STUDY OF BONE TISSUE REPARATION AFTER A FEMUR FRACTURE DEPENDING ON THE CORRECTION OF ARTERIAL HYPERTENSION IN MODEL OBJECT RATTUS NORVEGICUS (RAT GRAY).

The processes of bone remodeling and regulation of blood pressure are caused by common genetic determinants underlying the development of these diseases. To solve practical medical problems, it seems relevant to carry out the correction and treatment of syntropic diseases at the same time with the aim of achieving the maximum positive effect. The most serious complication of osteoporosis is bone fractures, especially fractures of the proximal femur, which are a serious medical and social problem. The aim of our work was to evaluate the repair of bone tissue after fractures of the proximal femur with subsequent intramedullary osteosynthesis on the background of arterial hypertension and its correction. A model object was used in the work - gray rats, lines Wistar and SHR, which were operated on. For the animals of one of the groups with genetically determined arterial hypertension, correction of the above-mentioned pathology in the form of enalapril monotherapy in the postoperative period was applied. In this group, the picture of the dynamics of blood pressure indices corresponded to the cumulative effect of enalapril - after three weeks of taking the drug, the rats' systolic blood pressure indices corresponded to those of normotensive animals, and the indicators of adhesion of the fracture zone were higher than in the group of rats with arterial hypertension, which was not corrected. Adequate correction of the level of blood pressure in the postoperative period favorably affects the reparative capabilities of the bone, while at the same time increasing the chances of positive results of surgical treatment of patients.

Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate.

Fracture probabilities derived from the surrogate FRAX model for Armenia were compared to those from the model based on regional estimates of the incidence of hip fracture. Disparities between the surrogate and authentic FRAX models indicate the importance of developing country-specific FRAX models. Despite large differences between models, differences in the rank order of fracture probabilities were minimal. OBJECTIVE: Armenia has relied on a surrogate FRAX model based on the fracture epidemiology of Romania. This paper describes the epidemiology of fragility fractures in Armenia used to create an Armenia-specific FRAX model with an aim of comparing this new model with the surrogate model. METHODS: We carried out a population-based study in two regions of Armenia (Ararat and Vayots Dzor representing approximately 11% of the country's population). We aimed to identify all low-energy fractures: retrospectively from hospital registers in 2011-2012 and prospectively in 2013 with the inclusion of primary care sources. RESULTS: The differences in incidence between the surveys with and without data from primary care suggested that 44% of patients sustaining a hip fracture did not receive specialized medical care. A similar proportion of forearm and humeral fractures did not come to hospital attention (48 and 49%, respectively). Only 57.7% of patients sustaining a hip fracture were hospitalized. In 2013, hip fracture incidence at the age of 50 years or more was 201/100,000 for women and 136/100,000 for men, and age- and sex-specific rates were incorporated into the new "authentic" FRAX model for Armenia. Compared to the surrogate model, the authentic model gave lower 10-year fracture probabilities in men and women aged less than 70 years but substantially higher above this age. Notwithstanding, there were very close correlations in fracture probabilities between the surrogate and authentic models (> 0.99) so that the revisions had little impact on the rank order of risk. CONCLUSION: A substantial proportion of major osteoporotic fractures in Armenia do not come to hospital attention. The disparities between surrogate and authentic FRAX models indicate the importance of developing country-specific FRAX models. Despite large differences between models, differences in the rank order of fracture probabilities were minimal.