[The optimization of differential diagnosis and treatment of cervical radiculopathy (SHERPA study)]. / Optimizatsiya differentsial'noi diagnostiki i terapii vertebrogennoi sheinoi radikulopatii (issledovanie ShERPA).

OBJECTIVE: To improve the algorithm of differential diagnosis and complex treatment of patients with CR. MATERIAL AND METHODS: Forty-two patients with CR were divided into 2 groups. Patients of the first group (n=21) received basic treatment (NSAID, myorelaxants, local injections with glucocorticoids (on demand), B vitamins and non-pharmacological methods) and the anticholinesterase drug ipidacrine. The second group (n=21) had only basic treatment. The total duration of the study was 45 days. The effectiveness of treatment was evaluated with VAS, NDI, GROC and total duration of disability period. RESULTS: A battery of tests for the diagnosis of CR that included Spurling test, motor strength deficiency, ULTT, pain pattern, shoulder adduction test (diagnostic complex SPASIBO), has been developed. A positive result of all 5 tests guarantees the 94.7% accuracy of CR diagnosis. The application of ipidacrine has allowed a significant (p<0.05) reduction of pain, enhancement of daily living activities and subjective improvement of well-being of patients after 1 month of treatment and mostly after 45 days. Besides, there was a considerable (p<0.05) reduction of the disability period in the first group of patients compared to the control one. CONCLUSION: The diagnostic complex SPASIBO should be used in diagnosis of CR. It is highly recommended to include ipidacrine in the complex treatment of CR.

[Identification of non-steroidal anti-inflammatory drugs as a necessity basis of effectiveness and risk correlation conception]. / Identifikatsiia nesteroidnykh protivovospalitel'nykh sredstv kak osnova kontseptsii neobkhodimosti sootneseniia éffektivnosti i riskov.

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for treatment of pain, fever and inflammatory diseases. However, along with a high rate of efficacy, NSAIDs have been associated with an increased risk of gastrointestinal and cardiovascular complications related to the inhibition of the enzymes cyclooxygenase 1 and 2. The review addresses contemporary mechanisms of NSAID's side-effects and analyzes clinical trials of the efficacy and tolerability of aceclofenac, which is the most frequently prescribed NSAID, as in its traditional release form (100 mg 2 times a day) as well as in the controlled-release (200 mg a day) form.