[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.

[The influence of exercise therapy on the psychological status of women presenting with osteoporosis].

The objective of the present study was to evaluate effectiveness of correction of the psychological status of postmenopausal women suffering primary osteoporosis (OP) by means of exercise therapy. Diagnosis of OP was verified by dual energy X-ray absorptiometry. The degree of depression was assessed using the CES-D questionnaire and that of reactive anxiety by the C.D. Spielberger and Yu.L. Khanin method. A visual-analogue scale was used to obtain self-assessment of the patients' health and pain intensity. Physical rehabilitation was shown to cause reduction of reactive anxiety and alleviate pain syndrome. As a result, the quality of the patients' life improved regardless of OP severity. However, beneficial effect of exercise therapy was apparent only in patients presenting with mild and moderately severe anxiety/depressive disorders but was lacking in more serious cases.

[Possibilities of non-medicine correction of the quality of life and autonomic regulation in elderly women with osteoporosis].

It was investigated possibilities correction of quality of life and vegetative regulation in women with a primary osteoporosis in postmenopausal period by means of physiotherapy exercises course. Significant improvement of quality of life in patients with osteoporosis for the account antidepressive and analgesic properties of physiotherapy exercises, normalizing influence of physical rehabilitation on sympathetic department of vegetative nervous system is revealed. Dependence of influence of physiotherapy exercises on a condition of vegetative regulation of women with a primary osteoporosis from expressiveness of osteoporosis was established.

[Complex approach to treatment of patients with bone and joint pathology in a geriatric department].

The influence of therapeutic training of 240 patients with postmenopausal osteoporosis in combination with degenerate-dystrophic diseases of spine and joints on the awareness of the disease, dynamics of physical activity, and quality of life was studied. The training was conducted on the structured program for patients with osteoporosis and osteoarthrosis. It was worked out by the Family medicine department of Ural State Medical Academy. The program was revised by us and adapted to patients of gerontological hospital and given as "School for patients with chronic pain syndrome". The training was followed by the true increase of awareness of the disease and physical activity. In studying the quality of life, there were noticed improvements on the scale of pain, activity of work about the house, social activity and general status.