bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of palliative care in Norway: an overview
Authors: Schjølberg Tore
Published: January 2018

This article looks at the development of palliative care and the hospice movement in Norway during the last 15 years. The development of specialist hospital and community services and the hospice movement in Norway are discussed. These are considered against the background of similar developments elsewhere in Europe and the USA and in the context of research into care of the dying. Key events, such as the formation of the Norwegian Committee on Terminal Care (NCTC) and government directives and their influence are described.
Palliative nursing and managed care
Authors: Benoliel Jeanne Quint
Published: January 2018

The origins of modern palliative nursing lay in social changes during the 1950s and 1960s. In Europe and North America, pioneers in the social sciences cracked open the cultural silence about death and dying which was pervasive at that time. Pioneers in clinical practice fostered the establishment of the hospice as a service to humanise the experience of terminal illness and treat the distressing symptoms of painful dying. Both efforts were part of a social movement to improve the health and wellbeing of vulnerable people isolated from effective care by cultural norms and taboos about death.
Developing a home chemotherapy service
Authors: Daniels Lilian E
Published: January 2018

Achemotherapy at home service was established to meet the needs of the Walsall community by providing greater flexibility of choice for patients requiring outpatient chemotherapy. The aim was to extend existing services to meet the individual needs of patients with advanced disease who would benefit from palliative chemotherapy treatment but, who may, for physical or social reasons, find it difficult to attend hospital. Multidisciplinary collaboration, a home nursing assessment and a joint care plan with ongoing patient education and support, formed key elements of the home chemotherapy programme. Specific considerations regarding the safe handling of cytotoxic drugs and waste products in the community had to be addressed. The treatment of a sample of five patients in their own homes has been achieved, demonstrating the effectiveness and feasibility of such a service. A patient satisfaction survey and professional audit system are used, in order to measure its progress and assess future development needs.
Implications of pet-facilitated therapy in palliative nursing
Authors: Berrisford Judith A
Published: January 2018

Pet therapy is reviewed in terms of its history, physical and psychological benefits and potential problems. There are many reasons why pet therapy is ideally suited to palliative care and these are discussed. The introduction of an appropriate pet to a hospice or palliative care unit/service is described and possible pitfalls are identified.
Development of hospice care at Methodist Hospital
Authors: Gelle Nancy
Published: January 2018

Patients who are terminally ill in hospital are one type of the patient population affected by health-care reform. A hospital-hospice programme may be an appropriate alternative for their care. This article describes the process of creating a hospital-hospice programme. In order to identify the potential patient population, a review of the charts of all patients who died at Methodist Hospital over a 3-month period was carried out by the hospice medical director. The purpose of this review was to identify ‘hospice-appropriate’ patients and to determine the number of days of the patients' hospital stay that were appropriate for hospice care. The costs of the ‘appropriate’ hospice patients were reviewed to evaluate whether a reduction in charges would be accomplished by the implementation of this programme. The reduction in charges included treatment and tests that would not have been undertaken had the ‘hospice-appropriate’ patient been admitted to the hospital-hospice programme. A reduction in charges totalling several hundred thousand dollars occurred during the first year of the hospital-hospice programme's existence.
Truth-telling and collusion: the ethical dilemmas of palliative nursing
Authors: Kendall Margaret
Published: January 2018

Within the context of caring for a patient receiving palliative care, it is probable that a nurse will encounter a number of ethical dilemmas. Controversy will often be the partner of ethics in any discussion. This article looks at differing stances taken by opposing camps and offers an unbiased look at both sides of the debate, focusing on truth-telling and collusion. Case histories are analysed within a framework of ethical theory.
Palliative care nursing in France: a personal perspective
Authors: Turner Pauline
Published: January 2018

This article gives an account of a visit to palliative care services in France and identifies the benefits to be gained from the cross-fertilisation of ideas from a different European culture. Most of the challenging issues around terminal illness and death are experienced by the French, but palliative care provision has not been developed and established within the health-care system to the extent that it has in Britain. The role of the clinical nurse specialist (CNS) in palliative care in France closely matches the role of the palliative care CNS in Britain. Nurse-led community teams in France have the potential to develop specialist care practice in a way that will maximise the nursing role, enhance patient care and disseminate the principles of good practice.
Book Reviews
Authors: Stevensen Caroline , Gamlin Richard , Ball Philip RA
Published: January 2018

Treating AIDS with Chinese Medicine

Introducing Palliative Care

The Forgotten Mourners: Guidelines for Working with Bereaved Children
Clinical supervision in sustaining and developing nursing practice
Authors: Jones Alun
Published: January 2018

Clinical supervision and its influence on practice is of profound importance to nursing, midwifery and health visiting. This paper examines the role of clinical supervision in context and provides a case study illustration of fundamental concepts. A psychodynamic perspective is assumed for the discussion. The case for clinical supervision as a means to ensure the safe and effective delivery of health care is presented.
Correspondence
Authors: van Bommel Harry
Published: January 2018

Dear Editor,

I am a founding member of the Canadian Palliative Care Association. I helped my parents (in Canada) and my grandmother (in Holland) live at home until they died. I am a writer and educator and have written 16 books, including three in the field of hospice/palliative care. I write palliative care books from the perspective of the family and the patient. I am, at present, working on a fourth palliative care book Successful Hospice Care
The role of Macmillan nurse tutors: an interview study with post-holders
Authors: Herring Rachel , Wilson-Barnett Jenifer , Ball Stephen J
Published: January 2018

This article explores the role of Macmillan nurse tutors through in-depth, semi-structured tape-recorded interviews with 22 post-holders, focusing on their responsibilities, institutional affiliations and career aspirations. After full transcription, these qualitative data were subjected to open coding. Many tensions and variations within the role were revealed. However, these tutors appeared to be extremely committed to cancer and palliative care. They were concerned about how their future educational position would be maintained in a changing system of health care and health provision.
Complementary therapies in cancer care: an NHS approach
Authors: Stevensen Caroline
Published: January 2018

Complementary therapies are increasingly being used worldwide as a method of supporting people living with cancer. They offer improved quality of life, symptomatic control and self-help. There are established centres for complementary therapies in the UK; one such establishment is the Royal London Homoeopathic Hospital NHS Trust. This article describes the complementary cancer therapy programme offered at the RNHH. The programme includes homoeopathy, Iscador therapy, acupuncture, aromatherapy massage, Shiatsu, reflex zone therapy, relaxation and visualization training and breathing awareness classes. Other more conventional forms of assistance, including dietary advice, physiotherapy, occupational therapy and psychological support, are also offered. All therapies are advised according to individual need. Several case studies are presented to illustrate the use of the programme and its benefits.
AIDS and community nursing care
Authors: Hicken Ian , Butterworth Tony
Published: January 2018

This article reports on a study commissioned by the Department of Health to examine community nursing services for people with HIV disease. Data were gathered on discharge, referral patterns and coordination of services for people with HIV disease in six health authorities in England. Methods included discharge surveys, a district nurse survey, and service user focus groups. All data were collectively analysed within a structure-process-outcome framework. Findings demonstrate that given adequate and appropriate support, education, training and clinical preparation, district nurses are effective and willing providers of care for people with HIV disease. However, there are problems in care coordination, discharge planning and accessing resources. At its best, community nursing is providing individualized, holistic and comprehensive care packages, but practice in both acute and primary care settings was not always effective.
Research directions in palliative care nursing
Authors: Wilson-Barnett Jenifer
Published: January 2018

One of the most heartening aspects of palliative care and, in particular, the nursing contribution, is the rapid expansion of research activity directly pertinent to patients and their families. The courage of many research nurses in asking penetrating and sensitive questions is admirable. As they have often worked in the area and have the relevant skills, it is possible for nurses to identify important issues and explore them in a directly applicable way.
Book reviews
Authors: Booles Keith , Baldwin Moyra
Published: January 2018

Palliative Care for People with AIDS. 2nd edn.

What you Really Need to Know About Cancer Pain
Influence of nurse gender on the use of silence, touch and humour
Authors: Perry Beth
Published: January 2018

A combination of data gathering approaches, i.e. conversation, observation and narrative exchange, were used to study the beliefs and actions of exemplary nurses. The data were analyzed using hermeneutic phenomenology and grounded theory methods and the findings revealed three major themes: dialogue in silence, mutual touch and sharing the lighter side of life. Participants in the study were chosen by peer nomination and reputational sampling and included both genders. The results showed a contrast in the way that exemplary males and females used silence, touch and humour in their practice. More specifically, compared with the women in the group, the men used silence to achieve different purposes, tended towards non-physical touch and used different forms of humour. This paper presents an introductory examination of the influence of nurse gender on the use of silence, touch and humour.
Dignity and integrity at the end of life
Authors: de Raeve Louise
Published: January 2018

This article briefly examines what is meant by a ‘good death’ and looks in detail at the idea of ‘death with dignity’ as one such concept. This may be best understood not as a manner of dying, but as a manner of treating those who are dying. The relationships between dignity, self-respect and integrity are explored and illustrated with examples from both the literature and clinical practice. Nursing in a way that preserves or restores a patients' dignity in the face of illness and death makes severe demands on a nurse's integrity. The importance of having institutional mechanisms in place which assist the nurse in this work is emphasized, as is the need for clinical supervision in nursing.
Palliative nursing in a changing health-care system
Authors: White Libby
Published: January 2018

Although palliative care has been practised since ancient times, its development as a recognized discipline within health care began some 30 years ago. The resulting benefits to patients, including enhanced relief of distressing symptoms and improvement in overall quality of life are best demonstrated in the care of people with advanced cancer. Continued growth of palliative care, particularly in Western countries, has been assured by the emergence of doctors and nurses trained in the specialty, who have become the cornerstone of interdisciplinary palliative care teams.
Facilitation: the concepts in use in palliative care nursing
Authors: Durgahee Taleb
Published: January 2018

Facilitation is a fairly common technique for helping palliative care patients in the clinical setting. Reflective practice provides an opportunity for practitioners to think out the concepts in use while facilitating care. This study reports on the views of practitioners who experienced reflective learning and facilitation as part of a Course, and attempted to identify, in their practice, the concepts they used to facilitate patient care. The aim was to recognize concepts that practitioners (and teachers) can use to facilitate care. The methods used for research were participant observation and interviews. Data analysis consisted of coding and categorizing the concepts emerging from this study. The result was identification of the PACTS mnemonic crystallising the key concepts in facilitation: Purpose, Action, Collaboration, critical Thinking, and Support and confrontation.
Direct access by GPs to palliative nursing
Authors: Turner Pauline
Published: January 2018

This article presents the results of a pilot study evaluating direct access by GPs to specialist community palliative nursing support without an intermediary visit from a medical consultant. GPs wishing to refer terminally ill patients to the community palliative care team were given access via either medical assessment or nursing assessment. Results showed that the overall referral rate to the service increased during the period of the study. In addition, the new service was well received by the GPs who used it. A large number of referrals (75%) requested support for the patient and family. This study contributes to the ongoing debate about the need to identify and define supportive interventions and the most appropriate providers of these.
It never rained in the house of sleep…
Authors: Williams Alyson
Published: January 2018

Night — bat black, brooding, all encompassing darkness, blanketing the colours of the day; the outlines blur and shapes become fluid.
Evidence-based practice: meeting a need within palliative nursing
Authors: Latham Jane
Published: January 2018

Palliative care has progressed dramatically in terms of sound evidence-based practice since its inception in the mid 1970s. Far from being a negative judgemental statement this is intended as a historical statement of fact, recognising that without pioneers such as Dame Cicely Saunders within the hospice movement, we would not have a basis from which to evolve and improve palliative care.
Developing a symptom distress scale for terminal malignant disease
Authors: Sutcliffe-Chidgey Jayne , Holmes Sue
Published: January 2018

Symptom control is an important component of palliative care. The degree of distress caused by symptoms is individual. Instruments to measure symptom distress in patients with cancer have been developed, but have been poorly validated in the terminally ill. This study was an exploratory, descriptive, cross-sectional survey of 49 dying cancer patients, 60 professional carers (doctors and nurses) and 30 bereaved relatives. Semi-structured interviews were used to identify distressing symptoms for the dying cancer patient. The results indicated a diversity in the symptom experience and were used in the development of a physical symptom distress scale. Items were selected from a pool of symptoms generated from the three data sources, and compared with the literature of symptom distress in general cancer patients and symptom prevalence studies in terminal care. These were then compared with existing symptom distress scales. An adaptation of the physical sub-scale of the Rotterdam Symptom Checklist is proposed.
Fatigue in patients receiving chemotherapy for advanced cancer
Authors: Richardson Alison , Ream Emma
Published: January 2018

Severe and unremitting fatigue is a common symptom in individuals with advanced disease. Combined with weakness it comprises a syndrome known as asthenia. Asthenia is associated with advanced cancer, and becomes an increasing problem for patients as their disease progresses, having enormous implications for quality of life. However, despite its prevalence and impact, relatively little is known about this complex syndrome. The study described in this paper investigated and compared the fatigue experienced by cancer patients with different stages of disease, who were receiving chemotherapy. The results from this study both support the notion that fatigue increases as cancer progresses, and provide evidence for the prevalence of asthenia.
Cancer Nursing: Creating the Future 9th International Conference on Cancer Nursing, August 12-15 1996
Authors: Oliver Gill
Published: January 2018

During the weekend of 10-12 August 1996 over 1400 cancer nurses from over 70 countries began to converge on Brighton, England, the venue for the 9th biennial conference. It was hosted jointly by The Royal Marsden NHS Trust and the Royal College of Cancer Nursing Society, under the auspices of The International Society of Nurses in Cancer Care. The conference venue was the Metropole Hotel and the organisation of the event was in the capable hands of the RCN conference Unit.
Multi-faith hospices
Authors: Lister Anne N
Published: January 2018

The United Kingdom (UK) today has developed into a multi-cul-tural society. Health care professionals are called upon to care for people from cultures that are often different from their own. In order to do this effectively there has to be understanding and sensitivity to the needs of these patients. Evidence suggests that health care professionals are not alert to these needs.

Hospices, in particular, need to develop an awareness and a sensitivity to other cultures in order to care for the service users in a truly holistic sense. The changes required in attitude, practice and environment take time, planning and commitment from all members of the multi-disciplinary team, and indeed from the whole organisation.
Palliative care services and settings: comparing care
Authors: O'Henley Angus , Curzio Joan , Hunt Jennifer
Published: January 2018

The focus of this project was to review palliative care literature on services and settings to establish whether they meet needs of patients and expectations of care providers. In the first part of this two-part article, issues such as the actual and preferred location of death, the quality of care given and comparison of different care settings providing palliative care are identified. The studies were fairly consistent in the information provided regarding care for the terminally ill patient. Primarily, hospice and hospice-based home care teams emerged as the providers of best care. The literature highlighted the fact that dying is a complex process which hinders researchers by making measurement difficult; consequently research assessing the effectiveness of palliative care has been limited. Since palliative care is multi-dimensional, it cannot be easily encompassed by one means of assessment and results gained in one care setting are not necessarily applicable to others. Given the variety of services available, purchasers, providers and users need to know for which patients hospice is most effective and which care models work best. There is therefore a need to design and carry out studies which advance the understanding of dying and the care that will influence this process.
The net is out there
Authors: Sweeney John
Published: January 2018

This paper seeks to introduce the resources available via the Internet to improve information and education provision within palliative care. It describes well established online sources and how they may be found, introduces new terms related to Internet use and describes some of the equipment required for Internet access.
New innovative treatment in metastatic colorectal cancer
Authors: Massey Alison
Published: January 2018

Campto is a useful new agent in the treatment of colorectal cancer that can offer good quality palliative care for many metastatic colorectal cancer patients who have failed 5-FU. The key to successful treatment with Campto is to prescribe it for patients with a good performance status and without bulky disease.
Effects of TENS applied to acupuncture points distal to a pain site
Authors: Hidderley Margaret , Weinel Emily
Published: January 2018

The observation that patients with head and neck cancers undergoing radiotherapy continued to experience pain despite moderate analgesics prompted the first author to investigate whether transcutaneous electrical nerve stimulation (TENS), applied to acupuncture points away from the pain site, would increase the pain relief effect (Table 1). The pilot study involved four patients with head and neck cancers undergoing radiotherapy. The subsequent randomized trial involved 14 patients undergoing inguinal herniorrhaphy. Pain relief in the group receiving TENS on true acupuncture points was compared with that in patients receiving TENS on non-true points. Pain relief was evaluated by pain score and morphine use in the 24 hours following operation. Results of the pilot study suggested that TENS applied to acupuncture points enhanced pain relief. Patients in the follow-up trial had similar pain scores. Those given TENS to non-true acupuncture points required more morphine than those given TENS to true points, suggesting that endogenous opioids released from acupuncture points were boosting pain relief.
Clinical trials, palliative care and the research nurse
Authors: Ling Julie
Published: January 2018

This article describes the role of the research nurse in palliative care clinical trials. The need for these trials has been well documented, and there is a requirement to produce evidence that interventions employed in everyday practice actually work. This paper describes the explicit components and the multifaceted nature of the role of the research nurse in clinical trials in palliative care, and discusses the important part they can play in the advancement of this multidisciplinary specialty.
Palliative care services and settings: improving care
Authors: O'Henley Angus , Curzio Joan , Hunt Jennifer
Published: January 2018

The first part of this review focused on identifying studies which compared services and settings (O'Henley et al 1997). In the second part, the results of efforts to improve care in the areas previously identified as deficient are highlighted including communication, symptom control and support services. The guidelines that have been developed for palliative care are discussed along with the inherent difficulties faced by investigators when conducting research with the terminally ill. Nonetheless, more research is required to clarify which services work best for which kinds of patients and families in which circumstances.
Palliative nursing in New Zealand
Authors: Robertson Gaye
Published: January 2018

New Zealand has a well-developed framework for training and supporting palliative nurses. Palliative nursing in New Zealand was built on the pioneering efforts of nurses working with others in the setting up of hospices and cancer care services in the 1970s. The wisdom of established community and religious nursing services, and those travellers amongst us who return with new ideas, also contributed.
Functional health patterns applied to palliative care: a case study
Authors: Dunne Kathleen , Coates Vivien , Moran Ann
Published: January 2018

In all aspects of nursing appropriate care can only be delivered if patients' problems are appropriately identified. In palliative care assessment of need may be particularly difficult as patients experience such a wide range and complexity of problems. In this work Functional Health Patterns (FHP) were used to structure the assessment of a patient referred to as Maria. Once her needs were identified the data was verified and interpreted leading to nursing diagnoses. Case studies are a non-experimental approach in which a wealth of descriptive information is used to examine an issue in depth. In this paper a single case study design was used to apply FHP to identify the needs of Maria. In so doing the theoretical approach of FHP was applied in practice and was subjectively evaluated by an expert in the field of palliative care. The assessment outcomes are presented and may be of value to others wishing to review their patient assessment process.
The effect of sudden sibling loss on the adolescent or young adult
Authors: Henshelwood Libby
Published: January 2018

Most research on sibling loss has concentrated on the effect of sibling loss in early childhood, but little is known about how the sudden death of a sibling affects the late adolescent or young adult. Although there are no definite boundaries to define adolescence or young adulthood, for the purpose of this article, it occurs between sixteen and thirty years of age. This paper is a review of the literature on such a loss and examines how adolescents grieve and the effect of family dynamics before and after the death and attempts to indicate ways in which adolescents can be helped at such a time.
Letters
Authors: Nicholson Joy , Wilson Diana , Ling Julie , Rothwell Evanne , Peggs Tobias
Published: January 2018

Calculating opioid dose

Nursing on the net
Promoting mental wellbeing for older people living in care
Authors: Mendes Aysha , Palmer Sarah
Published: January 2018

Working to promote mental wellbeing and combat loneliness is an important part of providing adult social care. In this article, Aysha Mendes and Sarah Palmer discuss what is being done to ensure that older people in the UK are not being left behind
The legal process following business failure
Authors: Bernstein Adam
Published: January 2018

Care homes may fail for all manner of reasons. While there is sense in trying to keep a business alive and staff employed, failures can be unpleasant for all involved. In this article, Adam Bernstein discusses what can be done when the company fails
Challenging inaccurate inspection reports
Authors: Guntrip Laura
Published: January 2018

The inspection reports handed down by the Care Quality Commission can make or break a care home, regardless of whether they are accurate. In this article, Laura Guntrip explains the process behind providers ensuring their reports are as accurate as possible
How to … support family members at the end of life
Authors: Ashurst Adrian
Published: January 2018

The end of a family member's life is almost always a difficult time. In this article, Adrian Ashurst discusses his personal experience, looking at the importance of providing support for people who are caring for a loved one at the end of life
Effect of nursing check-ups on the behaviour of individuals with diabetes: A clinical trial
Authors: Teston Elen Ferraz , Peternella Fabiana Magalhães Navarro , Sales Catarina Aparecida , do Carmo Fernandez Lourenço Haddad Maria , Cubas Marcia Regina , Marcon Sonia Silva
Published: January 2018

Aim:

To verify the effect of nursing check-ups guided by assisted self-care on the health care practices of individuals with diabetes in Brazil.

Method:

A randomised clinical trial, involving the participation of 134 individuals with diabetes, randomly distributed into control and intervention groups. Members of the intervention group participated in three nursing check-ups every 2 months, and received two phone calls over a period of 5 months. The control group received the normal care offered at the health care unit. The data were collected via a survey.

Results:

The individuals in the intervention group presented a greater chance of undertaking glycemic monitoring (OR 3.5; 95% CI 1.6–7.5), dietary control (OR 3.3; 95% CI 1.5–7.4) and attending medical check-ups (OR 3.7; 95% IC 1.2–6.3) when compared with individuals from the control group. They also had a greater chance of carrying out regular physical activity (OR 3.3; 95% IC 1.98–4.56) when compared with before and after the intervention.

Conclusion:

The nursing check-ups and assisted self-care of the participants allowed individuals to adhere to healthy behaviors.
New voluntary standards for senior practice nurses
Authors: Saunders Mary
Published: January 2018

The Queen's Nursing Institute and the Queen's Nursing Institute Scotland have published voluntary standards for senior practice nurses. Mary Saunders explains why the standards were needed and how they will be used
A new phase for flu vaccinations
Authors: Oxtoby Kathy
Published: January 2018

During flu season millions of over-65s are at risk of contracting the virus. To address the issue, recent work has been done on the development of a national flu vaccine. Kathy Oxtoby investigates this new development and the trial in which it is being tested
GP Forward View and financial safety
Authors: Taylor Keith
Published: January 2018

Could your practice become economically secure while implementing the GP Forward View? Keith Taylor draws on lessons from one practice to explain how
Effective significant event analysis
Authors: Taylor Kate
Published: January 2018

Significant event analysis is commonly used to enhance safety in general practice and aid learning and improvement. Kate Taylor looks at what can make the process more streamlined in general practice
Requirement Based Testability Estimation Model of Object Oriented Software
Authors: Khan Mohammad , Khanam M. A. , Khan M. H
Published: January 2018

To measure testability before the actual development starts will play a crucial role to the developer, designers and end users as well. Early measurement of testability, especially in early requirement stage to assist the developer for the further development process, and will also assures us to produce and deliver the high quality requirement that can surely reduce the overall cost and improves the quality of development process. Taking view of this fact, this paper identifies testability estimation factors namely understandability and modifiability and establishes the correlation among testability, understandability and modifiability. Further, a model is developed to quantify software testability in requirement phase and named as Requirement Testability Model of Object Oriented Software-RTMOOS. Furthermore, the correlation of Testability with these factors has been tested and justified with the help of statistical measures.
Fibonacci Cordial Labeling of Some Special Graphs
Authors: Rokad A. H.
Published: January 2018

An injective function g:V(G)→{F0,F1,F2,...,Fn+1},where Fjis the jth Fibonacci number(j=0,1,...,n+1), is said to be Fibonacci cordial labeling if the induced functiong∗: E(G) →{0,1}defined by g ∗(xy)=(f(x)+f(y)) (mod2) satisfies the condition |eg(1)−eg(0)|≤1. A graph having Fibonacci cordial labeling is called Fibonacci cordialgraph. In this paper, i inspect the existence of Fibonacci Cordial Labeling of DS(Pn),DS(DFn),EdgeduplicationinK1, n,Jointsum ofGl(n),DFn⊕K1,nand ring sum of star graph with cycle with one chord and cycle with two chords respectively.
ChASTOTA PERELOMOV BEDRA I PREDPLECh'Ya I ZATRATY NA IKh LEChENIE V MOSKOVSKOY OBLASTI
Authors: DREVAL' A V , MARChENKOVA L A , KRYuKOVA I V
Published: January 2018

The aim of the study was to assess incidence of hip and distal forearm fractures and quality of the early medical aid and direct financial expenses for treatment those fractures in Moscow Region in the period of 1998-2002.
Methods: For performing retrospective study among population aged 50 years Kolomensky area of Moscow Region was chosen. Source documents about patients with hip and distal forearm fractures were obtained from traumatologic hospital and traumatologic station of Kolomensky area. Cost of medical aid was calculated on the basis of the prices of the State Obligatory Medical Insurance of Russian Federation.
Results: 527 hip fractures and 2420 distal forearm fractures were registered during 1998-2002. Hip fractures incidence varied from 77.1/100 000 to 156.6/100 000 among males (p0.05). Distal forearm fractures incidence changed from 247.1/100 000 to 309.3/100 000 among males (p>0.05) and from 1213.0/100 000 to 1025.0/100 000 among females (p>0.05). Incidence of both fractures was significantly higher (p70 years old and there was no any dependence of distal forearm fractures incidence on age. Only 4% of hip fractures were surgically operated at the first 2 months after fracture. Direct financial expenses for treatment of patients with hip fracture for first the 2 months after fracture had made was over 582 - in average and early medical care cost for all hip fractures was about 104 714 - in Kolomensky area in the period of 1998-2002. Medical aid to patients with distal forearm fracture cost over 10- in average and financial expenses for treatment of all distal forearm fractures had made about 25 180 - in Kolomensky area for 5 years. We consider provisional amount of hip fractures may be about 23 500 and amount of distal forearm fractures may be about 105 300 during 1998-2002 in Moscow Region. Early medical care cost for all hip fractures was about 3 644 047- and for all distal forearm fractures about 876 264- in total in the period of study.
Conclusions: Retrospective study among Moscow Region population aged 50 years revealed high incidence of hip and distal forearm fractures both in males and females in the period of 1998-2002. The investigation revealed that patients with hip fractures did not receive an adequate qualified medical aid and very high financial assets were spent for early medical care to fractures in Moscow Region.
Rasprostranennost' osteopenicheskogo sindroma i osobennosti kostnogo metabolizma u zdorovykh detey primorskogo kraya
Authors: Vasil'eva T G , Maksimova O G , Kochetkova E A
Published: January 2018

We investigated 130 healthy children and adolescences, its dates of dual-energy X-ray absorbtiometry, bone metabolism markers. The formation of bone mass peak, bone's mineralization in healthy children is depending on age, anthropometric status, sex, dietary with uneven activity in the different local of skeleton. The level of bone metabolism markers is depending on period of life, with maximal dates in patient's 12-14 yeas old. The level of osteopenic syndrome in healthy children consist 15,39%.
Klinicheskie i biokhimicheskie aspekty issledovaniya insulinonodobnogo faktora rosta-1 v syvorotke krovi u retsipientov s narusheniyami kostnogo obmena posle peresadki serdtsa i pochki
Authors: Buzulina V P , Pronchenko I A , Tomilina N A , Vedernikova R N , Rzhevskaya O N , Ermakova I P
Published: January 2018

Insulin-like growth factor-1 (IGF-1), parathyroid hormone (PTH), biochemical markers of bone resorption and formation, bone mineral density (МПК) in spine and hip were determined in 46 recipients following heart transplantation (HI) and 79 -following kidney transplantation (KT) receiving triple immunosuppressive therapy. Serum IGF-1 in total recipients group (n=125) in mean was significantly lower then in health volunteers (187±102 and 250±51 ng/ml respectively; p
EFFEKTIVNOST' PRIMENENIYaKOMBINIROVANNOY TERAPII KAL'TsIEMS VYSOKIMI I SREDNIMI DOZAMI VITAMINA D3dlya profilaktiki postmenopauzal'nogo osteoporoza
Authors: DREVAL' A V , MARChENKOVA L A , KRYuKOVA I V , TIShENINA R S , BALAShOVA N V , PORTNOY L M , MYLOV N M , RUBIN M P
Published: January 2018

The aim of this study was to assess the effectiveness of the combined treatment with calcium and middle (400 mg daily) or high doses (800 mg daily) of vitamin D for prevention of osteoporosis in postmenopausal women with osteopenia in spine. Thirty patients, 45-70 years old, were divided into 3 equal groups: the women in the group 1 were treated with vitamin D3 400 IU. and calcium 1000 mg daily; the women in the group 2 received vitamin D3 800 IU and calcium 1000 mg daily; the patients from the group 3 did not receive any supplementation - the control 1 group.
A significant increase in BMD was found at lumbar spine (+1.9 % after 6 months, p
ROL' GORODSKOGO KABINETA OSTEOPOROZA V PROFILAKTIKE I LEChENII patsientovs osteoporozom i osteopeniey v obshchesomaticheskoy praktike
Authors: VERTKIN A L , MORGUNOV L Yu , NAUMOV A V , POLUPANOVA Yu S , GORULEVA E I , BANNIKOVA M B , BONDARYuK T O , KhALVAShI R Z , RONZIN A V , RUDENKO L V
Published: January 2018

Among patients with somatic diseases the most of those who had had the history of femoral neck fracture suffered from cardiovascular diseases. The consulting room for osteoporosis was established in the Moscow out-patients' clinic. More than 87% of patients with somatic diseases had the risk factors for osteoporosis. Low BMD was found in more than 72% of these patients. Thus, the consulting room for osteoporosis based on out-patients' clinic let us to diagnose and treat osteoporosis in proper time as well as to prevent the development of osteoporosis in patients with different somatic diseases.
VZAIMOSVYaZI MEZhDU MINERAL'NOY PLOTNOST'Yu KOSTEY i rostom, massoy tela,a takzhe pokazatelyami sostava tela u detey
Authors: SVEShNIKOV A A , REPINA I V
Published: January 2018

The changes in mineral mass, muscles, connective and adipose tissues have been studied in 1280 children of both sexes at the age of 5-20 years using GE/Lunar (USA) X-ray bone densitometer. No differences in mineral density (MD) of the skeleton have been revealed among boys and girls during the puberty period. The most intensive mineral density maturation was noticed in girls at the age 11-13 years and in boys at 14-17 years. Significant correlations have been found between mineral mass and body area as well as mineral mass and body weight.
1800 adults at the age of 21-85 years have been studied in order to investigate mineral mass/soft tissue mass (MM/STM) index in dynamics. MM/STM index was 0,041 at the age of 16 years, 0,061 at the age of 21-25 years and remained stable up to 50 years. At the age from 51 till 65 years it has been slightly reduced (0,050). At the age from 66 till 80 years it has been reduced more sharply up to 0,040.
The ratio mineral mass/adipose tissue mass was maximal at the age of 21-25 years - 0,102 and started to reduce up to 0,095 at the age of 26-30 years owing to the fat accumulation in women. At the age of 50 the index was 0,070, at the age of 80 years - 0,051.
PLEIOTROPIC EFFECTS OF THE BONE METABOLISM MODULATOR - STRONTIUM RANELATE IN TREATMENT OF WOMEN WITH THE POSTMENOPAUSAL OSTEOPOROSIS AND ARTERIAL HYPERTENSION.
Authors: Khozyainova N. Yu. , Tsareva V. M. , Bezaltynnykh M. S. , Bruk T. V. , Hozyainova N. Y. , Tsareva V. M. , Bezaltynnih M. S. , Brak T. V.
Published: January 2018

The trial was aimed at studying the effects of the modulator of bone metabolism - strontium ranelate on the parameters of cardiovascular remodeling in women with postmenopausal osteoporosis (OP) and arterial hypertension (AH). This effect includes the results of study of strontium ranelate in 48 women with postmenopausal osteoporosis AH 1-2 degrees and moderate or high cardiovascular risk. During 36 weeks 25 patients, in addition to antihypertensive therapy and calcium supplementation received strontium ranelate (Bivalos) 2 g / day. Bone mineral density (BMD) was evaluated by dual energy X-ray absorptiometry. The effect of strontium ranelate treatment on the thickness of the intima-media of the carotid artery (IMT) by the method of duplex scanning on structural and functional parameters of the heart by echocardiography also evaluated. Adding of strontium ranelate to the antihypertensive treatment and calcium supplementation in women with postmenopausal OP and AH has a positive effect on central hemodynamics, cardiovascular remodeling and diastolic filling.
RESULTS AND EFFECTIVENESS PREDICTORS OF ALENDRONATETHERAPY IN POSTMENOPAUSAL PATIENTS WITH PRIMARYHYPERPARATHYROIDISM
Authors: Dedov I I , Belyaeva A V , Rozhinskaya L Ya , Mokrysheva N G , Mirnaya S S , Kolesnikova G S , Il'in A V , Sazonova N I , Chernova T O , Artemova A M , Dedov I I , Belyaeva A. V. , Rozhinskaya L. Y. , Mokrysheva N. G. , Mirnaya S. S. , Kolesnikova G. S. , Ilyin A. V. , Sazonova N. I. , Chernova T. O. , Artemova A. M.
Published: January 2018

Primary hyperparathyroidism (PHPT) is a common disorder often associated with reduced bone mineral density (BMD) and osteoporosis. The main goal in treating patients who refuse surgery is the correction of bone complications.
The aim of this study is to evaluate safety and efficacy of alendronate treatment in patients with PHPT and osteoporosis. Eligible patients were postmenopausal women suffering from PHPT who did not meet surgical guidelines or ignored surgery due to different reasons. 55 osteoporotic or osteopenic women received alendronate 70 mg weekly and 43 were leaved under medical observation for the reasons of not being osteoporotic or financial unable to comply with treatment/
Results: After 2 years of treatment alendronate group showed statistically significant gain in BMD at L24 +4,0±4,2%, Neck +2,2±4,4%„ TH +2,3±4,5%. At the same time observational group showed decrease in BMD at L24 -4,2±4,0%, TH -3,5±3,8%, R33% -4,0±6,5%, [95% CI -7,6; -0,4]. On the whole BMD dynamics in groups differed at the following sites: L2 (p=0,00004), Neck (p=0,005), TH (p=0,001), R33% (p=0,006). '
Alendronate intake was accompanied by serum Ca decrease (at 1 year point -4,3±5,4%, p=0,00005, at 2 year -2,7±6,4%, p=0,04), 24 hours'Ca excretion decrease from (Me) 8,5 to 6,3 mmol/day at 1 year point, (p=0,007) without PTH elevation. As well as CTx fell at Me: 66% at 1 year and at 60% at 2 year point and OK at 39% and at 27%, correspondingly, p
Otsenka riska padeniy zhenshchin s postmenopauzal'nymosteoporozom, poluchayushchikh al'fakal'tsidol
Authors: Strunina M. V. , Telyushchenko M. V. , Popov A. A. , Izmozherova N. V.
Published: January 2018

The study objective: to assess the influence of alfacalcidol treatment
on risk of falling in real clinical practice.
Methods. Prospective cohort study included 46 postmenopausal
women aged from 52 to 78, who had high risk of falling, low bone
mineral density, glomerular filtration rate from 65 to 30 ml/min,
signed informed consent and were naïve to calcium, vitamin D and
antiresorptive agents. All patients have participated in Osteoporosis
Patients School Classes, received prescriptions for daily 1 mcg alfacalcidol
and approved recommendations on lifestyle modifications
including diet, exercises and movement patterns. Individual risk of
falling was assessed with the help of Guralnik Short Physical Performance
Battery Score.
Results. There were no new cases of falling and fractures in the
cohort during 12 months. During the study period 28 women showed
compliance to alfacalcidol 80% or more (group 1), in 15 patients
compliance was less than 80% (group 2) and 3 women decided to
quit the study. Only group 1 demonstrated significant physical function
changes for the better while there were no significant changes
in group 2.
Conclusion. In a group of postmenopausal women with high risk
of falling and fractures, significant positive changes in lower extremity
performance and balance tests were registered only in women
with 80% or higher compliance to alfacalcidol consumption.
EPIDEMIOLOGIChESKIE ASPEKTY PERVIChNOGOGIPERPARATIREOZA V ROSSII
Authors: Rozhinskaya L. Ya. , Rostomyan L. G. , Mokrysheva N. G. , Mirnaya S. S. , Kirdyankina N. O.
Published: January 2018

Primary hyperparathyroidism (PHPT) is the third most
frequent endocrine disorder and has a variable clinical
presentation. Asymptomatic PHPT became the predominant
form of the disease with increase of its incidence after the
introduction of automated serum calcium measurement in
North America and Europe. Data from Russia is lacking. Aim:
To present the clinical profile of PHPT in Russia. Materials
and Methods: This retrospective study was conducted at
endocrinology centers in 8 regions of Russia. We analyzed
the clinical presentation, and treatment options in patients
with confirmed PHPT (1995-2010). Results: 738 patients (F:
M-8:1) with age ranging from 13 to 83,4 years (mean 54,3)
were analyzed. 54% was from Moscow (n=397), 11% - from
Moscow region (n=79) and 35% - from 53 regions of Russia
(n=262). Symptomatic PHPT was the most common form (74%)
and was revealed with osteoporosis in 56%, nephrolithiasis - in
45% and ulcer disease - in 18%. Our data showed an increase
in the incidence of PHPT (especially mild PHPT) after 2005
compared with earlier period. 64,9% of patients were treated
surgically, 17 patients undergone repeated parathyroid surgery.
28,3% received bisphosphonates, calcitonin and/or cinacalcet .
11,5% was observed without treatment. Conclusions: This
data analyzes some causes of delayed diagnosis of PHPT in
Russia, characterized age and gender distribution of patients
with PHPT and demonstrates the changes in clinical profile of
disease from 1995 to 2010. PHPT still remains symptomatic
disorder in our country most frequently with skeletal and renal
manifestations.
KLINIKO-RENTGENOLOGIChESKIE OSOBENNOSTIPOSTMENOPAUZAL'NOGO OSTEOPOROZA NA FONE DEGENERATIVNO-DISTROFIChESKIKh IZMENENIY POZVONOChNIKA
Authors: Kirpikova M N , Cvinina S A , Belosel'skiy N N , Nazarova O A , Stakovetskiy M K
Published: January 2018

The purpose of the work is studying clinico-radiological
features of a combination of postmenopausal osteoporosis
and degenerate-dystrophic changes at the spine (vertebral
column).
Material and methods. It were examined 66 women with
postmenopausal osteoporosis and a dorsodynia syndrome. It
were estimated expression of a dorsodynia on a visually-analogue
scale (VAS), motor performance (function) level, quality of a
life (Qualeffo-41). There was spent X-ray examination of a spine
with an estimation of degenerate-dystrophic changes in points.
Results and conclusions. All patients had degenerate-dystrophic
changes of a backbone with various degree of expression.
Patients with considerable displays of an osteoporosis at
radiological research and overestimate of bone mineral density
were prevailed . The authentic negative interrelation (r =-0,59
is taped; р
Obesity and osteoporosis
Authors: Shishkova V. N. , Shishkova V. N.
Published: January 2018

Osteoporosis and obesity, two disorders of body composition, are growing in prevalence. Interestingly, these diseases share several features including a genetic predisposition and a common progenitor cell. With aging, the composition of bone marrow shifts to favor the presence of adipocytes, osteoclast activity increases, and osteoblast function declines, resulting in osteoporosis. Secondary causes of osteoporosis, including diabetes mellitus, glucocorticoids, immobility and metabolic syndrome are associated with bone-marrow adiposity. Unraveling the interface between bone and fat at a molecular and cellular level is likely to lead to a better understanding of several diseases, and to the development of drugs for both osteoporosis and obesity.