The aim of the study was to assess the clinical performance of the model combining areal bone mineral density (aBMD) at spine and microarchitecural texture (TBS) for the detection of the osteoporotic fracture. The Eastern European Study is a multicenter study (Serbia, Bulgaria, Romania and Ukraine) evaluating the role of TBS in routine clinical practice as a complement to aBMD. All scans were acquired on Hologic Discovery and GE Prodigy densitometers in a routine clinical manner. The additional clinical values of aBMD and TBS were analyzed using a two steps classification tree approach (aBMD followed by TBS tertiles) for all type of osteoporotic fracture (All-OP Fx). Sensitivity, specificity and accuracy of fracture detection as well as the Net Reclassification Index (NRI) were calculated. This study involves 1031 women subjects aged 45 and older recruited in east European countries. Clinical centers were cross-calibrated in terms of BMD and TBS. As expected, areal BMD (aBMD) at spine and TBS were only moderately correlated (r (2) = 0.19). Prevalence rate for All-OP Fx was 26 %. Subjects with fracture have significant lower TBS and aBMD than subjects without fracture (p < 0.01). TBS remains associated with the fracture even after adjustment for age and aBMD with an OR of 1.27 [1.07-1.51]. When using aBMD T-score of -2.5 and the lowest TBS tertile thresholds, both BMD and TBS were similar in terms of sensitivity (35 vs. 39 %), specificity (78 vs. 80 %) and accuracy (64 vs. 66 %). aBMD and TBS combination, induced a significant improvement in sensitivity (+28 %) and accuracy (+17 %) compared to aBMD alone whereas a moderate improvement was observed in terms of specificity (+9 %). The overall combination gain was 36 % as expressed using the NRI. aBMD and TBS combination decrease significantly the number of subjects needed to diagnose from 7 for aBMD alone to 2. In a multi-centre Eastern European cohort, we have shown that the use of TBS in addition to the aBMD permit to reclassified correctly more than one-third of the overall subjects. Furthermore, the number of subjects needed to diagnose fell to 2 subjects. Economical studies have to be performed to evaluate the gain induced by the use of TBS for the healthcare system.

The goal of the present study was to determine the prevalence of hyperuricemia in patients with coronary artery disease (CAD), within three months after coronary events. Also, we aimed to determine whether the presence of hyperuricemia holds correlation with severe CAD, overall heart functioning and risk factors for CAD. The study included 505 consecutive CAD patients, 385 males and 120 females, aged 60.9 ± 9.6 years, with a mean body mass index (BMI) 28.0 ± 3.7 kg/m. All patients were admitted to specialized cardiovascular rehabilitation within three months post-acute myocardial infarction (AMI) without revascularization (32.6%), percutaneous coronary intervention (PCI) with myocardial infarction (32.1%) and with coronary bypass graft (35.3%). The mean value of serum acidum uricum (SUA) was 345.5 ± 100.3 µmol/L, where 115 (22.8%) patients had asymptomatic hyperuricemia. Patients with asymptomatic hyperuricemia had significantly higher average number of risk factors, lower HDL cholesterol and higher creatinine and triglycerides levels, lower ejection fraction (EF). Multivariate stepwise analysis revealed that five parameters were capable to predict SUA levels. We can conclude that in patients with CAD, SUA levels are independently associated with BMI, triglyceride and creatinine levels and negatively with EF. Thus, one can say that asymptomatic hyperuricemia is not significantly associated with the severity of CAD.

Wellens’ syndrome, also known as LAD (left anterior descending) coronary T-wave syndrome, “widow maker” or warning sign, is a potentially unrecognized critical proximal LAD stenosis with possible fatal consequences. It can be associated with extensive acute anterior wall myocardial infarction, with left ventricular dysfunction and a lethal outcome within a few days after the onset of symptoms. It usually consists of a typical ECG finding in the precordial leads that represents a significant proximal LAD stenosis in patients with unstable angina pectoris. Although this syndrome is not indicated for PCI (the patient is usually pain-free at the time of electrocardiography registration), it is necessary to recognize the characteristic pattern and perform an emergency coronary angiography and percutaneous or surgical revascularisation of the affected blood vessel. Here we present the case report of a 47 year-old woman without previous anamnesis of coronary disease. On admission to the Coronary Care Unit she was chest pain-free and had all the indicators of Wellens’ syndrome

BackgroundIt is well known that chronical rheumatoid diseases have negative impact on life quality. Pain and joint swelling, limited motion, stiffness and deformity from one side, as well as fatigue, poor sleep quality and depression, on the other hand, significantly reduce life quality.ObjectivesComparison of life quality, pain intensity and fatigue intensity of patients with rheumatoid arthritis (RA) and knee osteoarthritis (knee OA).Methods150 patients have been examined: 75 patients with RA and 75 patients with knee OA. Groups were homogenous regarding gender and age. Life quality has been estimated by means of questionnaire- Short Form Medical Outcomes Instruments (SF 36) SF 36F-physical sphere and SF 36M-mental sphere. Pain and fatigue intensity was estimated by scale VAS.ResultsAverage value of SF 36F with patients suferring from RA was 35.62±21.73 in regard to patients suffering from knee OA 61.72±18.85, p<0001. Average value of SF 36M with patients suffering from RA was 44.79±24.18 compared to patients with knee OA having 68.12±20.77, p<0001. Pain intensity with patients with RA was 47.79±24.66 compared to patients with knee OA ranging 46.08±18.82, p=0.622. Fatigue intensity with patients suffering from RA was 48.28±25.64 compared to patients with knee OA having 29.23±15.58, p<0001.ConclusionsPatients with RA have significantly less quality of life and greater fatigue intensity compared to patients with knee OA. Pain intensity was not statistically significantly different. Although patients with RA have poorer values of quality of life, taking into account a big number of patients with knee OA, a significant implication of this disease is recognized. Pain is significant predictor of poor quality of life.Disclosure of InterestNone declared

ObjectivesTo evaluate the connection between SUA and severity of coronary heart disease (CHD) assessed by angiography in patients with CHD.Methods198 patients (75.8% men) undergoing cardiovascular rehabilitation at the Institute “Niska Banja” from October 1, 2014, to January 31, 2015, were evaluated. Mean (SD) patient age (62.1±10.4), prevalence of patients with 3-vessel coronary artery disease with stenosis >70% (31.3%), coronary artery bypass grafting (CABG) (37.4%), percutaneus coronary intervention (PCI) (38.9%), primary PCI (32.8%), mean ejection fraction (50% ±11). Prevalence of hyperuricemia (>386 μmol/l) 33.3%, hypertension 85.9%, hypelipoproteinemia 81.8%, diabetes mellitus 24%, family history of CHD (47%) and mean number risk factors 2.65. Patients were separated into a normal SUA group (n=132, with SUA <386 μmol/L) and a high SUA group (n=66, with SUA ≥386 μmol/L).ResultsPatients with high SUA had significantly higher 3-vessel coronary artery disease with stenosis >70% (40.9% vs. 26.5%; P=0.04), low ejection fraction (EF<34%)(19.7% vs. 8.3%; p=0.021), obesity (27% vs. 14.4; P=0.03), significantly higher triglycerides (2.38±1.7 vs. 1.88±1.44; P=0.028) and serum creatinine (111.5±46 vs. 90±21; p<0.001).ConclusionsSUA levels were independently associated with EF in patients with CHD. Hyperuricemia is associated with severity of CAD- 3-vessel coronary artery disease with stenosis >70%.Disclosure of InterestNone declared