OSTEOPOROSIS: ASSESSMENT OF A RISK FOR RECURRENT LOW-TRAUMA FRACTURES IN POSTMENOPAUSAL WOMEN

Objective: to assess a risk for new fractures in a cohort of postmenopausal women who have sustained low-trauma fractures, by using the FRAX® algorithm, and to compare the assessments with data on the fractures have occurred during a prospective follow-up study.Subjects and methods. The investigation enrolled 128 postmenopausal women (mean age, 64.9±8.3 years) who had sustained low-trauma fractures at five sites (the hip, forearm, humeral neck, vertebral column, and ankle). A ten-year fracture risk was assessed using the FRAX® algorithm with and without regard for bone mineral density (BMD). New osteoporotic fractures were recorded during a three-year prospective follow-up study.Results and discussion. The average FRAX® algorithm values for all new osteoporotic and hip fractures in the entire group were 18.0±5.6 and 3.7±3.7% (without consideration of BMD), 17.9±6.6 and 3.5±4.0% (with consideration of BMD) (p > 0.05). The true incidence of recurrent fractures over 3 years was 17.2%. During 3 years, the incidence of recurrent fractures in the women who had sustained low-trauma fractures of the proximal hip, humeral neck, and spinal column was 28.6, 25.0, and 22.8%, respectively, which exceeded the estimated 10-year fracture risk for these sites. The history of multiple low-trauma fractures versus single one increased the risk for subsequent fractures by 3.63 and 9.43 times among women with high or low estimated FRAX risk rate, respectively.Conclusion. The three-year prospective follow-up study has shown that the FRAX® algorithm underestimated the risk associated with the presence of recurrent fractures in the history; moreover, new fractures significantly more commonly occur in persons who have sustained low-trauma fractures in the proximal hip, humoral neck, and vertebral column

Cereal inflorescence: features of morphology, development and genetic regulation of morphogenesis

Cereals (Poaceae Barnh.) are the largest family of monocotyledonous flowering plants growing on all continents and constituting a significant part of Earth's many ecological communities. The Poaceae includes many important crops, such as rice, maize, wheat, barley, and rye. The qualitative and quantitative characteristics of cereal inflorescences are directly related to yield and are determined by the features of inflorescence development. This review considers modern concepts of the morphology, development and genetic mechanisms regulating the cereal inflorescence development. A common feature of cereal inflorescences is a spikelet, a reduced branch that bears florets with a similar structure and common scheme of development in all cereals. The length and the structure of the main axis, the presence and type of lateral branches cause a great variety of cereal inflorescences. Complex cereal inflorescences are formed from meristems of several types. The transition from the activity of one meristem to another is a multi-step process. The genes involved in the control of the cereal inflorescence development have been identified using mutants (mainly maize and rice) with altered inflorescence and floret morphology; most of these genes regulate the initiation and fate of meristems. The presence of some genetic mechanisms in cereals confirms the models previously discovered in dicotyledonous plants; on the other hand, there are cereal-specific developmental processes that are controlled by new modules of genetic regulation, in particular, associated with the formation of a branched inflorescence. An important aspect is the presence of quantitative variability of traits under the control of developmental genes, which is a prerequisite for the use of weak alleles contributing to the variability of plant growth and yield in breeding programs (for example, genes of the CLAVATA signaling pathway)

The frequency of sarcopenia and factors affecting appendicular muscle mass in patients with systemic sclerosis

Aim. To determine the frequency of sarcopenia (SP) and to identify factors associated with the muscle mass in women with systemic sclerosis (SSc).Materials and methods. The study included 64 women with SSc aged 40–70 years. Questionnaires, clinical, instrumental, laboratory examinations and absorptiometry. Linear regression analysis was performed to identify factors associat ed with appendicular muscle mass (AMM).Results. Probable SP was detected in 35 (54.7 %), and confirmed SP – 17 (26.5 %) women with SSc. The frequency of SP did not differ depending on the form of the disease. Univariate linear analysis revealed the relationship between the AMM and BMI, nutritional status; mid-upper arm, waist, hip and calf circumferences, skin Rodnan score, cumulative dose of glucocorticoids (GC) and BMD of the proximal hip. Multivariate linear analysis confirmed the presence of associations between the AMM index and BMI (b = 0.65; p <0.001), the Rodnan skin score (b = –0.19; p = 0.047), the cumulative dose of GC (b = –0.22; p = 0.021).Conclusion. The study demonstrated that more than a quarter of patients with SSc had a confirmed SP. Although age is the main risk factor for SP in the general population, in our study it did not differ between patients with low and normal AMM. The cumulative dose of GC and the Rodnan skin score were negatively, and BMI was positively associated with the value of AMМ

Development of new SSR markers for homoeologous WFZP loci based on the study of structure and location of microsatellites in gene-rich regions of chromosomes 2AS , 2BS, 2DS

Microsatellites, or simple sequence repeats (SSRs), are ubiquitous in genomes of eukaryotes, including plant genomes. The structure and location of SSR loci determine their potential as molecular genetic markers and may have impact on the potential function of microsatellites in important biological processes. Identification and study of the distribution of SSR loci in gene-rich regions of the bread wheat genome and development of novel SSR markers based on these data are of practical interest, being important for the study of bread wheat genome organization. Bread wheat BACclone sequences containing homoeologous WFZP genes that control spikelet development served as the base for the identification and localization of SSR loci in generich regions of chromosomes 2AS, 2BS, and 2DS. It was found that di- and trinucleotide motifs were predominant. The most common dinucleotide motifs were AG and GA/TC. They were distributed in noncoding regions of genes, transposable elements (TEs) and unannotated sequences. Most identified trinucleotide motifs were associated with transposable elements. Homoeologous SSR loci were found in either genes or unannotated sequences. Comparison of these loci showed that the divergence in their structure was caused both by changes in repeat number and nucleotide substitutions. New SSR markers were developed and mapped. On the genetic maps of chromosomes 2A, 2B и 2D, they collocated with the WFZP-A-B-D genes. Thus, they can be used for gene tagging in molecular research and in marker-assisted selection

TREATMENT OF OSTEOPOROSIS IN REAL CLINICAL PRACTICE: FREQUENCY OF PRESCRIPTIONS AND THERAPY ADHERENCE WITHIN THE FIRST YEAR AFTER OSTEOPOROTIC FRACTURE

Objective: to estimate the frequency of prescription for antiosteoporotic agents in real clinical practice and treatment adherence within a year after experienced low-trauma osteoporotic fracture (LOF). Subjects and methods. A questionnaire survey was made in 192 subjects aged over 50 years (mean age 66±8 years) who had sustained fractures at different sites after a fall from standing height. Therapy and its compliance were assessed 4 and 12 months after LOF. Results. One hundred and five (55%) patients received therapy, including 80 (73%) took only calcium preparations and vitamin D; 9 (8%), 15 (14%), and 5 (5%) patients had calcitonin, bisphosphonates, and strontium ranelate, respectively. At the same time, 87 (45%) subjects were given no antiosteoporotic drugs for a year after fracture. Throughout the follow-up, 42% of the respondents received treat- ment; 18% interrupted it within the first 4 months after fracture, and 40% started therapy 4 months or later (mean 6.5 months) after it. The reason for the absence of treatment was no recommendations by a traumatologist or primary care specialists in 49% of cases. Among those taking the drugs, treatment was recommended by the specialists of the Osteoporosis Center, Research Institute of Rheumatology, Russian Academy of Medical Sciences, in 89% of cases and by primary care specialists in only 11%.Conclusion. The study indicated that after LOF, the patients did not receive adequate antiosteoporotic therapy, at the same time 49% had no respective recommendations made by traumatologists or primary care physicians. The frequency of prescription for pathogenic agents for the treatment of osteoporosis was considerably increased during patient observation in a specialized osteoporosis center

Остеопороз и его осложнения:приверженность лечению и возможности ее повышения

Objective. To estimate patient adherence to treatment with antiosteoporotic drugs within the first year after experienced low-trauma osteoporotic fractures (LOF). Material and methods. The data of a questionnaire survey were analyzed in 172 women aged 50 years or older (mean age 66+8 years) who had sustained fractures at different sites after a fall from standing height, were analyzed. Therapy and its compliance were assessed 12 months after LOF. Results and discussion. Among the 172 respondents, 55% received therapy, including 73% took only calcium preparations and vitamin D; 8% calcitonin; 14% bisphosphonates; 5% strontium ranelate. At the same time, 45% of those asked were given no antiosteoporotic drugs within the first year of life after fracture. Only 42%> continued to receive treatment following 12 months; 18% interrupted it within the first 4 months after fracture. Conclusion. In real clinical practice, osteoporosis was not treated in the majority of patients within the first year after LOF. One of the major reasons why it is not treated is the high cost of pathogenetic drugs. This reason can be successfully eliminated using generic drugs.Цель исследования - оценить приверженность пациентов лечению противоостеопоротическими препаратами в течение первого года после перенесенного малотравматичного остеопоротического перелома (МОП). Материал и методы. Проанализированы данные анкетирования 172 женщин 50 лет и старше (средний возраст - 66+8 лет), перенесших переломы различных локализаций в результате падения с высоты собственного роста. Оценка назначения терапии и приверженности лечению осуществлялась через 12 мес после МОП. Результаты и их обсуждение. Среди 172 анкетированных 55% пациенток получали терапию, в том числе 73% - только препараты кальция и витамина D, 8% - кальцитонин, 14% - бисфосфонаты и 5% - стронция ранелат. В то же время 45% опрошенных не получали никаких противоостеопоротических препаратов в течение первого года после перелома. Через 12 мес продолжали получать лечение только 42%> опрошенных, а прервали его в течение первых 4 мес после перелома - 18%. Заключение. В реальной клинической практике в течение первого года после МОП у большинства пациенток лечение остеопороза не проводилось. Одна из основных причин отсутствия терапии - высокая стоимость патогенетических препаратов. Данная причина может быть успешно устранена в случае применения дженерических лекарственных средств

Study on early inflorescence development in bread wheat (T. aestivum L.) lines with non-standard SCR-morphotype

Features of wheat (Triticum aestivum L.) inflorescence development define its architecture and have an impact on yield potential. Wheat lines and forms with altered inflorescence morphology are important genetic resources for the study on the genetic mechanisms underlying plant developmental programs and inflorescence architecture; they are also important for practical use to increase productivity. Normally, wheat spikelets are arranged in two parallel rows along the spike axis. The SCR (screwed spike rachis) lines represent a non-standard morphotype, which is characterized by a spiral arrangement of spikelets along the spiked rachis. The study of the early stages of the inflorescence development in SCR-lines using light and scanning electron microscopy revealed that the spiral arrangement of spikelets were not related to changes at the early stage of inflorescence development, and resulted from spiral growth of spike rachis cells at later stages of spike growth. Thus, the spiral arrangement of spikelets in cereal inflorescence may have resulted not only from peculiarities of the mutual arrangement of spikelet meristems (phyllotaxis), but also from cell growth features at later stages of inflorescence growth. It was shown that SCR is inherited as a dominant monogenic trait; its expression can be modified by genotypic background. The SCR-lines characterized using light and scanning electron microscopy represent an important genetic resource for further study of the molecular-genetic mechanisms determining plant architecture. Furthermore, they can be used to develop wheat lines and cultivars with new inflorescence phenotypes

УДОСКОНАЛЕННЯ БІЗНЕС–ПРОЦЕСУ ЗАЛУЧЕННЯ ДОДАТКОВИХ РЕСУРСІВ, НЕОБХІДНИХ ДЛЯ ПІДВИЩЕННЯ ФІНАНСОВОГО ПОТЕНЦІАЛУ СТРАХОВОЇ КОМПАНІЇ

The article considers the need to manage the financial potential of an insurance company. The analysis of optimization of the business process of financial support for the further development of the insurer has been carried out, deficiencies have been identified regarding the optimal option of attracting additional financial resources and measures for their correction have been developed.В статье рассмотрена необходимость управления финансовым потенциалом страховой компании. Проведен анализ оптимизации бизнес–процесса финансового обеспечения дальнейшего развития страховщика, определены недостатки оптимального варианта привлечения дополнительных финансовых ресурсов и разработаны мероприятия по их устранению.У статті розглянуто необхідність управління фінансовим потенціалом страхової компанії. Проведено аналіз оптимізації бізнес–процесу фінансового забезпечення подальшого розвитку страховика, визначено недоліки щодо оптимального варіанту залучення додаткових фінансових ресурсів та розроблено заходи щодо їх виправлення

Inheritance of signs of «many-flowered» common wheat and evaluation of productivity of the spike of F2 hybrids

Parameters of spike productivity in plants varieties Novosibirskaya 67 (N67), Saratovskaya 29 (S29), Puza-4 and «many-flowered» line Skle 123-09 were assessed in two years with different weather conditions. It was shown that «many-flowered» line Skle 123-09 is significantly higher in the number of grains per spike and number of grains per spikelet than varieties N67, S29 and Puza-4, and that the expression of «many-flowering» depends on the environmental conditions and the genetic background. It was shown that the «many-flowering» is a genetic trait and is therefore workable. A study of hybrids F2 С29×Skle123-09, N67×Skle 123-09, P-4×Skle 123-09 isolated plants with fan-shaped cones and a high number of grains per spikelet as Skle 123-09 and having the best performance of other features as ear varieties recipients. The seeds of these plants will be used to secure «flowering». Two-factor analysis of variance showed that the number of grains per spike knotted depends on growing conditions, genotype and their interaction. Variability of grains per spikelet in drought-resistant varieties of S29 and Puza-4 is mainly dependent on the genotype and, to a lesser extent, on the «genotype×environment» interaction. In variety N67 created for West Siberia, only genotype is a factor. The weight of a grain per ear primarily is primarily affected by «genotype×environment» (almost 60 %), while the influence of «genotype×environmental» was half as strong. The variability of «masse of one grain» in F2 hybrids (S29, P-4×Skle123-09) is influenced by environmental factors, genotype and their interplay. Genotype accounts for the highest impact (> 70 %). F2 hybrids (N67×Skle 123-09) share the greatest variability in the «genotype×environment» interaction (77 %)

Экономические аспекты осложненного остеопороза: стоимость лечения в течение первого года после перелома

Objective: to estimate the cost of treatment in patients with complicated osteoporosis (OP) in the first year after fracture under the conditions of the Moscow municipal healthcare system.Patients and methods. The investigation enrolled 196 women (mean age, 65.8±9.1 years) who had sustained fractures at five major osteoporotic sites (proximal hip (PH), distal forearm (DF), surgical humeral neck, vertebral column, and medial and/or lateral ankle). A unified questionnaire that included data on inpatient and outpatient treatment, patients' personal costs, and social benefits, as well as tariffs on services of the Moscow City Fund of Obligatory Health Insurance was used to estimate the cost of treatment for complicated OP during one year after fracture.Results. The direct cost of treatment for PH fracture amounted to 101,243 rubles and was significantly higher (p < 0.01) than that for fractures at other sites: DF (22,080 rubles); humeral neck (39,855 rubles), vertebral column (51,167 rubles), and ankle (43,345 rubles). The average cost of treatment in terms of indirect costs of treatment for complicated OP during a year was as high as 61,151 rubles. In the overall cost structure for the disease, hospital costs accounted for 44%; social benefits were 12% and the cost of antiosteoporotic drugs was only 7%, which was associated with the fact that the latter were rarely prescribed by primary healthcare physicians.Conclusion. Costs of treatment in patients with complicated OP in Moscow were estimated in relation to the site of low-energy fracture. The disease was shown to cause considerable economic losses regardless of the site of osteoporotic fracture; however, the cost of antiosteoporotic drugs has an insignificant share in the overall cost structure for treatment. At the same time, secondary prevention of OP requires that combination antiosteoporotic therapy should be performed in all patients who have sustained low-energy fracture.Цель исследования – оценка затрат на лечение больных при осложненном остеопорозе (ОП) в течение первого года после перелома в условиях муниципального здравоохранения Москвы.Пациенты и методы. В исследование включено 196 женщин (средний возраст – 65,8±9,1 года), перенесших переломы пяти основных остеопоротических локализаций: проксимального отдела бедра (ПОБ), дистального отдела предплечья (ДОП), хирургической шейки плеча, позвоночника и медиальной и/или латеральной лодыжки. На основе унифицированного вопросника, включавшего данные о стационарном и амбулаторном лечении, личных затратах пациенток и социальных выплатах, а также тарифах на услуги Московского городского фонда обязательного медицинского страхования, проведена оценка стоимости лечения осложненного ОП в течение 1 года после перелома.Результаты. Прямые затраты на лечение при переломе ПОБ составили 101 243 руб. и были достоверно выше (p<0,01), чем при переломах других локализаций: ДОП – 22 080 руб., шейки плечевой кости – 39 855 руб., позвоночника – 51 167 руб. и лодыжки – 43 345 руб. В среднем стоимость лечения с учетом косвенных затрат при осложненном ОП в течение 1 года достигала 61 151 руб. В общей структуре «стоимости заболевания» 44% приходилось на госпитальные затраты, 12% – на социальные выплаты и всего 7% – на противоостеопоротические препараты, что связано с их редким назначением врачами первичного звена здравоохранения.Выводы. Оценены затраты на лечение больных с осложненным ОП в зависимости от локализации НП в Москве. Показано, что заболевание приводит к существенным экономическим потерям независимо от локализации остеопоротического перелома, однако стоимость противоостеопоротических лекарственных средств занимает незначительную долю в структуре общих затрат на лечение. В то же время с целью вторичной профилактики ОП следует проводить комплексную противоостеопоротическую терапию всем пациентам, перенесшим НП