[The use of a fixed combination of diclofenac and orphenadrine in the treatment of acute pain syndrome in patients with discogenic lumbosacral radiculopathy and lumboischialgia]. / Primenenie fiksirovannoi kombinatsii diklofenaka i orfenadrina v terapii ostrogo bolevogo sindroma u patsientov s diskogennoi poyasnichno-kresttsovoi radikulopatiei i lyumboishialgiei.

Acute pain syndromes caused by discogenic lumbosacral radiculopathy and lumboischialgia are not uncommon in clinical practice and characterized by a high risk of becoming chronic. The pathogenetic aspects, features of the clinical picture, existing approaches to conservative treatment of these conditions are analyzed in this paper. Data on the efficacy and safety of a fixed combination of diclofenac and orphenadrine (Neodolpasse) use in the treatment of vertebrogenic pain syndromes based on the NEODOLEX study results are presented, and the authors' own clinical observations are given. Possible reasons for the high efficacy of Neodolpasse in patients with discogenic radiculopathies and nonspecific back and neck pain are discussed.

[Nociceptive and mixed pains in patients with multiple sclerosis]. / Notsitseptivnye i smeshannye bolevye sindromy u patsientov s rasseyannym sklerozom.

Nociceptive and mixed pain syndromes (NMPS) whose pathogenesis is linked with the formation of plaques of demyelination in the CNS are commonly present in patients with multiple sclerosis (MS). NMPS of diverse locations, mechanisms and clinical features significantly worse patients' disability and impair their social adaptation. At the same time, clinicians do not pay enough attention to these syndromes in routine practice. Early diagnosis of NMPS may be important not only for early and appropriate NMPS' therapy and improvement of patients' quality of life, but, possibly, for the diagnosis of the onset or relapsing phase of MS, in cases when NMPS are the symptoms of MS and are the signs of active demyelinating process. This review addresses contemporary views of the main types of NMPS in MS (headaches, musculoskeletal pains, painful tonic spasms, pain with spasticity). Epidemiologic data, pathogenesis, clinical manifestations and diagnostic options of NMPS in patients with MS are described along with current views on MS and NMPS comorbidity theories. Existing approaches to treatment of NMPS based on randomized trials data are analyzed.

[Neuropathic pain syndromes in patients with multiple sclerosis]. / Neiropaticheskie bolevye sindromy u patsientov s rasseyannym sklerozom.

Among the numerous pain syndromes (PS) of various localizations and types, observed in patients with multiple sclerosis (MS), the greatest attention of researchers is attracted by neuropathic PS. Neuropathic PS are often present already in the early stage of MS, significantly reduce the quality of life, hinder the social adaptation of patients, poorly respond to therapy. Central neuropathic PS, which pathogenesis is closely related with plaques in the central nervous system, are most common in patients with MS. Diagnostics of neuropathic PS in MS is based mainly on typical clinical symptoms; MRI and neurophysiological methods data are of secondary importance. This review focuses on modern concepts of three main neuropathic PS in MS: ongoing extremity pain, trigeminal neuralgia and Lhermitte's sign. Clinical symptoms of neuropathic PS, current ideas about their pathogenetic mechanisms, MRI and neurophysiological techniques data and the existing approaches to conservative therapy and surgical treatment based on randomized trials data are presented.

[Registry-based comparison of multiple sclerosis epidemiology trend data in 1999 and 2019: the case of Yaroslavl]. / Dinamika osnovnykh epidemiologicheskikh pokazatelei rasseyannogo skleroza po rezul'tatam sravneniya registrov patsientov 1999 i 2019 gg. v Yaroslavle.

OBJECTIVE: To compare the epidemiological indicators of multiple sclerosis (MS) in Yaroslavl when comparing the 1999 and 2019 registers to study the pathomorphism of the disease in this territory. MATERIAL AND METHODS: During the work, the data of the 1999 and 2019 registers were used, including the age of the debut, the date of diagnosis, the form of the disease, clinical characteristics, the treatment received and its duration. In 1999, 257 patients living in the city of Yaroslavl (155 women and 102 men) were included in the MS registry with a reliable diagnosis of MS according to Poser's criteria with confirmation according to neuroimaging data. In 2019, 479 people living in the territory of Yaroslavl (342 women and 137 men) were included in the register with a diagnosis of MS based on the criteria of MacDonald 2005, 2010, 2017. As of 01.01.19, 970 patients (530 women and 440 men) were included in the patient register of the Yaroslavl region. RESULTS AND CONCLUSION: Clinical and epidemiological review of Yaroslavl MS Registry data in 1999 and 2019 showed significant changes in disease pattern. The prevalence rate increased from 42.6 to 78.5 cases per 100,000 people. The morbidity rate rose from 1.58 to 3.28 cases per 100,000 people. The reasons for the increase are improvement in the diagnostic quality, new diagnostic criteria and the true growth of prevalence and morbidity. The use of disease modifying drugs (DMDs) has extended «the time to EDSS 3,0¼ by 4 years, «the time to EDSS 6,0¼ by 5-8 years.

[The Effect of Repeated Local Ischemia on the Temperature and Skin Microcirculation in Human Hand].

Thermal imaging and laser Doppler flowmetry were applied to study the effects of infrared (IR) radiation mediated by vascular response in healthy volunteers during regular unilateral arteriovenous occlusion of one of the fingers (4 times a day for 7 months with a gradual increase in exposure from 10 to 30 min). After repeated unilateral exposure, we observed consistent changes in temperature conditions and modes of thermoregulation of corresponding skin areas of both hands. We discovered a high level of positive correlation between the dynamics of IR emission from the experimental and control skin areas in the recovery phase after clamping, which indicates that systemic vascular response is involved. The possible mechanisms of post-occlusive changes in skin of the distal phalanges are discussed. These data suggest that multiple regular unilateral arteriovenous occlusions enhance the intradermal blood flow and can be used for the prevention of disorders of the peripheral microcirculation in various pathological conditions.