Background. The dermatosparaxial type of Ehlers-Danlos syndrome (EDSDERMS, VIIC, dEDS) is an extremely rare disorder. To date, 15 patients with this type of Ehlers-Danlos syndrome are known worldwide. The purpose was to improve knowledge and spread data about the orphan connective tissue disease — dEDS — on the example of a patient from a family in which the father and two sons have the same type of lesions. Materials and methods. We report a 6-year-old patient as well as his father and sibling with clinical symptoms of the dEDS, which we diagnosed based on the main diagnostic criteria: extreme skin fragility, craniofacial features, superficial skin trauma, wrinkling of the palms, especially when they are exposed to water for a long time, and a tendency to ecchymosis with a risk of subcutaneous hematomas and bleeding. Secondary diagnostic criteria were represented by atrophic scars, refractive errors (myopia), gingival marginal dysplasia, hypermobility of the finger and knee joints. The informed consent of the patient’s parents was obtained for the examination and publication of information, and the parents agreed to the publication of clinical photographs. Results. After laboratory and instrumental studies and consultations with related specialists (hematologist, geneticist, cardiologist, pediatrician, orthopedist, dermatologist), we excluded such diseases as Marfan syndrome, MASS-phenotype, congenital coagulopathies and thrombocytopathies, hemophilia, isolated vascular pathologies, as well as other types of Ehlers-Danlos syndrome and identified dEDS in the patient only clinically. Genetic testing did not reveal any pathological mutations or exonic deletions/duplications. The negative result of genetic testing in dEDS is due to the fact that certain types of mutations (e.g., deep intronic mutations) cannot always be detected by standard diagnostic genetic methods. Conclusions. It is possible to establish a diagnosis based on clinical symptoms, but an extended mutation search is mandatory for the entire family.
{"title":"Dermatosparaxis type of Ehlers-Danlos syndrome: case report","authors":"N.I. Balatska, O.A. Stroi, I.V. Grynevych, P.V. Husynin, O.P. Medvedieva, K.Yu. Kyrylchuk","doi":"10.22141/pjs.13.3.2023.385","DOIUrl":"https://doi.org/10.22141/pjs.13.3.2023.385","url":null,"abstract":"Background. The dermatosparaxial type of Ehlers-Danlos syndrome (EDSDERMS, VIIC, dEDS) is an extremely rare disorder. To date, 15 patients with this type of Ehlers-Danlos syndrome are known worldwide. The purpose was to improve knowledge and spread data about the orphan connective tissue disease — dEDS — on the example of a patient from a family in which the father and two sons have the same type of lesions. Materials and methods. We report a 6-year-old patient as well as his father and sibling with clinical symptoms of the dEDS, which we diagnosed based on the main diagnostic criteria: extreme skin fragility, craniofacial features, superficial skin trauma, wrinkling of the palms, especially when they are exposed to water for a long time, and a tendency to ecchymosis with a risk of subcutaneous hematomas and bleeding. Secondary diagnostic criteria were represented by atrophic scars, refractive errors (myopia), gingival marginal dysplasia, hypermobility of the finger and knee joints. The informed consent of the patient’s parents was obtained for the examination and publication of information, and the parents agreed to the publication of clinical photographs. Results. After laboratory and instrumental studies and consultations with related specialists (hematologist, geneticist, cardiologist, pediatrician, orthopedist, dermatologist), we excluded such diseases as Marfan syndrome, MASS-phenotype, congenital coagulopathies and thrombocytopathies, hemophilia, isolated vascular pathologies, as well as other types of Ehlers-Danlos syndrome and identified dEDS in the patient only clinically. Genetic testing did not reveal any pathological mutations or exonic deletions/duplications. The negative result of genetic testing in dEDS is due to the fact that certain types of mutations (e.g., deep intronic mutations) cannot always be detected by standard diagnostic genetic methods. Conclusions. It is possible to establish a diagnosis based on clinical symptoms, but an extended mutation search is mandatory for the entire family.","PeriodicalId":31851,"journal":{"name":"Bol'' Sustavy Pozvonocnik","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135855049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-13DOI: 10.22141/pjs.13.3.2023.384
I.P. Mazur, P.V. Mazur
Background. Studying the systemic influence of bone mineral density (BMD) and bone turnover on oral health and periodontal phenotype is relevant for predicting the course of periodontitis and making clinical decisions to achieve good treatment results. The purpose of the research is to study the oral health, periodontal phenotype, and bone metabolism depending on the BMD of the skeleton. Material and methods. One hundred and thirty-eight patients were examined and divided into three study groups depending on the BMD (Z-score): group І — increased BMD (Z-score > +1 SD), group ІІ (Z-score from +1 to –1 SD), group ІІІ (Z-score < –1 SD). The state of oral health, the severity and course of periodontal diseases, the peculiarities of bone metabolism according to biochemical markers of bone remodeling, and the BMD according to the results of dual-photon densitometry were determined. Results. Reduced bone turnover, resulting in decreased serum osteocalcin (18.96 ± 1.87 ng/ml in men and 19.11 ± 1.54 ng/ml in women), high level of parathyroid hormone was registered in patients with high BMD (group I). The oral health characteristics were identified, namely, the pathological tooth wear — abfraction (84.21 %) and attrition (76.31 %), the periodontal phenotype was characterized by a thick gingival biotype, mandibular exostoses, periodontitis and periodontitis were diagnosed. Increased bone turnover, active course of generalized periodontitis, thin gingival biotype, cervical caries and hyperesthesia of the dental hard tissues were registered in patients with low BMD (group III). Conclusion. The state of oral health, namely, the dental hard tissues, the periodontal phenotype has its own characteristics and are related to the morphotype of bone tissue — its BMD and bone metabolism. Such features must be taken into account when planning treatment measures for dental patients.
{"title":"Oral health, periodontal phenotype in patients with different mineral density (morphotypes) of bone tissue","authors":"I.P. Mazur, P.V. Mazur","doi":"10.22141/pjs.13.3.2023.384","DOIUrl":"https://doi.org/10.22141/pjs.13.3.2023.384","url":null,"abstract":"Background. Studying the systemic influence of bone mineral density (BMD) and bone turnover on oral health and periodontal phenotype is relevant for predicting the course of periodontitis and making clinical decisions to achieve good treatment results. The purpose of the research is to study the oral health, periodontal phenotype, and bone metabolism depending on the BMD of the skeleton. Material and methods. One hundred and thirty-eight patients were examined and divided into three study groups depending on the BMD (Z-score): group І — increased BMD (Z-score > +1 SD), group ІІ (Z-score from +1 to –1 SD), group ІІІ (Z-score < –1 SD). The state of oral health, the severity and course of periodontal diseases, the peculiarities of bone metabolism according to biochemical markers of bone remodeling, and the BMD according to the results of dual-photon densitometry were determined. Results. Reduced bone turnover, resulting in decreased serum osteocalcin (18.96 ± 1.87 ng/ml in men and 19.11 ± 1.54 ng/ml in women), high level of parathyroid hormone was registered in patients with high BMD (group I). The oral health characteristics were identified, namely, the pathological tooth wear — abfraction (84.21 %) and attrition (76.31 %), the periodontal phenotype was characterized by a thick gingival biotype, mandibular exostoses, periodontitis and periodontitis were diagnosed. Increased bone turnover, active course of generalized periodontitis, thin gingival biotype, cervical caries and hyperesthesia of the dental hard tissues were registered in patients with low BMD (group III). Conclusion. The state of oral health, namely, the dental hard tissues, the periodontal phenotype has its own characteristics and are related to the morphotype of bone tissue — its BMD and bone metabolism. Such features must be taken into account when planning treatment measures for dental patients.","PeriodicalId":31851,"journal":{"name":"Bol'' Sustavy Pozvonocnik","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135855047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Disruption of regional blood flow in patients with arteriovenous malformations (AVMs) of the lower extremities changes the conditions of bone tissue functioning. The purpose was to study the structural and functional state of bone tissue and its metabolism in patients with AVMs of the lower extremities using dual-energy X-ray absorptiometry and the markers of bone turnover. Materials and methods. Fifteen patients with AVMs had been examined. The clinical class of chronic venous disease (CVD) was evaluated according to CEAP; patients were divided into 2 subgroups: the first one was with CVD C1-C3 and the second one was with CVD C4-C6. Bone mineral density (BMD) was studied based on the X-ray absorptiometry. The level of bone metabolism markers, such as procollagen type 1 N-terminal propeptide (P1NP), C-terminal cross-linking telopeptide of type 1 collagen (β-CTx) and osteocalcin, 25-hydroxyvitamin D (25(ОН)D) and parathyroid hormone were studied. Results. Disturbances of the bone tissue indices of the affected limb were found in 70 % of the patients. Also, the statistically significant difference in BMD of the affected limb compared to the healthy limb was established (р = 0.005). A multidirectional level of P1NP was detected; β-CTx exceeded norm in 80 % of the patients; osteocalcin exceeded norm in 33 % of the cases. In 67 % of the patients, a decrease in serum level of 25(OH)D was noted. Increase of the β-CTx level in the first subgroup and its decrease in the second one was associated with stabilization of the AVMs course and age-related changes in the hormonal background of the patients. Conclusions. Disturbances in the structural state of bone tissue of the affected limb were found in 70 % of the patients; statistically significant difference between the BMD of the affected and healthy limb obviously caused by the influence of regional hemodynamic disturbances. Various deviations of the metabolism markers were found, which indicates the need to develop a system of drug therapy.
{"title":"Structural and functional state of bone in patients with arteriovenous malformations of the lower extremities","authors":"A.M. Zyma, R.V. Vyderko, T.A. Kincha-Polishchuk, A.I. Cheverda, L.M. Chernukha, Yu.M. Guk, O.G. Haiko, O.M. Magomedov, A.V. Zotya, O.Yu. Skuratov","doi":"10.22141/pjs.13.3.2023.381","DOIUrl":"https://doi.org/10.22141/pjs.13.3.2023.381","url":null,"abstract":"Background. Disruption of regional blood flow in patients with arteriovenous malformations (AVMs) of the lower extremities changes the conditions of bone tissue functioning. The purpose was to study the structural and functional state of bone tissue and its metabolism in patients with AVMs of the lower extremities using dual-energy X-ray absorptiometry and the markers of bone turnover. Materials and methods. Fifteen patients with AVMs had been examined. The clinical class of chronic venous disease (CVD) was evaluated according to CEAP; patients were divided into 2 subgroups: the first one was with CVD C1-C3 and the second one was with CVD C4-C6. Bone mineral density (BMD) was studied based on the X-ray absorptiometry. The level of bone metabolism markers, such as procollagen type 1 N-terminal propeptide (P1NP), C-terminal cross-linking telopeptide of type 1 collagen (β-CTx) and osteocalcin, 25-hydroxyvitamin D (25(ОН)D) and parathyroid hormone were studied. Results. Disturbances of the bone tissue indices of the affected limb were found in 70 % of the patients. Also, the statistically significant difference in BMD of the affected limb compared to the healthy limb was established (р = 0.005). A multidirectional level of P1NP was detected; β-CTx exceeded norm in 80 % of the patients; osteocalcin exceeded norm in 33 % of the cases. In 67 % of the patients, a decrease in serum level of 25(OH)D was noted. Increase of the β-CTx level in the first subgroup and its decrease in the second one was associated with stabilization of the AVMs course and age-related changes in the hormonal background of the patients. Conclusions. Disturbances in the structural state of bone tissue of the affected limb were found in 70 % of the patients; statistically significant difference between the BMD of the affected and healthy limb obviously caused by the influence of regional hemodynamic disturbances. Various deviations of the metabolism markers were found, which indicates the need to develop a system of drug therapy.","PeriodicalId":31851,"journal":{"name":"Bol'' Sustavy Pozvonocnik","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135855060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-13DOI: 10.22141/pjs.13.3.2023.380
L.M. Yena, G.M. Khrystoforova
Background. Assessment of elderly’s health status, medical, social service and care needs becomes important under global aging of the population. The purpose of the study was to assess the social, psycho-emotional and physical states of elderly patients based on geriatric screening tool during the war in Ukraine. Material and methods. 400 patients aged 60–89 were interviewed using original "Geriatric Assessment" questionnaire for the period 2022–2023. The questionnaire included 40 questions to assess social status, cognitive, psycho-emotional and physical states, morbidity, and chronic problems. Results. Unfavorable social signs were revealed — living alone (35 %), poor financial support (35 %), limitations of social relations (20 %), and lack of cultural life (70 %) along with low monotonous physical activity (97 %). The high frequency of depressed mood (97 %), anxiety (74 %) and dyssomnia (87 %) evidenced the low resistance to war stress in elderly. A moderate decrease in memory was registered in 60 %, pronounced — in 13 % patients. Among the neurological symptoms, dizziness (74 %) and balance disorders (50 %) dominated. The majority of respondents indicated physical decline: general weakness — 88 %, fatigue — 97 %, legs weakness — 76 %, hands weakness — 71 %. Unintentional weight loss, an indirect marker of sarcopenia, was identified in 32 %, height reduction as a marker of bone loss in 48 %, repeated falls and fractures in 12 and 8 %, respectively. History of stroke, myocardial infarction, neoplasma and COVID-19 was associated with higher frequency of balance disorders, inability to climb stairs, general weakness, hands and legs weakness, and nutrition disorders. Аs the age increased, the number of symptoms per patient enlarged and was greater in women compared to men. Conclusions. A high frequency of physical, cognitive, psychoemotional and social state disorders was registered in elderly patients during the war, which requires the attention of society for their possible correction.
{"title":"Assessment of social, physical, and mental health of elderly people during the war in Ukraine","authors":"L.M. Yena, G.M. Khrystoforova","doi":"10.22141/pjs.13.3.2023.380","DOIUrl":"https://doi.org/10.22141/pjs.13.3.2023.380","url":null,"abstract":"Background. Assessment of elderly’s health status, medical, social service and care needs becomes important under global aging of the population. The purpose of the study was to assess the social, psycho-emotional and physical states of elderly patients based on geriatric screening tool during the war in Ukraine. Material and methods. 400 patients aged 60–89 were interviewed using original \"Geriatric Assessment\" questionnaire for the period 2022–2023. The questionnaire included 40 questions to assess social status, cognitive, psycho-emotional and physical states, morbidity, and chronic problems. Results. Unfavorable social signs were revealed — living alone (35 %), poor financial support (35 %), limitations of social relations (20 %), and lack of cultural life (70 %) along with low monotonous physical activity (97 %). The high frequency of depressed mood (97 %), anxiety (74 %) and dyssomnia (87 %) evidenced the low resistance to war stress in elderly. A moderate decrease in memory was registered in 60 %, pronounced — in 13 % patients. Among the neurological symptoms, dizziness (74 %) and balance disorders (50 %) dominated. The majority of respondents indicated physical decline: general weakness — 88 %, fatigue — 97 %, legs weakness — 76 %, hands weakness — 71 %. Unintentional weight loss, an indirect marker of sarcopenia, was identified in 32 %, height reduction as a marker of bone loss in 48 %, repeated falls and fractures in 12 and 8 %, respectively. History of stroke, myocardial infarction, neoplasma and COVID-19 was associated with higher frequency of balance disorders, inability to climb stairs, general weakness, hands and legs weakness, and nutrition disorders. Аs the age increased, the number of symptoms per patient enlarged and was greater in women compared to men. Conclusions. A high frequency of physical, cognitive, psychoemotional and social state disorders was registered in elderly patients during the war, which requires the attention of society for their possible correction.","PeriodicalId":31851,"journal":{"name":"Bol'' Sustavy Pozvonocnik","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135854903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-13DOI: 10.22141/pjs.13.3.2023.387
N.V. Kuprinenko
No abstract
没有抽象的
{"title":"IOF-ESCEO World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases — 2023: the Ukrainian Association of Osteoporosis participation","authors":"N.V. Kuprinenko","doi":"10.22141/pjs.13.3.2023.387","DOIUrl":"https://doi.org/10.22141/pjs.13.3.2023.387","url":null,"abstract":"No abstract","PeriodicalId":31851,"journal":{"name":"Bol'' Sustavy Pozvonocnik","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135855064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Road traffic injury remains one of the most serious and complex types of human injury both in Ukraine and around the world. The purpose of the research: to determine the location and extent of spinal cord injuries as a component of polytrauma as a result of a road accident. Materials and methods. We formed a study array of 298 victims with spinal cord injuries from the array of road accident victims (1,696 people) who were treated in the emergency medical care hospital of the city of Kyiv, the emergency medical care hospital of the city of Chernivtsi, and three central district hospitals of the Kyiv region in 2020–2021. Formation of the research array was carried out by the method of irreversible randomization using the technology of random numbers. The selection criterion for inclusion in the study was the presence of spinal cord injury in road accident victims. At the same time, verification of the nature of the damage was determined at this stage of the study only by clinical and anatomical features, namely, the cervical spine, the thoracic spine and the lumbar spine. Results. It was established that 87.25 % receive damage to one part of the spine. Damage to all parts of the spine in road accidents occurs in 1.68 %. Among the combination of injuries of the spine, the combination of injuries of the thoracic and lumbar parts has the largest specific weight. Spinal cord injury occurs most often in drivers 37.05 %, the least common in pedestrians 30.82 %. According to the NISS, 51.02 % of victims receive a mild spinal cord injury, 39.99 % of victims receive a severe spinal cord injury. In victims with a severity of 25 points, damage to the cervical spine has the largest specific weight of 40.29 %, the smallest is the thoracic section of 28.70 %. In drivers and passengers, the cervical spine is most often damaged, 53.85 and 48.91 %, respectively. In pedestrians, the lumbar spine is most often injured, 47.19 %. The coefficient of combination of damage to several sections of the spine at the same time for drivers and passengers is 1.14, and for pedestrians — 1.6. Conclusions. Spine injuries occur in 17.98 % of victims of traffic accidents. Most often, the cervical spine is damaged in 46.64 %, thoracic — in 32.55 %, and lumbar — in 35.23 % of those injured as a result of traffic accidents.
{"title":"Spinal cord injury as a component of polytrauma in road accident victims","authors":"S.O. Guryev, V.A. Kushnir, N.I. Iskra, H.P. Kushnir","doi":"10.22141/pjs.13.3.2023.383","DOIUrl":"https://doi.org/10.22141/pjs.13.3.2023.383","url":null,"abstract":"Background. Road traffic injury remains one of the most serious and complex types of human injury both in Ukraine and around the world. The purpose of the research: to determine the location and extent of spinal cord injuries as a component of polytrauma as a result of a road accident. Materials and methods. We formed a study array of 298 victims with spinal cord injuries from the array of road accident victims (1,696 people) who were treated in the emergency medical care hospital of the city of Kyiv, the emergency medical care hospital of the city of Chernivtsi, and three central district hospitals of the Kyiv region in 2020–2021. Formation of the research array was carried out by the method of irreversible randomization using the technology of random numbers. The selection criterion for inclusion in the study was the presence of spinal cord injury in road accident victims. At the same time, verification of the nature of the damage was determined at this stage of the study only by clinical and anatomical features, namely, the cervical spine, the thoracic spine and the lumbar spine. Results. It was established that 87.25 % receive damage to one part of the spine. Damage to all parts of the spine in road accidents occurs in 1.68 %. Among the combination of injuries of the spine, the combination of injuries of the thoracic and lumbar parts has the largest specific weight. Spinal cord injury occurs most often in drivers 37.05 %, the least common in pedestrians 30.82 %. According to the NISS, 51.02 % of victims receive a mild spinal cord injury, 39.99 % of victims receive a severe spinal cord injury. In victims with a severity of 25 points, damage to the cervical spine has the largest specific weight of 40.29 %, the smallest is the thoracic section of 28.70 %. In drivers and passengers, the cervical spine is most often damaged, 53.85 and 48.91 %, respectively. In pedestrians, the lumbar spine is most often injured, 47.19 %. The coefficient of combination of damage to several sections of the spine at the same time for drivers and passengers is 1.14, and for pedestrians — 1.6. Conclusions. Spine injuries occur in 17.98 % of victims of traffic accidents. Most often, the cervical spine is damaged in 46.64 %, thoracic — in 32.55 %, and lumbar — in 35.23 % of those injured as a result of traffic accidents.","PeriodicalId":31851,"journal":{"name":"Bol'' Sustavy Pozvonocnik","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135854896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Osteoporosis is actually today's problem, as it affects the quality and length of life, and increases the risk of fragility fractures, which leads to significant medical, social, and economic problems. One of the reasons for the development of secondary osteoporosis is the use of vitamin K and new oral anticoagulants, the use of which is increasing. The purpose of this review was to analyze of literature data regarding the impact of oral anticoagulants on the bone state, the risk of osteoporosis and its complications in order to improve the awareness of doctors of various specialties. Materials and methods. The literature review was carried out based on the analysis of scientometric databases PubMed, Google Scholar, and Scopus using the keywords “vitamin K antagonists”; “warfarin; “osteoporosis”; “osteoporotic fracture”; “non-vitamin K antagonist oral anticoagulants”; “systematic review” for the period 2013-2023, but it did not exclude key works that were published earlier. The search was performed by two independent authors. 160 sources were selected for analysis, of which 53 were used that met the search criteria. Results. The analysis of researches showed that the effects of vitamin K antagonists and new oral anticoagulants on bone and the risk of fragility fractures are controversial. Nevertheless, the new oral anticoagulants in comparison to vitamin K antagonists seem to have a less negative effect on bone and the lowest risk of fragility fractures. The mechanism of such influence is still under examination. Conclusions. Most studies have demonstrated the adverse effects of vitamin K antagonists on bone health. A lower risk of fractures was observed with new oral anticoagulants than with vitamin K antagonists, in particular, warfarin. Taking into account the analyzed data of the literature, it is recommended to also assess the risk of fragility fractures when prescribing vitamin K antagonists or new oral anticoagulants.
{"title":"Effects of oral anticoagulants on bone health (systematic literature review)","authors":"H.V. Mostbauer, T.A. Karasevska, L.P. Antonenko, Iu.V. Rudenko, A.B. Bezrodnyi","doi":"10.22141/pjs.13.3.2023.386","DOIUrl":"https://doi.org/10.22141/pjs.13.3.2023.386","url":null,"abstract":"Background. Osteoporosis is actually today's problem, as it affects the quality and length of life, and increases the risk of fragility fractures, which leads to significant medical, social, and economic problems. One of the reasons for the development of secondary osteoporosis is the use of vitamin K and new oral anticoagulants, the use of which is increasing. The purpose of this review was to analyze of literature data regarding the impact of oral anticoagulants on the bone state, the risk of osteoporosis and its complications in order to improve the awareness of doctors of various specialties. Materials and methods. The literature review was carried out based on the analysis of scientometric databases PubMed, Google Scholar, and Scopus using the keywords “vitamin K antagonists”; “warfarin; “osteoporosis”; “osteoporotic fracture”; “non-vitamin K antagonist oral anticoagulants”; “systematic review” for the period 2013-2023, but it did not exclude key works that were published earlier. The search was performed by two independent authors. 160 sources were selected for analysis, of which 53 were used that met the search criteria. Results. The analysis of researches showed that the effects of vitamin K antagonists and new oral anticoagulants on bone and the risk of fragility fractures are controversial. Nevertheless, the new oral anticoagulants in comparison to vitamin K antagonists seem to have a less negative effect on bone and the lowest risk of fragility fractures. The mechanism of such influence is still under examination. Conclusions. Most studies have demonstrated the adverse effects of vitamin K antagonists on bone health. A lower risk of fractures was observed with new oral anticoagulants than with vitamin K antagonists, in particular, warfarin. Taking into account the analyzed data of the literature, it is recommended to also assess the risk of fragility fractures when prescribing vitamin K antagonists or new oral anticoagulants.","PeriodicalId":31851,"journal":{"name":"Bol'' Sustavy Pozvonocnik","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135855048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-13DOI: 10.22141/pjs.13.3.2023.382
P.V. Tanasiienko, Y.O. Skobenko
Background. Treatment of the fractures in patients with COVID-19, given the novelty of this problem, is one of the most difficult tasks of modern traumatology and orthopedics. The purpose of this study was to determine the peculiarities of the course of the traumatic process in victims with fractures of the upper limbs against the background of COVID-19. Materials and methods. To carry out our research, we retrospectively analyzed the treatment of 136 trauma patients who underwent inpatient treatment in one of the city hospitals of Kyiv from 2019 to 2021. In our study, we used the generally accepted AO/ASIF classification of fractures to determine the clinical and nosological characteristics of injuries in patients with COVID-19. Results. During the COVID-19 epidemic, fractures to the distal part of the forearm (28.8 %), clavicle (17.8%) and proximal part of the shoulder (15.1 %) were most often detected. Among segmental injuries in patients with COVID-19, forearm (in 42.5 % of cases) and shoulder (in 35.6 % of cases) fractures predominated. Also, simple fractures of type A (72.6 %) were more common, and much less fragmentary fractures of type B (21.9 %) and multifragmentary type C fractures (5.5 %) were present. It is worth noting a significant decrease in the number of hand injuries during the COVID-19 pandemic by almost 7 times. In our opinion, this is due to the lockdown introduced by the authorities of Ukraine, which significantly reduced the number of industrial injuries among the research sample. Conclusions. We concluded that the COVID-19 pandemic significantly affected the clinical and nosological structure and characteristics of bone fractures of the upper limb girdle, the analysis of cases proved that such changes in the clinical and nosological structure of fractures of the upper limb girdle are associated with changes in life activities during the pandemic and more typical for domestic trauma.
{"title":"Particularities of upper extremity fractures in patients with COVID-19","authors":"P.V. Tanasiienko, Y.O. Skobenko","doi":"10.22141/pjs.13.3.2023.382","DOIUrl":"https://doi.org/10.22141/pjs.13.3.2023.382","url":null,"abstract":"Background. Treatment of the fractures in patients with COVID-19, given the novelty of this problem, is one of the most difficult tasks of modern traumatology and orthopedics. The purpose of this study was to determine the peculiarities of the course of the traumatic process in victims with fractures of the upper limbs against the background of COVID-19. Materials and methods. To carry out our research, we retrospectively analyzed the treatment of 136 trauma patients who underwent inpatient treatment in one of the city hospitals of Kyiv from 2019 to 2021. In our study, we used the generally accepted AO/ASIF classification of fractures to determine the clinical and nosological characteristics of injuries in patients with COVID-19. Results. During the COVID-19 epidemic, fractures to the distal part of the forearm (28.8 %), clavicle (17.8%) and proximal part of the shoulder (15.1 %) were most often detected. Among segmental injuries in patients with COVID-19, forearm (in 42.5 % of cases) and shoulder (in 35.6 % of cases) fractures predominated. Also, simple fractures of type A (72.6 %) were more common, and much less fragmentary fractures of type B (21.9 %) and multifragmentary type C fractures (5.5 %) were present. It is worth noting a significant decrease in the number of hand injuries during the COVID-19 pandemic by almost 7 times. In our opinion, this is due to the lockdown introduced by the authorities of Ukraine, which significantly reduced the number of industrial injuries among the research sample. Conclusions. We concluded that the COVID-19 pandemic significantly affected the clinical and nosological structure and characteristics of bone fractures of the upper limb girdle, the analysis of cases proved that such changes in the clinical and nosological structure of fractures of the upper limb girdle are associated with changes in life activities during the pandemic and more typical for domestic trauma.","PeriodicalId":31851,"journal":{"name":"Bol'' Sustavy Pozvonocnik","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135854908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Postmenopausal osteoporosis (PMO), which is developed due the estrogen defi ciency in women after menopause, is the most common type of systemic osteoporosis. The latest Ukrainian recommendation for its management requires revision due to new data from high-quality research performed in recent years. The purpose was to develop a guideline on the diagnosis, prevention, and treatment of PMO based on an analytical analysis of modern literary sources in order to improve the awareness of the medical community of Ukraine. Methodology. To develop the guideline, an expert group of 13 leading Ukrainian scientists of various specialties was created who conducted a tho rough review of modern literature on this topic, assessed the level of existing evidence using the GRADE system, proposed and voted on 15 recommendations of the guideline. Results. The guideline contains chapters on diagnosis and diff erential diagnosis of PMO, assessment of the osteoporotic fracture risk, the role of bone turnover markers in the management of PMO, and modern strategies of antiosteoporotic treatment. Conclusions. The Ukrainian guideline on the diagnosis, prevention, and treatment of PMO, which contains 15 main recommendations, created on the basis of a tho rough analysis and synthesis of modern literature data, is an important tool for the management of PMO and is recommended by Ukrainian Association of Osteoporosis for use in Ukrainian me dical community.
{"title":"Guideline for diagnostic, prevention and treatment of postmenopausal osteoporosis","authors":"N.V. Grygorieva, V.M. Kovalenko, М.О. Коrzh, T.F. Tatarchuk, N.V. Dedukh, S.S. Strafun, Z.M. Dubossarska, G.O. Protsenko, A.V. Kalashnikov, А.S. Musiіenko, S.I. Regeda, O.O. Efimenko, E.F. Chaykivska","doi":"10.22141/pjs.13.3.2023.378","DOIUrl":"https://doi.org/10.22141/pjs.13.3.2023.378","url":null,"abstract":"Background. Postmenopausal osteoporosis (PMO), which is developed due the estrogen defi ciency in women after menopause, is the most common type of systemic osteoporosis. The latest Ukrainian recommendation for its management requires revision due to new data from high-quality research performed in recent years. The purpose was to develop a guideline on the diagnosis, prevention, and treatment of PMO based on an analytical analysis of modern literary sources in order to improve the awareness of the medical community of Ukraine. Methodology. To develop the guideline, an expert group of 13 leading Ukrainian scientists of various specialties was created who conducted a tho rough review of modern literature on this topic, assessed the level of existing evidence using the GRADE system, proposed and voted on 15 recommendations of the guideline. Results. The guideline contains chapters on diagnosis and diff erential diagnosis of PMO, assessment of the osteoporotic fracture risk, the role of bone turnover markers in the management of PMO, and modern strategies of antiosteoporotic treatment. Conclusions. The Ukrainian guideline on the diagnosis, prevention, and treatment of PMO, which contains 15 main recommendations, created on the basis of a tho rough analysis and synthesis of modern literature data, is an important tool for the management of PMO and is recommended by Ukrainian Association of Osteoporosis for use in Ukrainian me dical community.","PeriodicalId":31851,"journal":{"name":"Bol'' Sustavy Pozvonocnik","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135469675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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