55 research outputs found

    THE PREVENTION, DIAGNOSIS, AND TREATMENT OF VITAMIN D AND CALCIUM DEFICIENCIES IN THE ADULT POPULATION OF RUSSIA AND IN PATIENTS WITH OSTEOPOROSIS (ACCORDING TO THE MATERIALS OF PREPARED CLINICAL RECOMMENDATIONS)

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    The paper presents data on the role of vitamin D and calcium in the function of many human organs and tissues.Β Lifestyle, dietary preferences, and insufficient physical activity contribute to the high prevalence of vitamin D and calciumΒ deficiencies in the adult population of Russia, causing different diseases and abnormalities. The authors haveΒ worked out recommendations for the preventive use of vitamin D and calcium in healthy population, give consumptionΒ rates for these substances, and describe the clinical and laboratory signs of vitamin D deficiency and indicationsΒ for screening. They also propose treatment regimens for vitamin D deficiency and depict the signs of intoxication inoverdose. Particular emphasis is laid on the place of vitamin D and calcium in the therapy of osteoporosis

    MUSCULOSKELETAL COMPLICATIONS OF HYPERCORTISOLISM AND ACROMEGALY

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    BOLEZN' PEDZhETA

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    VLIYaNIE TsINAKALTsETA (MIMPARY) NA POChEChNUYu OSTEODISTROFIYu U PATsIENTOV, NAKhODYaShchIKhSYa NA PROGRAMMNOM GEMODIALIZE

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    Π’ ΡΡ‚Π°Ρ‚ΡŒΠ΅ прСдставлСн ΠΎΠ±Π·ΠΎΡ€ соврСмСнной Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Ρ‹ ΠΈ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ Π½Π°ΡˆΠΈΡ… исслСдований, ΠΎΠ±ΠΎΠ±Ρ‰Π°ΡŽΡ‰ΠΈΠ΅ ΡΠΊΡΠΏΠ΅Ρ€ΠΈΠΌΠ΅Π½Ρ‚Π°Π»ΡŒΠ½Ρ‹Π΅ ΠΈ клиничСскиС Π΄Π°Π½Π½Ρ‹Π΅ ΠΎ влиянии Ρ†ΠΈΠ½Π°ΠΊΠ°Π»Ρ†Π΅Ρ‚Π° Π½Π° Π³ΠΎΡ€ΠΌΠΎΠ½Π°Π»ΡŒΠ½ΠΎ-биохимичСскиС ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ фосфорно-ΠΊΠ°Π»ΡŒΡ†ΠΈΠ΅Π²ΠΎΠ³ΠΎ ΠΎΠ±ΠΌΠ΅Π½Π°, Π½Π° ΠΌΠ°Ρ€ΠΊΠ΅Ρ€Ρ‹ костного ΠΌΠ΅Ρ‚Π°Π±ΠΎΠ»ΠΈΠ·ΠΌΠ°, ΠΌΠΈΠ½Π΅Ρ€Π°Π»ΡŒΠ½ΡƒΡŽ ΠΏΠ»ΠΎΡ‚Π½ΠΎΡΡ‚ΡŒ костСй, Ρ‚Π°ΠΊΠΆΠ΅ Π½Π° гистоморфомСтричСскиС ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ ΠΏΠΎΡ‡Π΅Ρ‡Π½ΠΎΠΉ остСодистрофии Ρƒ Π³Π΅ΠΌΠΎΠ΄ΠΈΠ°Π»ΠΈΠ·Π½Ρ‹Ρ… ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с Π²Ρ‚ΠΎΡ€ΠΈΡ‡Π½Ρ‹ΠΌ Π³ΠΈΠΏΠ΅Ρ€ΠΏΠ°Ρ€Π°Ρ‚ΠΈΡ€Π΅ΠΎΠ·ΠΎ

    MEDICAL METHODS OF CORRECTION OF RENAL OSTEODYSTROPHY

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    The article presents a literature review summarizing the contemporary data on the effects of drug therapy on various parameters of renal osteodystrophy: phosphate binders, vitamin D preparations, bisphosphonates, denosumab, and calcimimetics. We discuss the results of pilot study of the efficacy of teriparatide and denosumab on parameters of bone metabolism in patients with chronic kidney disease

    DIAGNOSIS AND TREATMENT OF PATIENTS WITH SECONDARY HYPERPARATHYROIDISM AND RENAL INSUFFICIENCY. THERAPEUTIC POTENTIAL OF PARICALCITOL

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    A review of the literature is devoted to the issue of secondary hyperparathyroidism (SHPT) with underlying chronic renal failure. Initial manifestations of the disease can be observed even with a minimal decrease in the rate of glomerular filtration and are pathophysiologically associated with violations of normal metabolism of vitamin D with its conversion into D-hormone. SHPT pathogenesis is based on the D-hormone deprivation and triggering of pathophysiology mechanisms of bone remodelling, increased FRP-23, PTH, changes in the serum levels of calcium and phosphorus, which may further lead to significant changes in the bone tissue structure and cardiovascular complications. Active metabolites of vitamin D and vitamin D analogues (Paricalcitol) were developed for the replacement of active forms of vitamin D in conditions of D-hormone deficiency. Due to its chemical structure and pharmacokinetics, Paricalcitol is able to block the synthesis of parathyroid hormone to a greater extent and increase the absorption of calcium and phosphorus in the intestine to a lesser extent, which gives it advantages over pre-existing active metabolite

    ANABOLIChESKAYa TERAPIYa OSTEOPOROZA.TERIPAPARATID: EFFEKTIVNOST', BEZOPASNOST' I OBLAST' PRIMENENIYa

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    This review of the literature has been dedicated to experimental and clinical studies of mechanism of action and efficacy of 1β€”34 amino acid fragment of parathyroid hormone β€” teriparatide as well as others contries experience of its prescribtion. Teriparatide is an osteoanabolic agent which stimulates bone formation by affecting bone modeling and by stimulating bone remodeling. The effects on modeling lead to increased bone formation whereas the effects on bone remodeling lead to increased bone turnover. Thus, in its mode of action teriparatide differs from all others medicines currently available to treat osteoporosis. Daily subcutaneous injections of teriparatide are proved to be effective to prevent low-traumatic vertebral and non-vertebral fractures in postmenopausal women with the history of vertebral fractures. Teriparatide is effective to treat osteoporosis in male and even more effective than alendronate to treat glucocorticoid-induced osteoporosis. Due to high cost and some restriction related to the duration of therapy (up to 18 months in Russia and 24 months in others countries) teriparatide should be recommended to treat severe osteoporosis in patients with a history >1 moderate clinical vertebral fracture or two or more vertebral fragility fractures or in case the previous treatment was not effective. Teriparatide should be prescribed after bisphosphonates or other antiosteoporotic treatment, but not in the combination with bisphosphonates. The prescribtion of bisphosphonates after teriparatide is effective to maintaine and further improve the effect. Thus, teriparatide is effective to treat severe osteoporosis and osteoporosis resistant to other therapy

    MODERN VIEW ON THE EFFECTIVENESS OF THERAPY FOR POSTMENOPAUSAL OSTEOPOROSIS. INNOVATIVE DRUGS OF TARGETED ACTION

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    ΠŸΠΎΡΡ‚Π΅ΠΏΠ΅Π½Π½ΠΎΠ΅ ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠ΅ ΠΏΡ€ΠΎΠ΄ΠΎΠ»ΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ ΠΆΠΈΠ·Π½ΠΈ Ρ‡Π΅Π»ΠΎΠ²Π΅ΠΊΠ°, стрСмлСниС ΠΊ ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡŽ Π΅Π΅ качСства Ρ‚Ρ€Π΅Π±ΡƒΠ΅Ρ‚ ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² ΠΏΡ€ΠΎΡ„ΠΈΠ»Π°ΠΊΡ‚ΠΈΠΊΠΈ ΠΈ лСчСния остСопороза. ΠžΡΠ½ΠΎΠ²Π½ΡƒΡŽ Ρ‡Π°ΡΡ‚ΡŒ Π»ΠΈΡ†, ΠΏΠΎΠ΄Π²Π΅Ρ€ΠΆΠ΅Π½Π½Ρ‹Ρ… ОП, ΡΠΎΡΡ‚Π°Π²Π»ΡΡŽΡ‚ ΠΆΠ΅Π½Ρ‰ΠΈΠ½Ρ‹ Π² ΠΌΠ΅Π½ΠΎΠΏΠ°ΡƒΠ·Π΅. Разносторонний ΠΏΠΎΠ΄Ρ…ΠΎΠ΄ ΠΊ ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΠ΅ восстановлСния баланса костного ΠΌΠ΅Ρ‚Π°Π±ΠΎΠ»ΠΈΠ·ΠΌΠ° ΠΏΡ€ΠΈΠ²Π΅Π» ΠΊ Π²Π½Π΅Π΄Ρ€Π΅Π½ΠΈΡŽ Π² ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΡƒ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠ² с Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌΠΈ ΠΌΠ΅Ρ…Π°Π½ΠΈΠ·ΠΌΠ°ΠΌΠΈ дСйствия. Π’ послСднСС врСмя ΠΊΡ€Π°ΠΉΠ½Π΅ Π²Π°ΠΆΠ½Ρ‹ΠΌ аспСктом являСтся ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΠ΅ привСрТСнности ΠΊ Π»Π΅Ρ‡Π΅Π½ΠΈΡŽ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², ΠΏΠΎΠ»ΡƒΡ‡Π°ΡŽΡ‰ΠΈΡ… ΠΌΠ½ΠΎΠ³ΠΎΠ»Π΅Ρ‚Π½Π΅Π΅ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ остСопороза. Π˜Π½Π½ΠΎΠ²Π°Ρ†ΠΈΠΎΠ½Π½Ρ‹ΠΌ шагом являСтся Π²Π½Π΅Π΄Ρ€Π΅Π½ΠΈΠ΅ Π² ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΡƒ примСнСния Π½ΠΎΠ²ΠΎΠ³ΠΎ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Π° моноклонального чСловСчСского Π°Π½Ρ‚ΠΈΡ‚Π΅Π»Π° ΠΊ Π»ΠΈΠ³Π°Π½Π΄Ρƒ RANK дСносумаб. Π’ ΠΎΠ±Π·ΠΎΡ€Π΅ прСдставлСны Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ ΡΡ€Π°Π²Π½ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… ΠΌΠ½ΠΎΠ³ΠΎΡ†Π΅Π½Ρ‚Ρ€ΠΎΠ²Ρ‹Ρ… слСпых Ρ€Π°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹Ρ… исслСдований эффСктивности дСносумаба ΠΈ ΠΏΠ΅Ρ€ΠΎΡ€Π°Π»ΡŒΠ½Ρ‹Ρ… бисфосфонатов. Показано Π±ΠΎΠ»Π΅Π΅ Π²Ρ‹Ρ€Π°ΠΆΠ΅Π½Π½ΠΎΠ΅ достовСрно влияниС дСносумаба (ΠΏΠΎΠ΄ΠΊΠΎΠΆΠ½ΠΎ 60 ΠΌΠ³ 1 Ρ€Π°Π· Π² 6 мСс.) Π½Π° прирост МПК Π²ΠΎ всСх ΠΎΡ‚Π΄Π΅Π»Π°Ρ… скСлСта (ΠΊΠ°ΠΊ Π±ΠΎΠ³Π°Ρ‚Ρ‹Ρ… трабСкулярной, Ρ‚Π°ΠΊ ΠΈ ΠΊΠΎΡ€Ρ‚ΠΈΠΊΠ°Π»ΡŒΠ½ΠΎΠΉ костной Ρ‚ΠΊΠ°Π½ΡŒΡŽ), Π·Π½Π°Ρ‡ΠΈΠΌΠΎΠ΅ сниТСниС риска ΠΏΠ΅Ρ€Π΅Π»ΠΎΠΌΠΎΠ² ΠΏΡ€ΠΈ Ρ…ΠΎΡ€ΠΎΡˆΠ΅ΠΉ пСрСносимости лСчСния
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