Complex resistance of spring and winter bread wheat lines to biotic and abiotic stresses

An original initial material of spring and winter bread wheat with group resistance to stem and leaf rust was developed using new donors of resistance to stem rust: winter soft wheat GT 96/90 (Bulgaria) and accession 119/4-06rw with genetic material of the species Triticum migushovae and (Aegilops speltoides and Secale cereale), respectively, a line of spring wheat 113/00i-4 obtained using the species Ae. triuncialis and T. kiharae, as well as spring accession 145/00i with genetic material of the species Ae. speltoides resistant to leaf rust. The transfer of effective Sr-genes to progeny was monitored using molecular markers. New lines underwent a field assessment of resistance to leaf and stem rust in the epiphytotic development of diseases in the Central Region of the Russian Federation, as well as in the North Caucasus and Western Siberia, and showed high resistance to these pathogens. Fourteen genotypes of spring wheat with group resistance to these diseases and parental forms that participated in the origin of the lines were evaluated for resistance to spot blotch (Cochliobolus sativus) and tan spot (Pyrenophora tritici-repentis) using isolates from Kazakhstan and Omsk in laboratory conditions. A highly resistant parental form of winter soft wheat from “Arsenal” collection 119/4-06rw (wheat-Ae. speltoides-rye hybrid 2n = 42) with group resistance to two spots, four medium-resistant genotypes to both isolates of tan spot from Kazakhstan and Omsk populations of the pathogen, as well as genotypes resistant to the Omsk isolate of P. triticirepentis (parental form 113/00i-4 and lines 1-16i, 6-16i, 9-16i) were isolated. Among the lines of winter wheat, four were identified with group resistance to spot blotch and tan spot. Additionally, the stress resistance of the lines to NaCl salinization and prolonged flooding of seeds with water was evaluated at the early stages of ontogenesis in laboratory conditions. Lines 33-16i, 37-16i, 32-16i and 9-16i showed a high ability to withstand excess moisture. Lines 33-16i, 37-16i, 32-16i and 3-16i were characterized by high salt tolerance, exceeding the average of 49.7 %. Among the winter genotypes, lines were identified with increased resistance to hypoxia (37-19w, 32-19w, 16-19w, 90-19w) and with increased salt tolerance (20-19w, 9-19w, 37-19w, 90-19w), significantly exceeding the standard cv. Moskovskaya 39. The listed lines are of interest as sources of resistance to anaerobic and salt stress, as well as donors of resistance to a group of fungal diseases: leaf and stem rust and tan spot. We attribute the increased level of resistance of the new initial material to the presence of alien translocations in the original parental forms involved in the origin of the lines

Роль немедикаментозных методов в комплексе мероприятий по профилактике и лечению остеопороза (обзор литературы)

The review represents the results of investigations into the role of nondrug methods in the treatment and prevention of osteoporosis (OA). The data available in the literature suggest that a number of non-drug technologies, first of all exercise therapy, aquatic therapy, reflexotherapy, electrical stimulation, and electromagnetic therapy, have proven efficiency and a certain potential for reducing the risk of osteoporosis and its complications and for improving bone metabolism. Expanding the range of these methods and increasing their validity for clinical introduction are very promising.В обзоре литературы представлены результаты исследований, посвященных изучению роли немедикаментозных методов в лечении и профилактике остеопороза (ОП). Данные литературы свидетельствуют о том, что ряд немедикаментозных технологий, прежде всего лечебная физкультура, акватерапия, рефлексотерапия, электростимуляция, электромагнитотерапия, обладают доказанной эффективностью и имеют определенный потенциал для снижения риска развития ОП и его осложнений, а также улучшения костного метаболизма. Расширение спектра и повышение степени доказательности этих методов для внедрения в лечебную практику является весьма перспективным

Сравнение эффектов селективной плазмофильтрации, плазмодиафильтрации с системами MARS и Prometheus при лечении печеночной недостаточности

The mortality of patients with hepatic failure remains high. Often the patient's life can be saved only with extracorporeal liver support (ELS). ELS systems – MARS® и Prometheus® have proved their efficacy but their widespread use is constrained by their very high cost. Introduction in clinical practice of new affordable ELS systems is a topical issue. The objective: to compare clinical and laboratory effects of selective plasma exchange (SPE), plasmadialfiltration (PDF) with use of the selective membrane plasma separators EvaclioTM and MARS® and Prometheus® (FPSA) systems in the treatment of liver failure. Subjects and methods: 15 extracorporeal procedures of each type were performed in 52 patients with acute liver failure (14) and acute-on-chronic liver failure (38): MARS, FPSA, PDF, SPE with use of Evaclio ЕС-2C, and ЕС-3C, ЕС-4C. The clinical and laboratory parameters (total, direct and indirect bilirubin, total protein, albumin, creatinine, urea, etc.), severity of the condition according to MELD score were determined before and after the session and the next morning. Changes, side effects and complications of procedures were assessed and compared. Results. Reduction of concentration of direct bilirubin was comparable with FPSA, PDF and SPE on Evaclio ЕС-3C20 и ЕС-4C20 (38-42%), indirect bilirubin – with PDF and SPE on Evaclio ЕС-3C20 и ЕС-4C20 (29-34%). Low-molecular metabolites (urea, creatinine) were better removed with FPSA (35-44%) and PDF (40-42%). The reduction of their concentration with SPE was insignificant. The reduction of albumin level was the highest with FPSA (10.2%) and SPE on Evaclio ЕС-4C20 (14.3%). All investigated ELS methods did not exert a significant influence on the basic parameters of blood coagulation and quantity of blood cells. No side effects and complications were observed. Conclusion: Selective plasma exchange and plasmadiafiltration are generally comparable in clinical and laboratory effects in the treatment of liver failure with MARS and Prometheus system provided significantly lower costs.Летальность пациентов c печеночной недостаточностью остается высокой. Часто спасение жизни пациента возможно только с использованием экстракорпоральной детоксикации (ЭКД). Системы экстракорпоральной поддержки печени MARS® и Prometheus® продемонстрировали свою эффективность, однако их широкому использованию препятствует очень высокая стоимость. Внедрение в клиническую практику новых, более доступных методов ЭКД является актуальной задачей. Цель: сравнение клинических и лабораторных эффектов процедур селективной плазмофильтрации (СПФ), плазмодиафильтрации (ПДФ) с использованием фракционаторов плазмы EvaclioTM, систем MARS® и Prometheus® (FPSA) при лечении печеночной недостаточности. Материалы и методы: 52 пациентам с острой (14) и декомпенсацией хронической печеночной недостаточности (38) выполнено по 15 экстракорпоральных процедур: MARS, FPSA, ПДФ, СПФ с использованием фракционаторов Evaclio ЕС-2C, ЕС-3C, ЕС-4C. До, сразу после и на следующее утро исследовались клинические и лабораторные (билирубин и фракции, общий белок, альбумин, мочевина, креатинин и др.) показатели, тяжесть состояния по шкале MELD. Оценивались и сравнивались их динамика, побочные эффекты и осложнения процедур. Результаты. Уменьшение концентрации прямого билирубина было сравнимо при FPSA, ПДФ и СПФ на Evaclio ЕС-3C20 и ЕС-4C20 (38‒42%), непрямого билирубина – при ПДФ и СПФ на Evaclio ЕС-3C20 и ЕС-4C20 (29‒34%). Низкомолекулярные метаболиты (мочевина и креатинин) лучше всего удалялись при FPSA (35‒44%) и ПДФ (40‒42%). Снижение их концентрации при СПФ было незначительным. Снижение уровня альбумина было наибольшим при FPSA (10,2%) и СПФ на Evaclio ЕС-4C20 (14,3%). Все исследованные методы ЭКД не оказывали существенного влияния на основные показатели системы свертывания и клеточный состав крови. Побочных реакций и осложнений не отмечено. Вывод. СПД и ПДФ по клиническим и лабораторным эффектам не уступают системам MARS® и Prometheus® при существенно меньшей стоимости

THE PREVENTION, DIAGNOSIS, AND TREATMENT OF VITAMIN D AND CALCIUM DEFICIENCIES IN THE ADULT POPULATION OF RUSSIA AND IN PATIENTS WITH OSTEOPOROSIS (ACCORDING TO THE MATERIALS OF PREPARED CLINICAL RECOMMENDATIONS)

The paper presents data on the role of vitamin D and calcium in the function of many human organs and tissues. Lifestyle, dietary preferences, and insufficient physical activity contribute to the high prevalence of vitamin D and calcium deficiencies in the adult population of Russia, causing different diseases and abnormalities. The authors have worked out recommendations for the preventive use of vitamin D and calcium in healthy population, give consumption rates for these substances, and describe the clinical and laboratory signs of vitamin D deficiency and indications for screening. They also propose treatment regimens for vitamin D deficiency and depict the signs of intoxication inoverdose. Particular emphasis is laid on the place of vitamin D and calcium in the therapy of osteoporosis

B-type natriuretic peptide-induced delayed modulation of TRPV1 and P2X3 receptors of mouse trigeminal sensory neurons

Important pain transducers of noxious stimuli are small- and medium-diameter sensory neurons that express transient receptor vanilloid-1 (TRPV1) channels and/or adenosine triphosphate (ATP)-gated P2X3 receptors whose activity is upregulated by endogenous neuropeptides in acute and chronic pain models. Little is known about the role of endogenous modulators in restraining the expression and function of TRPV1 and P2X3 receptors. In dorsal root ganglia, evidence supports the involvement of the natriuretic peptide system in the modulation of nociceptive transmission especially via the B-type natriuretic peptide (BNP) that activates the natriuretic peptide receptor-A (NPR-A) to downregulate sensory neuron excitability. Since the role of BNP in trigeminal ganglia (TG) is unclear, we investigated the expression of BNP in mouse TG in situ or in primary cultures and its effect on P2X3 and TRPV1 receptors of patch-clamped cultured neurons. Against scant expression of BNP, almost all neurons expressed NPRA at membrane level. While BNP rapidly increased cGMP production and Akt kinase phosphorylation, there was no early change in passive neuronal properties or responses to capsaicin, \u3b1,\u3b2-meATP or GABA. Nonetheless, 24 h application of BNP depressed TRPV1 mediated currents (an effect blocked by the NPR-A antagonist anantin) without changing responses to \u3b1,\u3b2-meATP or GABA. Anantin alone decreased basal cGMP production and enhanced control \u3b1,\u3b2-meATP-evoked responses, implying constitutive regulation of P2X3 receptors by ambient BNP. These data suggest a slow modulatory action by BNP on TRPV1 and P2X3 receptors outlining the role of this peptide as a negative regulator of trigeminal sensory neuron excitability to nociceptive stimuli. \ua9 2013 Vilotti et al

KAChESTVO LEChENIYa POSTMENOPAUZAL'NOGO OSTEOPOROZA V MOSKOVSKOY OBLASTI

Aim of the study. To examine the quality of treatment of postmenopausal osteoporosis (OP), the level of commitment to therapy and the factors on which it depends, and the amount of social and economic costs associated with the treatment of OP in the Moscow Region (MR). Material and Methods. The study was conducted by questionnaire of 362 postmenopausal women aged 55 and older (median 65 (59, 70) years) from 17 districts and municipal entities of MR with verified diagnosis of postmenopausal OP. The questionnaire included a survey “Attitudes to the therapy of OP” and the scale of attitudes «Factors hindering receive quality medical care for OP. « Results. During the past year, respondents appealed to the medical facilities for OP treatment up to 15 times inclusive (an average of 2 (1, 4) times), 30.4% of patients were hospitalized or were unable to work due to the OP, in 14.3% of respondents disability leaf has lasted for more than six months. OP therapy in most cases was not assigned due to lack of adequate advice from the doctor, who did not insist on compulsory treatment (in reply to 50% of respondents) did not give clear recommendations (43.8%) or did not explain the specific instructions for the drug use ( 25.0%). When choosing a method of treatment 84% of respondents relied on the recommendations of the endocrinologist and the remaining 16% - of a gynecologist, rheumatologist, orthopedist, or trauma specialists who are not directly related to the treatment of OP. The major part in the treatment of postmenopausal OP is occupied by well-known brands of combination therapy with calcium and vitamin D, whereas strontium ranelate was used only by 13.9% of respondents, alendronate - 11.1°%, zoledronic acid — 8.8%. Despite the identified high adherence to therapy, most patients treated previously believe that efficient and convenient for the administration drug for the treatment of OP does not exist (39.1% and 34.8% respectively). Average monthly costs for patients treated OP are 1700 (300, 2000) rubles, while the high cost of antiosteoporotic drugs is the most important cause of the irregular treatment and the most significant factor of poor quality medical care to patients with OP. Conclusion: OP is associated with more visits to medical facilities and long periods of disability; the quality of treatment of OP in MR needed to be improved

SOVREMENNYE VOZMOZhNOSTI I PERSPEKTIVY MEDITsINSKOY REABILITATsII I SANATORNO-KURORTNOGO LEChENIYa BOL'NYKh OSTEOPOROZOM

Целью медицинской реабилитации при остеопорозе является уменьшение болевого синдрома в спине, уменьшение грудного кифоза и двигательных нарушений и повышение качества жизни пациента. К методам немедикаментозной реабилитации больных остеопорозом относят кинезиотера-пию, массаж, аппаратную физиотерапию, бальнеотерапию, корсеты и ортезирование. Как метод реабилитации применяется симптоматическая терапия: при острой и хронической боли в спине у больных с переломами позвонком на фоне остеопороза - анальгетики, нестероидные противовоспалительные препараты и миорелаксанты, при наличии психо-эмоциональных симптомов - антидепрессанты, снотворные и анксиолитические средства. В программы реабилитации больных остеопорозом рекомендуется включать аэробные нагрузки, тренировку осанки, упражнения с отягощением для укрепления костей и мышц, упражнения на растяжку и развитие равновесия. Правильно подобранные упражнения улучшают мышечную силу, чувство равновесия, повышают минеральную плотность кости (МПК), снижают риск падений, боль в спине, потребность в анальгетиках и улучшают качество жизни у пациентов. В этом аспекте перспективным, но малоизученным направлением медицинской реабилитации при остеопорозе является акватерапия. Корсеты и ортезы применяются у больных остеопорозом с переломами тел позвонков. Их ношение способствует уменьшению боли в спине, быстрой мобилизации и восстановлению физической активности, уменьшению грудного гиперкифоза. Из методов аппаратной физиотерапии наиболее эффективными и перспективными при остеопорозе считаются чрескожная электростимуляция, электромагнитотерапия и лазеротерапия. Также есть опыт эффективного использования методов рефлексотерапии, бальнеотерапии и пелоидотерапии. С современных позиций, наиболее эффективным в реабилитации пациентов с переломами является комплексный подход. В частности, доказана эффективность комплексной реабилитации (лечебная физкультура, переменное магнитное поле и электромагнитное излучение КВЧ-диапазона) у пациентов после операций по поводу переломов шейки бедренной кости. Важное место в реабилитации больных с тяжелым остео-порозом и другими метаболическими заболеваниями скелета отводится санаторно-курортному лечению. В настоящее время в России функционирует 1211 санаториев различных форм собственности, из них 542 - для детей. Коечный фонд всех санаториев составляет 333 тысячи койко-мест, из них детских - 122 тысячи. В ведомственном подчинении Минздрава России находятся 45 санаториев. Федеральные санатории должны выполнять две основные функции. Во-первых, проводить медицинскую реабилитацию, которая оплачивается в рамках системы обязательного медицинского страхования. База у этих санаториев хорошая, но некоторые из них нуждаются в дооснащении. Во-вторых, оказывать услуги санаторно-курортного лечения, то есть поддерживать человека в работоспособном состоянии. Это и медицинские услуги, и оздоровительные мероприятия, и культурный отдых. При этом первостепенное значение имеют специализированные санатории, например, для больных и инвалидов с заболеваниями опорно-двигательного аппарата, в том числе, с остеопорозом. Ежегодно в российских санаториях отдыхает и лечится приблизительно более 5,7 миллиона человек, из них более 1,7 миллиона детей. Лечение в санаториях Минздрава России получают каждый год более 610 тысяч пациентов, из них более 17 тысяч - инвалиды, а также 337 тысяч детей

THE RELEVANCE, BENEFITS AND CLINICAL PERSPECTIVES OF THE COMBINED TREATMENT OF OSTEOPOROSIS BASED ON BONE-ANABOLIC THERAPY

Combination therapy of osteoporosis based on bone-anabolic and antiresorbtive agents has a great clinical perspective. An analysis of available publications shows that combination therapy is appropriate from the standpoint of increasing the effectiveness of treatment. Combination therapy can be executed as a simultaneous use of teriparatide with denosumab, raloxifene or hormonal therapy, and the subsequent administration of bisphosphonates, denosumab or raloxifene after treatment with teriparatide. The review presents the evidence-based data on the effect of combined and sequential regimens for osteoporosis fracture risk

Oral bisphosphonates as the therapy of choice in patients with moderate risk of fractures

Nowadays clinicians have access to high-quality diagnostic algorithms to determine the risk of fractures and the need for treatment, as well as the ability to choose the most advanced drug therapy that will be the most suitable, comfortable and safe for the patient with osteoporosis. This algorithm for the selection of therapy is based on an assessment of the fracture risk, which is determined by the presence and severity of low-energy fractures, the level of bone mineral density (BMD), and the 10-year probability of fractures. Patients with a moderate risk of osteoporotic fractures are the most controversial category of patients regarding the choice and assessment of the prognosis of treatment, since they either have no history of fractures or have suffered only one low-energy fracture due to osteopenia or normal BMD. In such cases, oral bisphosphonates with a planned treatment duration of 5 years were recommended as starting therapy for osteoporosis. Alendronic acid is the most well-known and widely prescribed oral bisphosphonate, characterized by financial availability and a favorable profile of clinical efficacy in the treatment of osteoporosis. The effectiveness of treatment with oral bisphosphonates is largely determined by the tolerability of the drug and patient adherence to treatment. Gastrointestinal side effects and the lack of patient motivation are the main reasons for the low adherence to anti-osteoporotic therapy. Due to the low incidence of adverse events and the convenient pharmacological form for enhancing treatment compliance, alendronate buffer solution in soluble effervescent tablets may be preferred in patients with a moderate risk of fractures. Solubilized in a buffer solution alendronate less contacts the mucous membrane of the esophagus and stomach, minimizing contact between the particles of the drug and the mucous membrane of the upper gastrointestinal tract, and ultimately reducing the local irritating effect and the likelihood of gastroesophageal reflux

PRIVERZhENNOST' PROFILAKTIKE OSTEOPOROZA I VLIYaYuShchIE NA NEE FAKTORY U ZhITEL'NITs MOSKOVSKOY OBLASTI

Despite high prevalence and severity of complications, osteoporosis (OP) in Russia is still not recognized as a socially significant disease and there are no common standards for prevention of OP and associated fractures. The aim of the study was to investigate the adherence of healthy females to prevention measures of OP and the affecting it factors to develop the principles governing the preventive strategy of OP. Methods. The study is performed in Moscow Region (MR) in a form of a questionnaire survey in the population of adult healthy women aged >20 years. The data are obtained using "Questionnaires on osteoporosis prevention" and "The test of knowledge in the field of osteoporosis" developed in Clinical Research Institution of Moscow Region named after M.F. Vladimirsky. Study comprised 1712 female aged from 20 till 87 years (median 55,0 years [45,0; 44,0]) living in 16 districts and 11 cities of MR. Taking into account the quality of the filling of questionnaires, data provided by 1631 women were included in the statistical analysis. Results. It is established that 31% of female inhabitants of MR are engaged in OP prevention, using for this purpose mainly calcium-containing drugs (64,3%) and increased consumption of calcium in food (59,8%). 93% of these women get preventive therapy at their own expense, spending on them on the average 200 rub a month, and preventive medication has appeared more saving than non-pharmacological preventive measures. Socially active working women at the age of 50-69 years are motivated on prevention of OP better than others. Level of the OP awareness and undertaking densitometry screening also directly influence adherence to OP prevention