in all aspects of activity. oleg vasilyevich, thank you very much for the conversation. thank you very much, all the best. hello, in russia, since the decade of science and technology, the ntv television company and the state corporation rosatom are presenting a program: we are science, science and we are a program about how science will change our lives in the next 10 years. i'm vladimir antokhin, i'm ekaterina shugaeva. in 10 years , science will defeat osteoporosis. the topic of the program is very serious today, in fact, and it seems to me that this is a problem that many adults face. well that’s exactly why i invited optimists who believe that in 10 years science will really defeat osteoporosis.

this is antonina starodubova, general practitioner , nutritionist, good evening, and vadim dubrov, traumatologist, orthopedist, hello, good evening, and according to tradition, my guests are skeptics, this is denis yakushev, orthopedic traumatologist, good evening, and galina melnichenko, endocrinologist, good evening, good evening, at the end of the program our guests are optimists, they will make a forecast with what probability in 10 years science will really osteoporosis will win, our expert, professor kapustin, will tell us about the history of osteoporosis . i once heard something while sitting in the clinic. it is very easy to identify, just look at the nails, well, all these statements, to put it mildly, do not correspond to reality, in fact, osteoparic changes have been found even on skeletons that are more than 400 years old. and

osteoparic postures can be seen in paintings of both ancient greece and ancient china. today, about 200 million people in the world suffer from osteoporosis and are especially vulnerable women after menopause, well, older people. the study of osteoporosis as a separate disease began in the mid-19th century. for a long time , caution does not develop itself; a person does not even suspect that it is developing.

came to us with fractures , this is natural, by the way, when i was listening to professor kapustin just now, i was a little surprised, because uh, from my point of view , osteoporosis is not a disease, but a natural state of our body, with age, but how is it for me, it’s been breaking since childhood, but no, you have character it’s so simple, the problem here is a little different, i’ve always said that the problem is in character, but seriously.

with osteoporosis, but without pain, with osteoporosis , but without the troubles that this disease brings, let’s think about this possibility, so i’m an optimist, we will definitely discuss this today, antonina vladimirovna, when was the disease of acute porosity discovered then? and how they tried to treat it before, well, i know, some people still ate chalk. well, you can use chalk, or you can

use egg shells, this is really a problem, which people believe that bones are from... is really closely related to age , postmenopause, and indeed , for a long, long time this problem has existed, and before people still lived to the point of otoporosis, we know from the mummies that are in egypt , we know from images in ancient greece and ancient china, and we also know that

such skeletons are represented among the indians in south and north america, mainly in south and peru.

yes, what does science know today about the causes of its occurrence? after all, osteoporosis is a systemic metabolic disease, yes, characterized by a decrease in the density, yes, of bone tissue and the most important disturbances in architectonics, that is, if we look at the sponges, yes, we can see it. such a sponge is an ordinary bone, yes, it is dense , quite elastic, porous, finely, finely , precisely finely porous, and the cells, the gaps between them are quite rough, thick, that is , it can withstand the weight of a person, and any other load, and we see a bone, for example, damaged by osteoporosis, yes, we see, yes,

that the cells are almost six to seven times larger, the gap between them increases, yes, the beams become more fragile, thereby at the end ... division and that’s what they say, that this whole structure leads to what, to fractures during low-energy injury , and what is a fall from one’s own height, a person walks, walks, falls, either a fracture of the ray begins in a typical place, or a fracture of the neck, if he fell on the butt , a fracture of the compression vertebrae occurs, that is, in principle, in simple words, this an increase in porosity, well, that is, the bone was of the same porosity,

between construction and destruction, it goes on constantly, yes, blasts are built where they are needed, classes are stolen, why do they always function, why yes, because we have microfractures. exists constantly in the vertebrae, in the bones, that is , they are always there at the microscopic level, thereby ophthioclasts, osteoblasts must constantly adhere, heal, improve the structure, that is, like this, and in case of osteoparatic, let’s say, damage, yes, osteoclasts begin to predominate more , superosteoblasts lag behind, lag behind, and the process of bone regeneration occurs constantly in the body until

... if you imagine a bone, you started talking about this about architectonics, like the eiffel tower, show us it, here it is, this bone, inside it is all made like an eiffel tower, and the evil osteoclasts are constantly destroying it, destroying it, and the good osteoblasts are building and building, one detail remains - an osteocyte, a bone walled up forever, a cell in the bone, an osteocyte. structural unit, but you i was asked how to make a diagnosis, but

this is a chronic condition, let’s remember other chronic conditions, how to diagnose hypertension, you can have clinical manifestations, or you may not have them , just measure your blood pressure, then suddenly suddenly find out that a stroke may develop, let's remember diabetes mellitus, yes, you can have symptoms, you can not have them, and the same thing... to have a fracture as a complication, and there are a variety of fractures, so how to make a diagnosis? you need to understand that there are risk groups, there are scales that allow us to measure this risk. everyone has a family history, there is a grandmother, if the grandmother

broke her hip, then perhaps her granddaughter after menopause should also think about this topic, and then come. with the exception of those diseases that could create this osteoporosis. okay, denis sergeevich, but somehow i myself can understand, well, today galina afanasyevna said that there are actually asymptomatic cases, and osteoporosis, as a change in the body, i myself can somehow understand, that’s what should alert me so that i still go to the doctor,

i just did an analysis, which is possible, but i’ll tell you why this issue worries us. and i’m especially concerned because , by the way, we have a mutual friend pavel, he has a wonderful cat, he read that cats are very susceptible to osteoporosis, so he says, well, if uh, for example, i if i go to the doctor, then how can i, for example, by appearance or by some manifestations understand that i am in charge, how can i understand when i need to be sent to the doctor, look, the most important thing maybe. it was shown in a courtesan , all the signs actually showed this, the first thing is that the man walked, walked, walked, walked, walked straight, walked straight, walked beautifully, then he became 50-60 years old, for some reason he began to bend over , and most importantly, ask him if you go up to the wall and try to touch the wall

with the back of your head, he won’t be able to, this is one of the signs, yes, that anyone can suspect that something is wrong with her. that is, such a deformation that he cannot calmly, yes, this indicates what, most likely they will find it there fractures, vertebrae, and this is a change, there are different, different, of course, the second is a person is always, for example, height was 165, 164, 178, a beautiful beautiful girl walked, then instead of 178 she became 172, oops, they measure her, then not only is she bent and her growth is small, this is the second sign, yes, she says , the third, how can we, folds appear on the sides, folds appear on the sides, so we have a nutritionist, so we can also check how, if we take the handle from the wing of the sharpening bone, and we should reach the ribs maybe a young adult has four

fingers, well, from four to three, but such people have two fingers. changes in bone shape and changes in density occurred when this disease, or this condition, let’s call it that, has been for several years now, there is such a thing as preventive examinations and medical examinations, this is a completely different story for

certain risk groups, well, starting with that , what galina afanasyina said, there are patients with secondary. and this already indicates that changes are taking place in the system, we must look for the reason for these changes, how daros treats today, great question. firstly, let's agree with you how much it needs to be treated , how much it needs to be corrected, correction and treatment are two different things,

let's start with correction, let 's make life comfortable, and you know, i think that 80 % of people suffering from osteoporosis, if they never get fractures, 80%, they will exist quite calmly and globally. there will be no medications, but we will think about a systematic approach, with the exception of problems with the spine, if much more interesting, let ’s spend a couple more words on the economy, because treating a patient with a fracture is very expensive, expensive, it’s easier to build a system in which the number of fractures will be fewer and... it will be much easier for society, because you not only need to treat the fracture, you need care for the patient for many months after this. the musculoskeletal system is an amazing and terribly interesting thing. and

not only the bone density changes, but the density of the tendons changes, the zone of the tendon-muscle transition changes. and it's no coincidence we know very well that in older people, for example, there is damage to the quadriceps tendon. occurs many times more often than in young people, you need to understand when and what to do, then we begin to build a system of work, physical activity, if you do not feed a person calcium and deprive foods of this mineral, it will be bad if there is no hormonal support, if there will be no sunshine with the synthesis of vitamin d. all this together, it requires general attention, yes, but i would like to run after the bus, we at 80 are 90 at 100 and even at 120, so to the question

we will be back in the future, but after advertising, advertising on ntv, the unpredictable show superstar is on air, the fourth season, and the theme of today is a hit movie, i will be a big king,

unfortunately, our expert, professor kapustin, does not believe in this. every 3 seconds , an acute aparatic fracture occurs in the world. after 50 years, every second woman and every fifth man will have a broken bone for the rest of their lives. the problems will only increase in the future due to the aging population of our country. today in russia osteoporosis 14 million people are affected, which is approximately 10%. population, another 20 million people have osteopenia, leaving 34 million people at high risk of fractures.

seven vertebral fractures occur every minute in people over 50, and a hip fracture occurs every 5 minutes. in russia, mortality within a year after a fracture reaches 50%. of those who survive, 3% remain bedridden. daily calcium intake is approximately 400 mg, recommended intake is 1 g and, most importantly, we have a large population

is located in the northern. uh-huh, in a word , our prospects are not very bright, so, for dinner i now eat cottage cheese, cheese, well, here ’s some chalk for you, yes, okay, good, yes, antonina vladimirovna, well, really the data is somehow not very rosy, but there are some guaranteed methods of prevention to avoid acute diarrhea in the future, they talked about calcium, well, everyone there knows this egg, yes, the shell, it’s hard, yes, the shell is hard, well, hard, right? so we put it there in a special medium of acetic acid and then it slowly sizzles with calcium calcium is slowly being washed away, what will happen in the end, yes, there are many methods of traditional medicine, this is true, but still, in continuation of the previous question, i would like to emphasize that the best treatment is prevention, i will insist on this and

i would like to remember or those who did not know . remind you that the main process of bone formation still occurs in children and adolescents, somewhere it is considered on average up to 24 years old, it is at this age that proper nutrition is especially critical, we all know that yes, it is very important sources of b vitamin d calcium, the same fish, dairy products, absolutely right, physical activity is very important, it should be predominantly axial loads, that is , children in... russians must definitely go in for sports, what to form and braids, what are axial loads , gravitational, jumping, jumping rope in full, dancing, running, walking, at least what i really like, and otherwise no one will stick to it, it’s good if i’m not 24, but 25, let’s say, it’s coming the period when the bush the tissue must be maintained, and that is, all this , all these recommendations remain relevant, but i wanted to emphasize that in addition to well-

known facts, such as sources of vitamin. d calcium, which can generally be found on the internet, we also know that other nutrients are also needed, protein, obviously, yes, that it is needed not only for bones, but also for muscle tissue, yes, so that we have bones, chicken is our everything, not only chicken, fish, seafood, which are also sources of other biological compounds , a whole range of biologically active compounds, selenium, zinc, it is known that potassium and magnesium are needed for normal functioning of bone tissue as well. according to the latest data from all over the world, we experts all over the world recommend following the principles of a healthy diet, it would seem that this is only for healthy people, no, this will also be true for patients who already have it, you are now talking a lot about a lack of calcium, but an excess calcium, and if you overeat it, will your bones get even worse? fortunately we have a number of protective mechanisms; not everything we consume goes into the bloodstream to the bone

tissue, we have intestines. we will now say that people will start eating calcium, and maybe this is also bad, and excess and deficiency are really very bad, very harmful to health, but this is not such a direct dependence, that is, there is no direct dependence if we overeat calcium, what will be bad for bone tissue, no, only if the metabolism is disturbed, let me still emphasize the importance of comprehensive adherence to the principles of a healthy diet, because only a healthy diet is varied, balanced... with proteins, fats, carbohydrates, and micronutrients and vitamins, only in combination, this allows us not only to maintain health in general, but to maintain the health of bone and muscle tissue, i would like to remind you that bone is not only calcium, but it is also proteins that connected, this is a very complex system , when we talk about bone, for some reason we most often

imagine the bone... which is in grandma's borscht, it is dead, the bone is alive in the body, completely different, it has a huge number of vessels, it has the highest metabolism, calcium given and accepted, because it is needed for muscle contractility and so on, so relatively recently we will be defending a dissertation on this topic, we have begun, for example, on some patients, at the institute of medical and biological problems we can carry out histolysis. we started feeding patients leucine, an essential amino acid, and it turned out that feeding leucine, as a biological additive, affects the young, the synthesis of collagen, but does not affect the elderly at all, the fact is that the system of work of the whole organism changes, and the fact that we will take

the same tasty things with pleasure will tell the excitement that she experiences: you know, katya, i started to get nervous when you started talking about the fact that you are afraid that you have osteoporosis, that here you are now let’s go look for osteoporosis, i calmed down a

little when antonina vladimirovna started talking about gaining peak bone mass, now, the first violin will say that if our young and beautiful girls remember that sex hormones are involved in the creation... of bones, and sex hormones skeletons don't are being produced. in order for a woman to menstruate, she must have a certain supply of leptin, the hormone of adipose tissue, we even went a little beyond one bone, we also have muscles, we have adipose tissue, so if a young girl is in the period of gaining peak mass bones will think first of all about... that it should become thinner than the protik, it will not gain peak mass, sorry, the same possibility of getting a lack of sex hormones due to, because physical exercise is great, but if

you get aminorrhea from the summer, because not leaving the fitness room, you can get changes in the architectonics of bone tissue in certain places, however, you know, the most amazing thing is that if... there is one of the main breakthroughs, that we will be able to explain how possible, i agree with you, to ensure prevention, at least on the scale in which it can be provided , of damage to bone tissue, in old

age, yes, it’s just very sad that in fact we are not taught this balance from childhood, we have more or less been taught proper nutrition, which no one respects, i see that what children eat at school, it terrifies me what their parents give them, i see that...

in no case, i tell my patients that movement is life, and life is movement, this was, is and must be , there must be butra gymnastics, you know how i look at china with such tenderness in the morning, when they all come out and start doing gymnastics, like we do in the soviet union, i still remember, i woke up, my grandmother sounded at 6 in the morning on the radio, oops, hands, oops, we turned on the tv and the tv and also gymnastics, anthem in the morning, then gymnastics, it’s right, it’s right, that means it’s right, we need gymnastics. well, there are things that are reasonable and the load is different, i completely agree, tai chi in the morning is a fabulous thing, but if you are 85 years old, don’t be surprised that you are carrying a bag of potatoes

, you have microfractures of the spine, you talk so sadly all the time, like as if you know, i conclude that you need to accept it, no, you need to do what you need to do, the word is a skeptic, but you can’t do what you want? biosynthesis, but all this requires a certain

sequence, certain time periods, i want to say that in our country the association of doctors for osteoporosis works great, yes, where traumatologists are included, our specialists in osteoporosis, rheumatologists, the association of endocrinologists, we issue clinical recommendations about when what drugs will be , will there be such a drug, say, biphasic, yes, so that this biphasic one. the slow -release drug sequentially switched on and off various processes, you know, we haven’t even gotten to the point yet an ideal anabolic, maybe these two-phase drugs, then we named only some of the participants in the game, vadim erikovich wanted to talk about collagen, something else, and other participants, the same sclerostin, someone who is absolutely terrible, sclerostin. and what, he is there, he also participates in

the destruction of collagen, which is involved in the formation, let’s produce collagen , and this turns out to be something that destroys, a lot of knowledge, a lot of sadness is said in one old collagen is produced when, when we let's move, okay it is being produced, i ran for the bus, collagen has been developed, i have beautiful skin, but my bones have collapsed, i can’t carry the main bag of potatoes, balance is a wonderful thing, but can i ask? question, a question from a pessimist, please tell me, can life be eternal? everything, well, everything in the world is relative, because for some, no, christians believe in eternal life, so let’s have the eternal life of the physical body, well, if 10,000 years compared to one year, then probably yes, you know, uh, no , we do not claim to be eternal, we claim to very high quality century. the most important thing is when i hear about the mortality rate of

femoral neck fractures, we are all mortal. our goal is to make a person's life long and fulfilling. how to do this is a huge question, i confirm that this is a multi-component system consisting of proper nutrition and proper exercise. a new generation of pharmaceuticals, and now we are using new drugs, including genetically modified ones, which allow us to bypass the viciously working cell launch some biochemical shunts, this is a new, completely new approach in the treatment of diseases, and it has existed literally for the last 5-10 years, this is what is now called.

otherwise the possibility of mutations, i remind you that mutations are approximately 25% beneficial and 75 vicious, we need to make sure that we exist for a long time, effectively, and we do not make our species worse than it is today, yes, there really is an option, i i don’t know, maybe, you said, it’s really possible to avoid mutations, but everyone breaks the femoral neck 80, 80 it’s difficult to operate, maybe by the age of 60 everyone will have to get artificial femoral necks. you took this off my tongue and moreover,

unfortunately, the doctor who worked in our clinic recently left, we did his doctoral thesis, doctoral research, we thought about reinforcing kostinka, yes, in advance, those who are predisposed to a future fracture of the neck, but then we start the conversation with what we talked about, how to correctly select those people who are at risk? how to accompany them, how to convince them, take a healthy person and start him, reinforce, reinforce, and he says: i don’t want to, you know why, why i don’t want to, because there’s an advertisement on ntv. he taught philip kirkorov to sing, guys, this is my friend, look, and he made friends with thieves in law, i am a very kind person, but if god forbid you hurt me, how did the singer felix tsarikati become a star, a frisky boy, curly, in love, but

girls were hanging on it in clusters, why does he need his own lake and 70 hectares of land, these are my poles, mustaf, the father of two daughters, he did not tie the knot. i was always afraid of losing my freedom. like at 54 decided to steal his wife? has anyone ever looked after you like this before? no, just mom. are you standing and looking at the floor? you can't look up. and why doesn’t he hold back his tears when he talks about his son? i do everything, change diapers and feed. felix tsarikati. and his secret is worth a million. not making it up again? on saturday at 13:00 on ntv. on the air of the program. science and we is a program about how science will change our lives in the next 10 years. dear guests, optimists and skeptics. we have a question for you all, with what probability in your opinion, science will still cope with such a problem as osteoporosis. antanya

vladimirovna, do you have a forecast? will science be able to do it in 10 years? i'm an optimist and i think he can handle it. just a few decades ago we did not... or even such drugs that can preserve bone tissue, reduce the level of pain, that can slow down the process of destruction of bone tissue, now, in addition, we know very well the mechanisms of prevention, there is only a little left, tell the population about these mechanisms, introduce it, i think we we are moving in the right direction and the prospect of ten years is enough for us to convince the population to adhere to the right way of life.

safe treatment regimens for those diseases for which drugs are used , minimizir will be able to minimize the risks of osteoporosis, i hope that we can teach the population something, and i believe that new drugs will appear that will reduce the risks of fractures in osteoporosis, they can be used, but when one fracture has already occurred, then we will be able to apply. drugs that reduce the risks of other other fractures, but i'm betting on 10%. 10%. thank you very much, firstly, i can reassure galina afanasyina that thanks to our efforts, she will receive many additional patients with osteoporosis. i will explain it very

simply: we have a wonderful city, in which the city leadership spends a huge amount of money and effort on helping patients. 5 years ago , about 7% of patients died from fractures of the femoral neck within a year. after what has been done over the past 5 years, the mortality rate in moscow within a year after a fracture does not exceed 11%. we have reduced mortality rate is six times. this is an amazing number. and now we know very well that if a person has the first one. fracture, then we can diagnose stoparosis without conducting any additional research, include it in a program of support, treatment, assistance, thus identifying the disease in time, if we were able to help the patient literally get back on his feet,

then we can provide him with the most important thing , so that patients don’t fight you off, that’s all, and you know, uh, from us, uh, so i think that of course, we cannot talk about curing osteoporosis, i say again, this is a systemic part; you cannot run away from this time of your own life, but make sure that people at an advanced age die not from fractures, not from pain - caused by spinal deformation, but for any other diseases, we’ll leave it to cardiologists. and therapists do a little bit of their work, i think it’s 80-85 percent, let’s do 85 too, thank you. i am an operating traumatologist, yes, dealing mostly with endoprosthetics, that is replacement of joints, i see what a huge influence

moscow has, namely financial financial flows on the development of the school of osteoporosis , on prevention, on ensuring that doctors are taught competently, so that they need to operate quickly, so i want this to be implemented in ours, in everyone, in every city and most importantly in the outback, but still, what is the probability that science will defeat your realistic about 20, 20? 20%, thank you very much, volodya, well, listen, today, of course, with a 50/50 chance science will win, we’re just straight optimists and the skeptics agreed, but i know, today i am grateful to galina afana for her words about young girls, i, as you know, have three daughters, in fact, when they said today that problems with osteoporosis may be determined by what is put into the child up to... years, and how the girl develops, how she eats, how she moves, plays sports,

there shouldn’t be any of this thinness either, she should be a normal, healthy girl, this is very important, that’s why i , in fact, even if we as adults cannot avoid problems with osteoporosis, let's take care of our children , our girls, and make sure that they don't lose weight under any circumstances, that they eat right and play sports, remember, but we laid an egg at the beginning. this is what happened to him, so really, as was said today, take care of the bone from a young age, not only in girls, but in men, in men too, it was a program, science and we are a program about how science will change including our life with you in the next 10 years, take care of yourself, go to the doctors, look at we science on ntv every week, see you in a week.

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