Epidemiology of hip fractures in Bulgaria: development of a country-specific FRAX model.

A retrospective population-based survey was undertaken in a region of Bulgaria to determine the incidence of hip fracture. The estimated number of hip fractures nationwide for 2015 was 9322 and is predicted to increase to 11,398 in 2050. The hip fracture rates were used to create a FRAX model. OBJECTIVE: To describe the epidemiology of hip fractures in Bulgaria, which was then used to develop the country-specific fracture prediction FRAX® tool. METHODS: We carried out a retrospective population-based survey in Stara Zagora, Bulgaria, representing approximately 4.6% of the country's population. We identified hip fractures occurring in 2015, 2016 and 2017 from hospital registers and primary care sources held by the regional health insurance agency. Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Bulgaria. Fracture probabilities were compared with those from neighbouring countries having FRAX models. RESULTS: The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 9322 and is predicted to increase to 11,398 in 2050. FRAX-based probabilities were higher in Bulgaria than those in Serbia or Romania, lower than those in Turkey and similar to those in Greece. CONCLUSION: The FRAX model should enhance accuracy of determining fracture probability among the Bulgarian population and help guide decisions about treatment.

Melatonin receptor 1b polymorphisms in women with Systemic Lupus Erythematosus.

AIM: The pineal hormone melatonin could exert an important influence on the immune system and autoimmunity. Its effect on the immunocompetent cells might be mediated at least partially through specific melatonin receptors. However, the role of melatonin - melatonin receptor 1B (MTNR1B) interrelations in human autoimmune diseases is still unknown. Therefore, the present study aimed to investigate the possible influence of the MTNR1B gene polymorphisms for the development and clinical expression of systemic lupus erythematosus (SLE). METHODS: 109 female SLE patients and 101 healthy women were genotyped for the MTNR1B rs1562444, rs10830962 and rs10830963 polymorphisms. RESULTS: No genotype distribution differences were found between patients and controls. The presence of MTNR1B rs10830963 C/C genotype was related to increased prevalence of leucopenia compared to genotypes C/G and G/G after Bonferroni correction for multiple comparisons [36.5% vs. 14.5%, p=0.014]. Moreover, the rs10830963 G/G carriers had lower number of lupus criteria in comparison to patients with C/C genotype. CONCLUSIONS: The present data suggested that MTNR1B polymorphisms could influence the clinical features in lupus patients, and especially the susceptibility to leucopenia.

[Alpha-2 macroglobulin in serum and synovial fluid of patients with rheumatoid arthritis and osteoarthrosis]. / Alpha2-makroglobulin v syvorotke i sinovial'noi zhidkosti bol'nykh revmatoidnym artritom i osteoartrozom.

AIM: To study concentrations of alpha-2-macroglobulin (A-2-MG) in blood serum and synovial fluid (SF) in patients with rheumatoid arthritis and formulation of basic clinical, laboratory and x-ray criteria of RA activity. MATERIALS AND METHODS: A-2-MG levels were measured in the serum and SF from 151 RA patients and in the serum of 20 patients with osteoarthrosis (OA) and 62 healthy donors. The serum concentration for RA patients was 166 +/- 65.3 mg%, for OA patients--175.26 +/- 36.99 mg% and for healthy donors--177.772 +/- 50 mg%. Mean concentration of SF A-2-MG in RA patients was 98.77 +/- 82.43 mg%. CONCLUSION: Changes in the concentration of A-2-MG are unrelated to inflammation activity in the joints of RA and OA patients. Serum and synovial concentration of this protein corresponds to changes in the concentration of IgM and rheumatoid factors in RA patients.

[The early and late treatment results with azathioprine in Behçet's syndrome]. / Ranni i kusni rezultati ot lechenieto na sindroma na Behçet s azathioprin.

Four patients (one man and 3 women) with generalized form of Behçet's syndrome with 3-7 years duration were followed up. Prior admission to the clinic the patients had been treated symptomatically, two of them with cyclophosphamide and one patient with corticosteroids without effect. In the clinic they were treated with Azathioprin 2 mg/kg body mass. At the end of the second month remission of the disease was registered in all four patients which lasts without discontinuing the treatment in one of the patients 7 years, in the second patient--4 years, in the third patient--3 years and in the fourth patient--2 years. The supporting treatment is 1 mg/kg body mass of Azathioprin which begins at the end of the first year after achieving a stable clinical remission. No side effects were observed.

[The sensitivity and specificity of the ARA diagnostic criteria for osteoarthrosis of the knee joint (1986). American Rheumatism Association]. / Chuvstvitelnost i spetsifichnost na ARA-diagnostichnite kriterii za osteoartroza na koliannata stava (1986).

The sensitivity and specificity of the ARA criteria for osteoarthrosis of the knee joint (1986) were studied in 61 clinically ill patients. It was established that the diagnostic sensitivity and specificity for the group of clinical and laboratory criteria is 89.2% and 75% respectively, for the clinical and roentgenologic--91.9% and 83.3% and for the classical criteria--94.6% and 70.8%.