PAIN, JOINTS, SPINE <table id="table1" border="0" width="100%"> <tbody> <tr> <td colspan="2" align="center" valign="top"><strong>The journal Pain, joints, spine (Bolʹ, sustavy, pozvonočnik), the official journal of the Ukrainian Association of Osteoporosis, is platinum open-access peer-reviewed periodical for rheumatologists, traumatologists, neurologists, general practitioners, and allied specialists with interest in joint and spine diseases and pain management.</strong></td> </tr> <tr> <td colspan="2" valign="top"><hr noshade="noshade" size="1" /></td> </tr> <tr> <td valign="top" width="25%"><img src="" /></td> <td valign="top" width="75%"><strong>The founder:</strong> Zaslavsky O.Yu. Published with assistance of the Ukrainian Association of osteoporosis, Ukrainian Association of menopause, andropause and diseases of the musculoskeletal system.<br /><strong>Publisher:</strong> Zaslavsky O.Yu.<br /><strong>Language of edition: </strong>Ukrainian, English, Russian. <p><strong>Registration Certificate:</strong> КВ № 17141-5911 Р. Issued by the Ministry of Justice of Ukraine 21.10.2010.</p> <p><strong>Founded:</strong> March 2011<br /><strong>Publication frequency:</strong> 4 times per year.</p> <p><strong>ISSN</strong> 2224-1507 (print)<br /><strong>ISSN</strong> 2307-1133 (online)</p> <p><strong>DOI: 10.22141/2224-1507</strong></p> </td> </tr> <tr> <td colspan="2" valign="top" width="100%"><hr /></td> </tr> <tr> <td colspan="2" align="center" valign="top" width="100%"><strong>The journal has official endorsement from the</strong> <table border="0" cellspacing="0" cellpadding="0"> <tbody> <tr> <td valign="top" width="356"> <p><strong><a href="" target="_blank" rel="noopener">European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO)</a></strong></p> </td> <td valign="top" width="356"> <p><strong><a href="" target="_blank" rel="noopener">All-Ukrainian public organization<br />Ukrainian Association of Orthopedists-Traumatologists</a></strong></p> </td> </tr> <tr> <td> <p><a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="141" /></a></p> </td> <td> <p><a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="141" /></a></p> </td> </tr> <tr> <td> <p><a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="37" /></a></p> </td> <td> <p><a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="100" /></a></p> </td> </tr> </tbody> </table> </td> </tr> <tr> <td colspan="2" valign="top" width="100%"><strong>The journal is the official publication of the Ukrainian Association of Osteoporosis.</strong></td> </tr> <tr> <td colspan="2" valign="top" width="100%"><a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="37" /></a></td> </tr> <tr> <td colspan="2" valign="top" width="99%"><hr /></td> </tr> </tbody> </table> <table id="table2" border="0" width="100%"> <tbody> <tr> <td align="left" valign="top" width="98%"><strong>The journal in its publication activity is guided by the recommendations of the following editorial associations:</strong><br /><a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="37" /></a></td> </tr> <tr> <td align="left" valign="top" width="98%"><hr /></td> </tr> <tr> <td align="left" valign="top" width="98%"><strong>We endorse the following declarations:</strong></td> </tr> <tr> <td align="left" valign="top" width="98%"><a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="37" /></a> <a href="" target="_blank" rel="noopener"><img src="" alt="" width="100" height="37" /></a></td> </tr> </tbody> </table> <hr /> en-US <p>Our edition uses the copyright terms of <strong>Creative Commons</strong> for open access journals.</p><p>Authors, who are published in this journal, agree with the following terms:</p><ol><li>The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a <span style="text-decoration: underline;"><a href=""><strong>Creative Commons Attribution 4.0 International License</strong></a></span>, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.</li><li>Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.</li><li>The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.</li><li>The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.</li><li>The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.</li><li>The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.</li></ol> (Dzerovych Natalia) (Оnchul Larisa) Tue, 20 Jul 2021 08:59:02 +0300 OJS 60 Ukrainian FRAX version in the male osteoporosis management <p><em><strong>Background.</strong> </em>At present, FRAX is a well-known and widely-used risk assessment tool for major osteoporotic fractures. The Ukrainian version of the FRAX algorithm was presented in 2016; with the “intervention threshold” for additional DXA exa­mination and antiosteoporotic treatment of the Ukrainian women published in 2019. However, the data on its possible uses in men are limited. The purpose of the study was to evaluate the possibilities of using the previously developed criteria of the Ukrainian FRAX algorithm in Ukrainian men. <em><strong>Materials and me­thods.</strong></em> We exa­mined 653 outpatients aged 40–88 years (mean age (M ± SD) — 60.5 ± 11.8 years). We analyzed the results both in the general group and in the age subgroups; in particular, with an account of low-trauma fractures, included in the FRAX calculation, and compared them with the corresponding indices of the Ukrainian wo­men.<em><strong> Results.</strong></em> The most frequent (26.6 %) risk factor for osteoporo­tic fractures in the group of Ukrainian men was a history of low-trauma fracture (the corresponding index in women was 51.3 %), its presence being the reason for antiosteoporotic treatment initia­ting. Following upon the risk of major osteoporotic fractures calculated by FRAX, only 6.7 % of men without previous fractures were found to require additional DXA examination in order to re-evaluate the osteoporotic fracture risk, and none had a high fracture risk. 73 % of men without fractures did not have any risk factor inclu­ded in the FRAX algorithm. <em><strong>Conclusions.</strong></em> This study showed a grea­ter need for both antiosteoporotic treatment without DXA assessment and additional densitometric examination for the osteoporotic fracture risk assessment for the Ukrainian women rather than men, along with a special attention to the presence of previous fractures in men, and consideration of other risk factors for osteoporosis, even those not included in this FRAX algorithm.</p> V.V. Povoroznyuk, H. Johansson, N.V. Grygorieva, J.A. Kanis, А.S. Musiіenko, M. Lorentzon, N.C. Harvey, E.V. McCloskey, E. Liu Copyright (c) 2021 Tue, 20 Jul 2021 00:00:00 +0300 Age-related changes in bone tissue in men <p><em><strong>The purpose</strong> </em>of the study was to establish age-related changes of male bone tissue. <em><strong>Materials and methods.</strong></em> The study was conducted by the Department of Clinical Physiology and Pathology of the Musculoskeletal System of the State Institution “D.F. Chebotarev Institute of Gerontology by the National Aca­demy of Medical Sciences of Ukraine”. It involved 342 healthy men aged 20 to 89 years without osteoporosis and osteoporotic fractures or any pathology with a confirmed impact on bone tissue, as well as any somatic pathology in the sub- and decompensation. The following methods of examination were used: questionnaire, anthropometric measurements, clinical and instrumental examination. Bone mineral density (BMD) was measured by the dual-energy X-ray absorptiometry machine “Prodigy, GEНС Lunar” at the level of the entire skeleton, lumbar spine (L1-L4), proximal femur and femoral neck, distal and ultra-distal forearm bones. <em><strong>Results.</strong></em> We have detected a significant 14.8 % decrease of BMD at the level of femoral neck in the group of men aged 60–69 years, by 20 % in the group of men aged 70–79 years, and by 24.1 % in the group of men aged 80–89 years compared to the men aged 20–29 years; at the same time, at the lumbar spine there was re­gistered a decrease of this parameter by 1.6 % in men aged 60–69 years, by 1.9 % in men of 70–79 years and by 0.8 % in men of 80–89 years, respectively. Among the examined practically healthy men, the bone tissue remained at the normal level relative to age in 67.8 %; osteopenia was detected in 27.8 %, and osteoporosis in 4.4 %. <em><strong>Conclusions.</strong></em> An age-associated BMD reduction was registered at various skeletal sites in the practically healthy men wi­thout any clinically significant factors affecting bone tissue metabolism. The most pronounced BMD loss was observed at the level of fe­moral neck. At the same time, 4.4 % of examined had osteoporosis without any clinical signs.</p> A.S. Musiienko, N.V. Zaverukha Copyright (c) 2021 Tue, 20 Jul 2021 00:00:00 +0300 Life quality of men with ankylosing spondylitis: association with the disease course and the structural and functional state of bone tissue <p><em><strong>Background.</strong> </em>Multiple peculiarities of ankylosing spondylitis clinical course have a significant influence on the phy­sical, mental and social status of patients. Systemic loss of bone tissue manifesting itself through the development of osteoporosis and its complications is not excluded either. However, currently there is no sufficiently clear information on the influence of osteoporosis or its metabolic components, as well as peculiarities of the disease clinical course on the physical and mental health components in the patients suffering from ankylosing spondylitis. Purpose: to study the quality of life indices using the SF-36 and HAQ questionnaires in men suffering from ankylosing spondylitis and to assess the associations of these indexes with the disease cli­nical course as well as structural and functional state of bone tissue.<em><strong> Materials and methods.</strong></em> 105 men suffering from ankylo­sing spondylitis and 25 practically healthy persons of the appropriate age and sex forming the control group were examined. In order to assess the quality of life indices, the SF-36 and HAQ questionnaires were used. <em><strong>Results.</strong> </em>It was established that men suffering from ankylo­sing spondylitis showed reliably lower indices of phy­sical (37.3 ± 1.5 points) and mental (44.2 ± 1.7 points) health components if compared to the control group (99.1 ± 0.3; 97.4 ± 0.7 points respectively). Under conditions of the low bone mineral density, quality of life indices (PCS; MCS) were only 12.2–7.1 % lower than in the patients with a preserved bone mineral density. It was shown that under conditions of the Vitamin D deficiency, quality of life components were significantly worse, specifically on account of the mental health component (р &lt; 0.05). It was also established that the lower quality of life was closely associa­ted with a high activity of the inflammatory process (ASDAS-СRP, BASDAI) and a high dose of glucocorticoids. <em><strong>Conclusions.</strong></em> Men suffering from ankylosing spondylitis show a significant reduction of life quality indices by the SF-36 (PCS; MCS) and HAQ questionnaires, which demonstrate no association with the age of the patients (except for MCS), di­sease form and duration, structural and functional state of bone tissue. However, they are significantly worse in subjects with the Vitamin D deficiency, a high dose of glucocorticoids and high disease activity.</p> S.V. Shevchuk, O.M. Pavliuk Copyright (c) 2021 Tue, 20 Jul 2021 00:00:00 +0300 Microglia and mast cells: new targets for the treatment of chronic pain <p>The article is devoted to the problem of effective ma­nagement of chronic pain. A review of the known mechanisms of development and maintenance of chronic pain and possible me­thods of influence is given. One of the reasons for the lack of chro­nic pain treatment effectiveness in some patients is the use of treatment regimens with drugs acting exclusively on the targets loca­ted in the nerve structures. Today an important role of micro­glia and mast cells in the development and maintenance of chronic pain conditions is well acknowledged. A new class of drugs from the group of acylethanolamides is described. One of the representatives of this group is palmitoylethanolamide. This drug may mo­dulate the activity of microglia and mast cells, thus increasing the pain threshold and the effectiveness of therapy. The use of palmitoylethanolamide in patients with chronic pain can increase the effectiveness of therapy.</p> V.I. Romanenko Copyright (c) 2021 Tue, 20 Jul 2021 00:00:00 +0300 Modic changes in the lumbar spine: histology, risk factors, clinical presentation and treatment <p>The article presents a literature review on the ­Modic changes (MCs) in the vertebral endplates, which are frequently detected in patients with chronic low back pain. The etiology of MCs is unknown; however, there are three causes which are considered the most probable today: mechanical, infectious and biochemical. They share a common mechanism of pro-inflammatory molecule migration from the degenerative disk. A close association has been identified and described between the MCs and a non-specific chronic low back pain. Disc degeneration ­exerts a further stress on the endplates and produces microcracks, through which the inflammatory mediators enter the bone marrow and provoke the MCs. At pre­sent, there are no evidence-based treatment protocols for the MCs. A certain progress has been made with antibiotic therapy, injections of steroids and antiresorbents; the effectiveness of anti-TNF-α therapy is being explored. The sporadic reference data on our disposal indicate that patients with MCs and chronic low back pain, along with instability, who do not respond to a conservative treatment, may be referred for the surgical treatment to relieve pain and improve quality of life. However, not all of the presented methods of surgical treatment with chronic back pain are effective in patients with the Mo­dic changes. The divergence of patient treatment outcomes presen­ted by various sources indicates the need for a further research to understand the MC pathogenesis and develop pathogenetic approaches to the treatment of this pathology.</p> V.S. Shapovalov, M.A. Bystrytska, N.V. Dedukh, O.I. Balyk Copyright (c) 2021 Tue, 20 Jul 2021 00:00:00 +0300 Requiescat in pace Vladyslav Volodymyrovych Povoroznyuk, the Editor-in-Chief of “Pain. Joints. Spine” (22.10.1954 — 12.06.2021) <p>No abstract</p> No authors Copyright (c) 2021 Tue, 20 Jul 2021 00:00:00 +0300