The modern methods of reproduction physiology of horses

The concept of development of horse breeding in Ukraine until 2020 provides for an increase in the number of horses through the intensive use of modern methods of reproduction biotechnology. However, the imperfection of these methods hinders their widespread use in practice. The aim of the work was to draw attention to the most important problems of the physiology of horse reproduction in Ukraine and to show ways to solve them that have already been proposed by domestic and foreign researchers. The development strategy of the physiology of horse reproduction in order to increase its effectiveness should take into account the least studied aspects that were discussed above. The article shows that taking into account the influence of micromycetes, the absolute number of colony forming units of E. coli in semen of stallions; immuno-and cytogenetic features; new methods of sanitary preparation of horses for sperm and insemination; the effect of permissible levels of feed mycotoxins on physiological functions improves the efficiency of equine reproduction physiology methods. However, we first discovered new physiological features of the effect of erythrocyte antigens of blood groups of horses of Ukrainian selection on the indicators of their native sperm. In the presence of ad/bcm and dg/cgm alleles of the blood group D system in stallions, sperm motility is on average less than 5 points; alleles ad/cgm, ad/d, ad/de, ad/dk, bcm/d, bcm/de, bcm/dg, bcm/dk, cegm/cgm, cegm/d, cegm/dg, cegm/dk, cgm/ceg, cgm/cgm, cgm/dg, cgm/dk, de/cgm, de/dk, dg/di, dk/d, dk/de, dk/dk is accompanied by sperm motility from 5 to 7 points; alleles bcm/cgm, dg/dk, de/d, cgm/d, cgm/de sperm motility is observed more than 7 points. The results obtained allowed us to develop for practice ways to increase the efficiency of sperm cryopreservation by immunogenetic parameters. In addition, open physiological correlations can increase the fertility of mares during mating

The role of IGF-1/GH in the aging process and the development of age-related diseases

One of the most important trends in geroscience is the search for the biomechanisms of aging and geroprotective methods. In recent years, more and more attention has been paid to the role of age-related decline in IGF-1 levels; processes that start with a decrease in the activity of the GH/IGF-1 axis. IGF-1 levels correlate differently with many age-associated diseases: diabetes mellitus, cancer, cardiovascular disease. A decrease in the level of IGF-1 and growth hormone in the elderly can contribute to the deterioration of the course of some pathologies, and also have a protective effect in the occurrence of different nosologies. The possibility of slowing down aging with the help of IGF-1 in basic research led to research aimed at studying the possibility of using IGF-1 preparations and growth hormone in clinical practice to slow down aging. We have studied the literature on the Pubmed platform, Scopus for the past 10 years in order to find some new information regarding influence of IGF-1 on aging, about the association between IGF-1 levels and major age-related diseases. We analyzed data of publications on the role of IGF-1 in aging and the development of age-related diseases. The search was carried out using key words: IGF-1, growth hormone, aging, the review included data from more than 60 publications

Prevalence of geriatric syndromes in frail patients and mortality risks

The prevalence of older people in Russian population increases rapidly. Therefore, the concept of healthy aging is becoming crucial in Russia and all over the world, and thus disability prevention is one aspect of this issue.AimTo assess a possible association between geriatric syndromes, comorbidities, and mortality rate among frail patients who receive home medical care in Moscow.Materials and methodsThe study included 450 patients with home medical care provided by the State Budgetary Healthcare Institution “Diagnostic Center No. 3 of the Moscow Health Department” from June 2019 to April 2021. Physical health, functional, cognitive, social and emotional statuses were evaluated by comprehensive geriatric assessment (CGA). The mortality rate after 1 year was assessed.ResultsThe all-cause case mortality rate in patients during the observation period was 22.4%. There was no difference in age and comorbidities in survivors and deceased patients, but the latter group had more geriatric syndromes. The association between risks of mortality and anemia and some geriatric syndromes, such as malnutrition and hearing impairment, total dependence (Barthel index less than 60) was observed

Особенности гериатрического статуса у пожилых пациентов с остеоартритом в сочетании с невропатической болью: данные российского эпидемиологического исследования ЭВКАЛИПТ

The main symptoms of osteoarthritis (OA) are pain and dysfunction of the joints. Neuropathic pain (NP) occurs in more than half of patients with OA, it is refractory in nature and is the cause for seeking medical advice more frequently, poor quality of life and disability.Objective: to evaluate the frequency of NP and its relationship with geriatric syndromes (GS) in patients with OA aged 65 years and older. Patients and methods. The subanalysis of the study EVKALIPT included 2286 patients with OA and chronic pain syndrome. All patients underwent a comprehensive geriatric assessment (CGA) and diagnostics of NP using the DN4 questionnaire.Results and discussion. The prevalence of NP in patients with OA was 22.7%. Patients with OA and NP more often experienced pain of any localization with a large number of tender points, they had a higher frequency and intensity of pain syndrome, they more often took analgesics and noted limitations in daily life. When conducting a correlation analysis, correlations of medium strength were found between the sum of scores according to DN4 questionnaire and the pain intensity assessment on a numerical rating scale at the time of examination (r=0.26; p<0.001) and in the previous 7 days (r=0.29; p<0.001). CGA data in patients with OA and NP demonstrated worse geriatric status and a higher incidence of GS. The most common GSs were basic (81%) and instrumental (64%) dependence in everyday life, senile asthenia (70%), urinary incontinence (69%), depression (69%) and cognitive impairment (67%). Multivariate analysis showed that, in addition to age, the presence of NP was independently associated with sensory deficits, depression, falls, urinary incontinence, and bedsores (odds ratio 1.77–2.49). Patients with NP were more likely to use mobility aids, absorbent underwear, and orthotics.Conclusion. NP was diagnosed in 22.7% of OA patients aged 65 years and older. Such patients have worse functional status, they are more often diagnosed with a number of GSs.Главные симптомы остеоартрита (ОА) – боль и нарушение функции суставов. Невропатическая боль (НБ) встречается более чем у половины больных ОА, носит рефрактерный характер и является причиной более частого обращения за медицинской помощью, низкого качества жизни и инвалидизации.Цель исследования – оценить частоту НБ и ее взаимосвязь с гериатрическими синдромами (ГС) у пациентов с ОА в возрасте 65 лет и старше.Пациенты и методы. В субанализ исследования ЭВКАЛИПТ включено 2286 пациентов с ОА и хроническим болевым синдромом. Всем больным проведены комплексная гериатрическая оценка (КГО) и диагностика НБ с помощью опросника DN4.Результаты и обсуждение. Распространенность НБ у пациентов с ОА составила 22,7%. Пациенты с ОА и НБ чаще испытывали боль любой локализации с большим количеством болевых точек, у них были выше частота и интенсивность болевого синдрома, они чаще принимали анальгетики и отмечали ограничения в повседневной жизни. При проведении корреляционного анализа обнаружены взаимосвязи средней силы между суммой баллов по опроснику DN4 и оценкой интенсивности боли по числовой рейтинговой шкале в момент осмотра (r=0,26; p<0,001) и в предшествующие 7 дней (r=0,29; p<0,001). Данные КГО у пациентов с ОА и НБ продемонстрировали худший гериатрический статус и более высокую частоту ГС. Наиболее распространенными ГС были базовая (81%) и инструментальная (64%) зависимость в повседневной жизни, старческая астения (70%), недержание мочи (69%), депрессия (69%) и когнитивные нарушения (67%). Многофакторный анализ показал, что с наличием НБ, помимо возраста, независимо ассоциированы сенсорный дефицит, депрессия, падения, недержание мочи и пролежни (отношение шансов 1,77–2,49). Пациенты с НБ чаще использовали вспомогательные средства для облегчения мобильности, абсорбирующее белье и ортопедические изделия.Заключение. НБ диагностирована у 22,7% пациентов с ОА в возрасте 65 лет и старше. Такие больные имеют худший функциональный статус, у них чаще диагностируется ряд ГС

Blogging the Virtual: New Geographies of Domination and Resistance In and Beyond Russia

Russia’s accelerating authoritarian turn has not ignored the internet, and in recent years, the Russian state has clamped down on internet activities that diverge from the statist line, employing a variety of strategies to dominate online spaces. Nevertheless, oppositional voices flourish on the Russian internet, taking shape in independent blogs and videos. This paper explores three political bloggers through surveillant and resistance assemblages, making sense of this contestation through an interpretation of the Deleuzian virtual that underscores the emancipatory potential of online activities for producing more egalitarian configurations, but also taking stock of the ways that these technologies have increased domination. Encompassing the blurriness between digital and corporeal spaces, the paper contributes by revealing new geographies of contestation against state strategies to dominate the Russian internet. Overlapping with but not corresponding to Russian territorial boundaries, these dynamics highlight shifting spaces of power and resistance in the increasingly illiberal world

Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease

OBJECTIVE: Cardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease.  METHODS: The Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention. Associations between patient characteristics, country characteristics (income inequality expressed as Gini coefficient, health expenditure, schooling, gross domestic product, birth rate and hospital beds) and cardiac endpoints were checked in a three-level model (patient-centre-country).  RESULTS: A total of 30 countries enrolled 2924 patients from 89 centres. At least one endpoint occurred in 645 women (22.1%). Maternal age, New York Heart Association classification and modified WHO risk classification were associated with the combined endpoint and explained 37% of variance in outcome. Gini coefficient and country-specific birth rate explained an additional 4%. There were large differences between the individual countries, but the need for multilevel modelling to account for these differences disappeared after adjustment for patient characteristics, Gini and country-specific birth rate.  CONCLUSION: While there are definite interregional differences in pregnancy outcome in women with cardiac disease, these differences seem to be mainly driven by individual patient characteristics. Adjustment for country characteristics refined the results to a limited extent, but maternal condition seems to be the main determinant of outcome

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Background: Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. Methods: The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. Findings: We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2–11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75–1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58–1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91–1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70–1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11–0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50–0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38–0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45–0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. Interpretation: Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. Funding: Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health

Случай успешного хирургического лечения разрыва гигантской аневризмы инфраренального отдела аорты у пациентки старческого возраста

Today, abdominal aortic aneurysm surgery is a fairly well-studied area of medicine. Nevertheless, some questions remain rather debatable. No clear criteria for giant aneurysms have been developed so far. The available foreign and domestic literature reports about 40 cases of surgical treatment of giant abdominal aortic aneurysms, 16 of which are cases of aneurysm rupture. Open surgery remains the method of choice in the treatment of giant aneurysms due to the pronounced technical difficulties of endovascular intervention. The authors present a case of successful surgical treatment of a giant aneurysm rupture in an elderly patient. The peculiarity of this patient's condition is the occurrence of aneurysm rupture after hospital admission. The patient refused surgical treatment for two years after aneurysm detection. On examination after admission, multispiral computed tomography revealed an aneurysm size of 101 mm. On the eve of surgery, pain syndrome in the left abdomen and tachycardia appeared. Aneurysm rupture was suspected and the patient was urgently admitted to the operating room. The surgery was performed under the conditions of machine reinfusion of autoblood. The patient underwent abdominal aortic aneurysm resection with linear prosthesis and retroperitoneal hematoma removal. The postoperative period had no peculiarities. On the 10th day after the operation the patient was discharged in satisfactory condition to the outpatient treatment. This clinical case demonstrates the possibility of successful surgical treatment of giant aneurysm rupture in elderly patients.Сегодня хирургия аневризмы брюшного отдела является достаточно хорошо изученным разделом медицины. Тем не менее некоторые вопросы остаются довольно дискутабельными. До сих пор не выработано четких критериев гигантских аневризм. В доступной зарубежной и отечественной литературе сообщается о 40 случаях хирургического лечения гигантских аневризм брюшного отдела аорты, 16 из которых – в состоянии разрыва аневризмы. Методом выбора при лечении гигантских аневризм остается открытая операция в связи с выраженными техническими трудностями эндоваскулярного вмешательства. В статье авторы приводят случай успешного хирургического лечения разрыва гигантской аневризмы пациентки старческого возраста. Особенностью течения состояния данной пациентки является возникновение разрыва аневризмы после поступления в стационар. Пациентка в течение двух лет после обнаружения аневризмы отказывалась от оперативного лечения. При обследовании после поступления в стационар по данным мультиспиральной компьютерной томографии размер аневризмы достигал 101 мм. Накануне операции появились болевой синдром в левых отделах живота, тахикардия. Был заподозрен разрыв аневризмы, пациентка экстренно подана в операционную. Операция проводилась в условиях аппаратной реинфузии аутокрови. Больной выполнены резекция аневризмы брюшного отдела аорты с линейным протезированием и удаление забрюшинной гематомы. Течение послеоперационного периода проходило без особенностей. На 10-е сутки после операции пациентка в удовлетворительном состоянии выписана на амбулаторный этап лечения. Данный клинический случай свидетельствует о возможности успешного хирургического лечения разрыва гигантской аневризмы у пациентов старческой возрастной группы