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Increased bone turnover markers (BTM) level is consider as independent risk factor of bone fracture. However, it was not used in 10-year probability of bone fracture method (FRAX) proposed by WHO, which helps in qualification of patients for pharmacological treatment of osteoporosis. The aim of the study was to evaluate the usefulness of BTM in qualification for pharmacological treatment of osteoporosis.The study was performed in 152 subjects (20 men and 132 women) referred to Krajowe Centrum Osteoporozy. One-hundred thirty two of them were qualified for pharmacological treatment and 20 for prophylaxis on the basis of qualitative method. The following BTM were examined in all patients: of bone formation - N-terminal propeptide of procolagen type I (PINP) and N-mid osteocalcin (OC) and of bone resorption - C-terminal cross-linked telopeptide of collagen type I (CTx).The values over that considered as independent fracture risk (in women only, no data for men) were found in 39 women with PINP, 39 with OC and 41 with CTx. Part of women had decreased serum BTM (10 women 3 BTM and 35 with 1 at least). There were not significant differences in serum BTM depending on the presence of clinical fracture risk factors: osteoporotic fracture in past, osteoporotic hip fracture in parents, chronic treatment with glucocorticosteroids and qualification for pharmacological treatment on the basis of qualitative and FRAX method. There was no significant difference in the presence of fracture risk factors depending on increased or decreased serum BTM.Results of the study did not show the practical use of BTM in qualification for pharmacological treatment of osteoporosis.

The paper discusses the problem of treating Asherman's syndrome, which due to common procedures in gynaecology and obstetrics becomes more and more frequent occurrence in gynaecological practice. The genesis of this syndrome is often a result of a too intensive excochleation of the uterus, accompanying infection and lack of endometrial reaction to oestrogens. The authors discussed 14 cases of patients in whom, after excochleation of the uterus, there appeared intrauterine adhesions followed by amenorrhoea. The therapy consisted in removing the adhesions by means of a hysteroscope and inserting an intrauterine device the shape of which was selected depending on the character and localization of adhesions and applying oestrogens locally into the uterus cavity. In order to have the menstrual cycle reconstructed, the patients were administered orally hormones during 4 successive artificially reconstructed cycles. Among the patients undergoing therapy, 86% of them began to menstruate again and 57% of them got pregnant. The use of hysteroscopy reduced maximally the risk of breaking the continuity of the uterus during the resection of large adhesions. Inserting a proper device prevented the recurrence of adhesions and local administering oestrogens into the uterine cavity provided good conditions for the reconstruction of the endometrium.