[Analysis of the state-of-the-art of consulting medical care to patients with glucocorticoid-induced osteoporosis or its risk according to the data of a questionnaire survey (GLUCOST study)].

AIM: To analyze the state-of-the-art of consulting medical care to Russian patients with glucocorticoid-induced osteoporosis (GCOP) or its risk. SUBJECTS AND METHODS: This GLUCOST study was organized and conducted by the Russian Association of Osteoporosis. A total of 1129 patients with chronic inflammatory diseases, who had been taking oral glucocorticosteroids (OGCSs) a long time (3 months or more), were examined. The patients filled out an anonymous questionnaire on their own. Whether the measures taken to diagnose, prevent, and treat GCOP complied with the main points of Russian clinical guidelines was assessed. RESULTS: 61.8% of the patients knew that the long-term treatment of GCOP might cause osteoporosis. 48.1% of the respondents confirmed the results of bone densitometry; 78.1% of the patients reported that they had been prescribed calcium and vitamin D supplements by their physician, but their regular intake was confirmed by only 43.4%; 25.4% of the patients had sustained one low-energy fracture or more. Treatment for GCOP was prescribed for 50.8% of the patients at high risk for fractures, but was actually received by 40.2%. Therapeutic and diagnostic measures were implemented in men less frequently than in women. When the patient was aware of GCOP, the probability that he/she would take calcium and vitamin D supplements rose 2.7-fold (95% Cl; 2.1 to 3.5; p = 0.001) and that he/she would follow treatment recommendations did 3.5-fold (95% Cl; 2.3 to 5.3; p = 0.001). Bone densitometry increased the prescription rate for antiosteoporotic medication and patient compliance. CONCLUSION: According to the data of Russia's large-scale GLUCOST survey, every four patients with chronic inflammatory disease who are on long-term OGCS therapy have one low-energy fracture or more. Due to inadequate counseling, the patients are little aware of their health and do not get the care required to prevent the disease. Less than 50% of patients who have GCOP and a high risk for fractures undergo examination and necessary treatment aimed at preventing fractures.

[Role of the muscle factor in the pathogenesis of painful forms of syringomyelia]. / Rol' myshechnogo faktora v patogeneze algicheskikh form siringomielii.

On the basis of examining the disease histories of patients with syringomyelia it was found that in 68.7% of the cases the disease began from algic manifestations. Under observation there were 48 patients with syringomyelia who complained of pains in the neck and the upper extremities. A connection between the algic syndrome and the pathology of the vertebral column cervical division was noted. It was local myopathosis which was found to be the principle factor causing the algic manifestations. It was discovered even in patients who had no cervical osteochondrosis. When the deep was discovered even in patients who had no cervical osteochondrosis. When the deep sensitivity was affected the myopathoses could not be determined. The myopathoses were characterized electromyographically by the presence of constant bioelectrical activity registered by needle electrodes. In the spectrum of motor unit activity shortened and prolonged potentials were revealed simultaneously. The regional circulatory changes in the upper extremities were found to be connected to a considerable extent with the intensity of the algic manifestations in local myopathoses. Segmental message is an effective means for eliminating the local myopathoses.

[Development of a test system for detection of anti-endotoxic immunity in young children, healthy donors and some groups of therapeutic patients]. / Razrabotka test-sistemy dlia detektsii antiéndotoksicheskogo immuniteta u detei rannego vozrasta, zdorovykh donorov i nekotorykh grupp terapevticheskikh bol'nykh.

The content of antibodies to soluble lipid A detritus was studied with the use of the enzyme immunoassay techniques. Some regularities of anti-endotoxic immunity were established: the elevated level of anti-lipid A antibodies in chronic bronchial tree diseases of bacterial etiology. On the other hand, cases of severe purulent septic infections in young children were found to be accompanied by a considerable decrease in the titer of anti-endotoxic antibodies. The approaches to the therapy of diseases caused by Gram-negative bacteria by means of specific immunoglobulins are discussed.

[Ground-based speleo-climatic wards and the experience with their use in bronchial asthma]. / Nazemnye speleoklimaticheskie palaty i opyt primeneniia pri bronkhial'noi astme.

Ambient air in ground wards made to contain natural potassium-sodium salt is close in characteristics to the atmosphere of underground wards but has a number of specificities: daily fluctuations of concentrations of light aeroions and aerosol particles, elevated concentration of light aeroions concentration, low radiation background, minimal bacterial contamination. The stay in ground wards brings great benefit for patients with bronchial asthma. Ground speleo-climatic wards are perspective in nonpharmacological treatment of patients with allergic respiratory diseases.