Abstract:
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. :Цель исследования. Анализ оказания консультативной медицинской помощи российским пациентам с глюкокортикоидным остеопорозом (ГК-ОП) или риском его развития. Материалы и методы. Исследование ГЛЮКОСТ организовано и проведено Российской ассоциацией по остеопорозу. Обследовали 1129 пациентов с хроническими воспалительными заболеваниями, длительно (3 мес и более) принимавших пероральные глюкокортикостероиды (ПО-ГКС). Пациенты самостоятельно заполняли анонимный вопросник. Оценивали соответствие принятых мер по диагностике, профилактике и лечению ГК-ОП основным положениям национальных клинических рекомендаций. Результаты. Знали, что длительное лечение ПО-ГКС может вызывать развитие остеопороза, 61,8% больных. Результаты остеоденситометрии подтвердили 48,1% респондентов; 78,1% больных сообщили о том, что врач назначал им добавки кальция и витамина D, но только 43,4% подтвердили их регулярный прием; 25,4% пациентов перенесли один низкоэнергетический перелом и более. Лечение по поводу ГК-ОП назначено 50,8% больным группы высокого риска переломов, а реально его получали 40,2% пациентов. Лечебно-диагностические мероприятия у мужчин проводились реже, чем у женщин. При осведомленности больного о ГК-ОП вероятность того, что он будет принимать добавки кальция и витамина D увеличивалась в 2,7 раза (при 95% доверительном интервале - ДИ от 2,1 до 3,5; р=0,001), соблюдать рекомендации по лечению - в 3,5 раза (при 95% ДИ от 2,3 до 5,3; р=0,001). Проведение остеоденситометрии повышало частоту назначения врачом противоостеопоротических препаратов и вероятность их приема пациентом. Заключение. По данным крупного российского исследования ГЛЮКОСТ, каждый четвертый больной с хроническим воспалительным заболеванием, принимающий длительную терапию ПО-ГКС, имеет один низкоэнергетический перелом и более. В связи с недостаточным уровнем консультации пациенты плохо информированы о своем заболевании и не получают необходимой помощи по его предупреждению. Менее 50% пациентам с ГК-ОП и высоким риском переломов проводится обследование и необходимое лечение, направленное на профилактику переломов.
journal_name
Ter Arkhjournal_title
Terapevticheskii arkhivauthors
Baranova IA,Ershova OB,Anaev EK,Anokhina TN,Anoshenkova ОN,Batyn SZ,Belyaeva EA,Bolshakova TY,Volkorezov IA,Eliseeva LN,Kashnazarova EV,Kinyaikin MF,Kirpikova MN,Klyuchnikova EP,Korolev MA,Kuneevskaya IV,Masneva LV,Muradoi
10.17116/terarkh201587558-64subject
Has Abstractpub_date
2015-01-01 00:00:00pages
58-64issue
5eissn
0040-3660issn
2309-5342journal_volume
87pub_type
杂志文章abstract:AIM:To analyse epidemiologically chronic heart failure (CHF) according to 1996 records for patients admitted to therapeutic and cardiological departments of Moscow city hospital N 64. MATERIALS AND METHODS:An individual sheet has been developed for computer. The statistical processing has been conducted according to A...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract:AIM:To evaluate telmisartan effects on 24-h blood pressure profile, sensitivity to insulin, carbohydrate and lipid metabolism in patients with metabolic syndrome (MS) and arterial hypertension (AH). MATERIAL AND METHODS:Twenty patients with MS and AH of the degree I-II received telmisartan in a dose 80 mg/day. 24-h BP...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract::A study was made of the rate of the cultivation of opportunistic bacteria (OB) from the feces of different groups of patients, normal persons and those examined in accordance with epidemic indications as well as of serological modulations in autogenous strains of the bacteria. The rate of the cultivation of the differ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::Diphtheria morbidity among adult population of Moscow is growing. The tests of different modes and schemes of heterogeneous antidiphtheria serum administration have found out that the highest efficacy of serotherapy was achieved with a single intravenous dose. Another treatment of diphtheria is hemosorption. Widely us...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::The authors describe the status of lipid peroxidation (diene conjugates and malonic dialdehyde) and the endogenous antioxidant enzyme superoxide dismutase in the course of the treatment of patients with acute focal pneumonia by means of the use of transthoracic intrapulmonary injections of unithiol and autologous ultr...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::The content of acetylcholine, histamine and the total amount of catecholamines were measured in blood of 33 patients with bronchial asthma, in 6 patients with preasthma and in 10 practically normal subjects before and after the use of graded exercise (bicycle ergometry). Subgroups of the patients with asthma of effort...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:AIM:To estimate cost-effect efficacy of vasaprostan treatment of inpatients with arterial chronic obliteration (ACO) with critical ischemia of the lower limbs (Fonten stage III-IV). MATERIAL AND METHODS:Case histories of 105 ACO patients with critical ischemia of the lower limbs (mean age 65 +/- 11.8 years) were analy...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:AIM:To study efficacy, safety, cardiohemodynamic effects of ID aerosol--isoket--for relief of anginal attacks and their prevention in long-term treatment. MATERIALS AND METHODS:15 patients with ischemic heart disease suffering from stable angina class II-III. Isoket was tried for efficacy, tolerance, hemodynamic param...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::A study was made of the presence of antinuclear antibodies to Ro, La, nDNA, RNP and Sm in 18 patients with Sjögren's disease (SD) and in 13 patients with Sjögren's syndrome (SS). Anti-Ro and/or anti-La were revealed in 12 SD patients (67%) and in 3 SS patients (23%, P less than 0.05) only. Anti-nDNA and anti-RNP were ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:AIM:To characterize clinically and electrocardiographically the condition of the heart in chronic iron deficient anemia (IDA), to study hemodynamic mechanisms of heart impairment for early detection of diastolic myocardial dysfunction in long-term course of sideropenia. MATERIAL AND METHODS:Clinical and ECG examinatio...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:AIM:To study effects of long-term administration of ACE inhibitor ramipril (hartil) on renin-angiotensin-aldosteron system (RAAS), dynamics of clinical symptoms of the disease and structural-functional indices of the right and left ventricle (RV, LI) in patients with chronic obstructive pulmonary disease (COPD) with de...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2008-01-01 00:00:00
abstract:AIM:To study effects of long-term morphine-clofelin epidural analgesia and infusion of nitroglycerin on formation of the necrosis focus and the clinical course of acute myocardial infarction (MI). MATERIAL AND METHODS:Ninety patients were examined within the first 12 hours of anterior macrofocal MI. Forty six patients...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract::The most important condition for effective prophylactic medical examination is early detection of diseases. The efficacy of prophylactic medical examination of rheumatic fever patients rises considerably under the conditions of stage-by-stage therapy. Another important condition for early detection and diagnosis is ra...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:AIM:To compare effectiveness of two long-acting calcium antagonists--amlodipin and diltiazem--in patients with ischemic heart disease (IHD) and stable angina of effort (SAE). MATERIAL AND METHODS:31 IHD patients with SAE entered the double blind randomized trial. The patients received either amlodipin (5-10 mg once a ...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2001-01-01 00:00:00
abstract:AIM:to compare respiratory function and laboratory data with the radiographic stages of intrathoracic sarcoidosis. SUBJECTS AND METHODS:Three hundred and eleven patients (70.4% for women and 29.6% for men; mean age, 44.7±0.6 years) with histologically verified sarcoidosis underwent X-ray computed tomography, spirograp...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh201587348-52
更新日期:2015-01-01 00:00:00
abstract:AIM:to assess the long-term angiographic and clinical results of percutaneous coronary interventions (PCI) with implantation of the drug-eluting stent (DES) Apollo in patients with stable angina pectoris. SUBJECTS AND METHODS:The study enrolled 48 patients with stable angina who had been implanted with 59 stents. A fo...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract::The results of hemodialysis therapy given in 1988-1994 to 57 patients with acute renal failure at the age of 17-62 years in hemorrhagic fever with renal syndrome (HFRS) are provided. A total of 306 procedures were performed. Hemodialysis was initiated early, before clinical presentation of uremia. The indications for ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::Clinical parameters have been studied in 45 peptic ulcer patients without and 47 ones with acute hemorrhage. Factors of acute hemorrhage risk in ulcer patients have been specified (old age, long history of the disease, previous hemorrhages, duodenal ulcer localization at the back and upper walls and gastric ulcer loca...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract:AIM:To develop and implement intervention programmes for patients with mitral prolapse (MP) under real conditions of general medical practices of Russia in the transition period. MATERIAL AND METHODS:The MP register covered 208 patients among the adult population (n = 3346) of 2 districts served by general practitione...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract::Catecholamines metabolism (24-h excretion, circadian rhythm of DOPA, dopamine, homovanillic acid, adrenaline, noradrenaline, vanilmandelic acid) was investigated in 124 young males with stage I essential hypertension treated by cranial electrostimulation. Relative activity of this metabolism stages was assessed. Patie...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::It has been shown that electrocardiotopography applied during the exercise test in patients with coronary heart disease makes the test more sensitive without changing its specificity as compared with the ECG in common 12 leads. The depression of the ST segment occurs on the electrocardiotopogram in the areas of the pr...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:AIM:Determine whether bone mineral density (BMD) assessed by dual-energy x-ray absorptiometry can be used as predictor of increased risk of death in hemodialysis patients. MATERIALS AND METHODS:A prospective study was performed of 516 patients with chronic kidney disease treated with hemodialysis (men 265, women 251, ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/00403660.2020.06.000277
更新日期:2020-07-09 00:00:00
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journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::The authors present pilot experience in extracorporeal blood purification (hemosorption, plasmapheresis) aimed at correction of cardiac arrhythmia. Seven responders of 8 patients treated had less frequent episodes of cardiac fibrillation the severity of which decreased, they suffered no more from high-grade extrasysto...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::Hepatic involvement in yersiniosis is associated with clinical symptoms of hepatitis, sometimes dominant in the clinical picture. Such cases need differentiation of yersiniosis with viral hepatitides A and B. Clinical and biochemical findings were compared for matched patients with yersiniosis-induced hepatic lesions,...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::The clinical picture of chronic obstructive bronchitis (COB) coupled with lung emphysema and diffuse pulmonary fibrosis studied in 198 patients was characterized by the autonomous and emotional syndrome which depended largely on the presence and degree of arterial hypoxemia, abnormality of lung ventilation, the degree...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::The authors summed up the results of a many-year study of 13 children with Sjogren's diseases and syndrome, presented clinical characterization of patients, a course of this childhood pathology, some therapeutic problems and catamnestic data. An excerpt from a case history of a child with Sjogren's syndrome was given....
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::Serum bile acids were studied in 27 patients with chronic noncalculous cholecystitis. It was ascertained that the total concentration of bile acids under study was appreciably increased as compared with the data derived in the control group patients. There was noticeable differences between modulations in individual f...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:AIM:The goal is to present the possibilities of diagnosis verification, the features of the clinical picture of tuberculous pericarditis in the therapeutic clinic and the results of its treatment. MATERIALS AND METHODS:The paper presents clinical observation and a general analysis of 10 cases of tuberculous pericardit...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/terarkh201890981-87
更新日期:2018-09-20 00:00:00
abstract::High-intensity impulse laser radiation proved effective in 23 patients with esophageal candidiasis. The highest effect was achieved in its use with nistatin. In low laser efficacy radiation should be combined with transendoscopic administration of granulocytes concentrate. This produced clinico-endoscopic remission in...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00