[Evaluation of the effectiveness of treatment of patients with nonspecific pain syndrome in the lower back with celecoxib and a combined preparation of B vitamins]. / Otsenka effektivnosti lecheniya patsientov s nespetsificheskim bolevym sindromom v poyasnitse tselekoksibom i kombinirovannym preparatom vitaminov gruppy B.

OBJECTIVE: To evaluate the effectiveness of the effect of celecoxib and the combined vitamin complex of group B in comparison with meloxicam in patients with acute and chronic nonspecific lumbar pain (LP). MATERIAL AND METHODS: The effectiveness of the effect on acute (44%; acute pain syndrome (APS)) and chronic (56%; chronic pain syndrome (CPS)) LP of moderate intensity (according to VAS/MPQ) (APS 5.7±2.3/2.13±0.67 points; CPS 5.2±2.8/1.47±0.61 points), the leading component of which is sensory sensations (when APS is lower than in CBS; Kr-W=6.15, p=0.04) and affective disorders in CPS (U=117.5, p=0.04) celecoxib without (APS 25%; CPS 75%) and with the addition of Neuromultivit (APS 36%; CPS 64%) and in comparison with meloxicam (APS 100%) against the background of basic therapy in 93 patients (61.3% women and 38.7% men; average age 49.9±9. years) with nonspecific LP pain syndrome in the lower back, with a low degree of severity of motor function (MF) disorders according to the ICF (2±1 points), due to spondyloarthrosis of the lumbosacral spine. RESULTS: It was found that celecoxib and meloxicam cause the same significant remitting decrease in the severity of APS and restoration of MF disorders in patients with APS, equally cause rare adverse events (gastropathy, increased blood pressure) in comorbid pathology. Celecoxib proved to be more effective in relieving CPS and improving MF (p<0.05), and the combination of celecoxib with Neuromultivit caused more pronounced relief of APS and CPS, restoration of MF (p<0.01). A steady decrease in the intensity of PS (1-2 points according to VAS), recovery of MF occurs only on the 10th-11th day of therapy (p<0.01), with complete relief of LP by day 21 only in 60.22% of cases. CONCLUSION: The results of the study confirm the benefits of celecoxib in combination with a vitamin complex for the relief of CPS.

[Structural-functional approach to chronic cerebral ischemia in elderly people.]

The aim of the study - experience in implementing a structural-functional approach to chronic brain ischemia (CCI) in elderly people by combining simultaneously produced measurements. Object of research - elderly patients with CCI 1 stage. As a result of the study, the methodological experience of the system study of CCI from the standpoint of the structural and functional approach in the elderly is shown. Thus, it has been demonstrated that the progression of chronic cerebral-dygemical morphological changes in the form of periventricular and subcortical leukoaareosis (according to magnetic resonance imaging) correlates with the degree of expression of cognitive dysfunction syndrome (according to the brief indicative test). Hyperhomocysteinemia are typical for patients with CCI 1 stage, what correlates with mild cognitive dysfunction. The identified biochemical, neuroimaging, neuropsychological correlates should be taken into account during medical and psychological rehabilitation of these people.

[Clinical experience of the use of agomelatine in the treatment of patients with depression and chronic brain ischemia].

OBJECTIVE: To study the efficacy and tolerability of agomelatine (valdoxan) in treatment of mild depressive states in patients with chronic brain ischemia (CBI). MATERIAL AND METHODS: The study comprised 33 patients (23 women, 10 men, average age 54.5 years), including 12 people (36.4%) with CBI, stage I, and 21 (63.6%) with CBI, stage II. All patients had a single depressive episode of mild severity. Diagnosis of affective and cognitive impairment was carried out using clinical and neuropsychological methods (the Hamilton Depression Rating Scale (HDRS-17), the Hospital Anxiety and Depression Scale (HADS), the night sleep questionnaire developed by A.M. Vein, the Mini-mental state examination (MMSE), the modified Mini-Cog method, the Montreal Cognitive Assessment Scale (MoCA), the Clinical Global Impression scale (CGI-S, CGI-I) to assess the degree and dynamics of the disease, the Patient Global Impression (PGI) scale. The survey had been performed after 2,4 and 8 weeks of treatment. Agomelatine (valdoxan) was used 1 time per day in the evening in a dose of 25 mg (1 tablet). RESULTS AND CONCLUSION: Agomelatine improved sleep from the second week of treatment, reduced anxiety symptoms after six weeks and depressive symptoms after eight weeks. The improvement of cognitive functions was noted as well. No side-effects was observed. The results revealed the high antidepressive activity of the drug in treatment of mild depressive states in patients with chronic brain ischemia, the balanced spectrum of effects on anxiety, depression, insomnia, the positive effect on cognitive functions that allows to recommend agomelatine in treatment of patients with CBI.

[Activity of genetically programmed cell death of lymphocytes in rheumatoid arthritis].

AIM: To study activity of genetically programmed cell death (PCD) of lymphocytes in patients with rheumatoid arthritis (RA). MATERIAL AND METHODS: Lymphocytes from 30 RA patients including 14 patients with RA history up to 2 years, and 12 healthy donors were studied for activity of caspase 4, 6, 8 usingfluorescence and caspase substrates 30, 60, 120, 150 and 180 min after start of the reaction and number of 1-2-thread serration of DNA with fluorescence of two DNA-tropic stains--EtBr and 4,6-DAPY Correlation was also studied between lymphocyte activity and RA activity, x-ray stage, duration, level of TNF-alpha. The trend in PCD activity of lymphocytes in immunosuppressive therapy was analysed. RESULTS: The activity of lymphocytic caspases in RA patients was low compared to healthy donors. A negative correlation was found between RA activity and activity of caspase 8 and 6. In RA therapy with methotrexate, sulphasalasine, glucocorticosteroids the activity of caspases and number of 1-thread serrations of DNA were subnormal. CONCLUSION: RA is associated with lymphocyte PCD disorders which may be involved in RA pathogenesis, in formation of clones of potentially autoaggressive lymphocytes, in particular. This process is not normalized by current methods of RA treatment causing unsatisfactory outcomes of RA therapy.