[The value of bone mineral density assessment by dual-energy x-ray absorptiometry for prediction of cardiovascular mortality in patients treated with hemodialysis].

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, mean age 44.811.4 years) who were observed for 5.73.2 years. Before inclusion in the study, in all patients was analyzed bone mineral density using dual-energy X-ray absorptiometry in three standard departments: lumbar vertebrae, proximal femur and distal forearm. The probability analysis of the outcome was carried out using the KaplanMeier method and Cox. RESULTS: During follow-up period 111 (21.5%) patients died, 50.5% from cardiovascular events. Survival analysis by KaplanMeier method allowed to prove the increased risk of death from cardiovascular pathology in hemodailysis patients with low bone mineral density of all evaluated areas. Step-by-step multivariate Cox regression analysis showed that the T score of the femur, showing the difference of BMD of the patient with normal value of BMD for young adult, had the greatest prognostic significance. CONCLUSION: Reduced bone mineral density in patients receiving hemodialysis is associated with an increased risk of death from cardiovascular disease. Dual energy x-ray absorptiometry can be used for assessment of this risk.

[Reproductive dysfunctions in female patients during therapy with atypical antipsychotics].

To specify interrelations between clinical and hormonal aspects of reproductive dysfunctions appearing during therapy with atypical antipsychotic agents (clozapine, olanzapine, quetiapine), 131 female patients with paranoid schizophrenia and schizoaffective disorder have been studied. Distinctive features of dynamics of prolactin as well as hypothalamic-pituitary-gonadal hormones levels for each medication studied and correlations between hormone indices and clinical presentations of reproductive dysfunctions (galactorrhea, disturbances of menstrual cycle and libido) were found.

[Clinical, biochemical, and morphological characteristics of chronic hepatitis with various etiology]. / Klinicheskie, biokhimicheskie i morfologicheskie osobennosti khronicheskikh gepatitov razlichnoi étiologii.

AIM: To investigate clinicomorphological features in patients with chronic diffuse lesions of the liver with consideration of the etiological factor. MATERIAL AND METHODS: Clinical, laboratory, serological and pathohistological examinations were performed in 67 patients with chronic hepatitis (CH). RESULTS: Out of 48 patients with chronic viral hepatitis (CVH), 32(66.6%) demonstrated association of hepatic lesion with alcohol or drug abuse. Knodell activity in the liver was prevalent in drug abusers with CVH. Fat dystrophy and high de Ritis index were typical for alcoholics. CONCLUSION: Viral hepatic lesions associated neither with alcohol nor drug abuse occur only in 1/3 of patients with CH.

[Chronic hepatitis: indicators of disease activity]. / Pokazateli aktivnosti protsessa pri khronicheskom gepatite.

AIM: To assess correlations between activity of chronic hepatitis (CH) by morphological data on the liver and alaninaminotransferase (AlAT) serum levels in patients with viral and alcoholic liver lesions. MATERIALS AND METHODS: Serological, biochemical blood tests and histology of hepatic biopsy were made in 47 patients with chronic hepatitis. RESULTS: The Knodell index characterizing the activity of chronic hepatitis by morphological evidence correlated with AlAT activity in the serum. Normal values may be associated with 1 to 5 scores by the Knodell index. AsAT/AlAT was higher in patients with CH free of virus markers. CONCLUSION: Morphological data (Knodell's index), AlAT activity and AsAT/AlAT indicate CH activity. AsAT/AlAT may help in elucidation of the presence or absence of alcohol abuse.