenous hypercorticism including secondary osteoporosis rapidly reverse on the base of hormonal remission after radiosurgical treatment of Cushing's disease (CD). The aim of the study was to assess BMD and bone turnover biochemical markers in postmenopausal women with complete CD-remission. We examined 43 women aged 38-67 years in physiological postmenopause who had a complete long-term hormonal CD-remission for at least 2 years (11±6,8 years in average) after combine treatment with hemiadrenalectomy and radiosurgery. Control group comprised 98 healthy postmenopausal women at the same age and postmenopausal age. Our main findings were BMD in postmenopausal CD-patients was higher vs. controls in lumbar spine (1,233±0,17 vs. 1,146±0,20 g/cm2, p
The aim of this study was to assess effectiveness ant tolerability of alendronate in women suffered of postmenopausal osteoporosis. 15 postmenopausal women with primary osteoporosis (age 61.0±4.8 (M±σ) years) was administered alendronate in dosage 70 mg weekly with calcium supplementation (1000 mg daily) for 12 months. Control group consisted of 19 women also suffered from postmenopausal osteoporosis (age 61.7±5.2 years) received only calcium salts for study period. There was a significant increase vs baseline in BMD in lumbar spine (in 2.1% in 6 months and in 2.7% in 12 months), in femoral neck from (in 2.1% and 3.3% accordingly), in trochanter (in 5.5% and 6.3% accordingly) and in total proximal femur (in 2.9% and 1.9% accordingly) in treated patients. We also found in treated group a marked decrease in serum ionized calcium from 1.24±0.03 to 1.21±0.03 mmol/l in 6 months and to 1.2±0.04 mmol/l in 12 months (р
У 30 больных (в возрасте 20-46 лет) терминальной хронической почечной недостаточностью (ТХПН), получающих лечение перитонеальным диализом (ПД), проведено сопоставление результатов денситометрии периферического (дистального отдела предплечья, проксимального отдела бедренной кости) и центрального скелета (поясничного отдела позвоночника), изучено состояние кальций-фосфорного обмена и биохимических маркеров костного метаболизма (активность общей щелочной фосфатазы - ЩФ и базальная концентрация паратиреоидного гормона - ПТГ). Остеопенический синдром диагностирован у 73,3% больных по результатам денситометрии дистального отдела предплечья, у 71,4% - по результатам денситометрии проксимального отдела бедренной кости и у 46,7% - по результатам денситометрии поясничного отдела позвоночника (различия статистически недостоверны). Тяжесть дефицита костной массы также не различалась в костях периферического и центрального скелета. Определялась прямая корреляционная зависимость между показателями денситометрии дистального отдела предплечья, с одной стороны, и показателями денситометрии проксимального отдела бедра и поясничного отдела позвоночника, с другой стороны. Больные с вторичным гиперпаратиреозом имели различную степень выраженности остеопении. Состояние кальций-фосфорного обмена характеризовалось склонностью к гипокальциемии (Саиониз.1,0±0,1ммоль/л), гиперфосфатемией (2,2±0,2ммоль/л) и увеличением произведения СахР(4,7±0,4ммоль2/л2). Усредненная активность общей ЩФ составила 402±233 ед/л (границы физиологической нормы 80-295), усредненная по группе базальная концентрация ПТГ - 646±318 пг/л (границы физиологической нормы 11-62); между ними установлена прямая корреляционная зависимость. При рентгенографи кистей у 2/3 больных определялось изолированное снижение рентгенопрозрачности костей или в сочетании с начальными или выраженными признаками вторичного гиперпаратиреоза. Результаты денситометрии периферического и центрального отделов скелета у больных ТХПН, получающих лечение ПД, являются одинаково информативными в диагностике остеопенического синдрома.