[Results of a randomized double blind parallel study on the efficacy and safety of tolpersione in patients with acute nonspecific low back pain]. / Rezul'taty randomizirovannogo dvoinogo slepogo parallel'nogo issledovaniia éffektivnosti i bezopasnosti primeneniia tolperizona u patsientov s ostroi nespetsificheskoi bol'iu v nizhnei chasti spiny.

AIM: To evaluate the efficacy and safety of tolpersione injection and oral formulations combined with NSAID over NSAID monotherapy in acute non-specific low back pain. MATERIAL AND METHODS: In this randomized double blind study 239 patients were included in the per protocol analysis. The first 5 days of treatment, patients received tolpersione or placebo injection which was followed by per os administration of tolpersione/placebo tablet up to 14 days. NSAID diclofenac tablet was used in both groups through the study. Functionality assessed by the Roland Morris Disability Questionnaire (RMDQ) at day 5 was the primary endpoint. Secondary endpoints were RMDQ at other time points, pain level change at rest and on movement assessed by the Visual Analogue Scale (VAS), the Clinical Global Impression of Improvement/Patient Global Impression of Improvement (CGI-I and PGI-I), change in the range of motion assessed by the distance from the fingertips to the floor, period of disability days, relative (%) changes in the daily dose of diclofenac from the 7th to the 14th day of therapy. RESULTS AND CONCLUSION: The primary and secondary endpoints clearly demonstrated the significant superiority of tolpersione added to NSAID monotherapy over NSAID monotherapy. The safety assessment revealed no statistically significant differences between the two groups. Based on the results, tolpersione injection and per os formulations can be considered an effective and safe drugs in the combined therapy for patients with acute nonspecific back pain.

[The effect of the succinic acid preparation on the dynamics of neurological and emotional disturbances in patients with dorsopathy].

OBJECTIVE: To study the dynamics of neurological and emotional disturbances in patients with dorsopathy treated with cytoflavin. MATERIAL AND METHODS: We examined 120 patients aged from 21 to 55 years, mean age 38±9 years. All patients received nonsteroid anti-inflammatory drugs, myorelaxants, vitamins. The main group comprised 67 patients who received cytoflavin (10ml of the solution in one injection once a day in 200 ml of isotonic solution of sodium chloride intravenously in drops in the morning during 10 days) in addition to standard treatment. The comparison group included 53 patients who received standard treatment during 10 days. RESULTS AND CONCLUSION: The use of cytoflavin allowed earlier arresting of the pain syndrome, restored the disturbed sensitivity, improved emotional status and decreased the severity of a neuropathic pain component.

[Alexithymia in patients with left-hemispheric cerebral infarction in the late recovery period]. / Aleksitimiya u bol'nykh s infarktom golovnogo mozga levopolusharnoi lokalizatsii v pozdnem vosstanovitel'nom periode.

AIM: To study emotional status, including alexithymia, anxiety and depression, in patients with cerebral infarction in the area of the middle cerebral artery (on the left side) in the late recovery period and to develop a method for correction of the damage. MATERIAL AND METHODS: The study included 30 patients with cerebral infarction in the area of the middle cerebral artery (on the left side). A comparison group consisted of 10 patients with chronic brain ischemia. RESULTS AND CONCLUSION: The results have demonstrated the correlation between the level of alexithymia and the severity of neurological deficit, sex-related level of anxiety and depression. The cerebral infarction impacts on the level of alexithymia. Alexithymia in patients with cerebral infarction affects the adequate self-esteem of physical and mental condition that may complicate the rehabilitation of these patients and demands correction as a combination of pharmacotherapy and psychotherapeutic intervention.

[The possibility of treatment of cognitive impairment in the complex therapy of patients with the consequences of cerebral infarction].

AIM: To study neuropsychological status of inpatients with the consequences of cerebral infarction treated with cortexin and mexidol. MATERIAL AND METHODS: We carried out a neurological and neuropsychological examination of 62 patients with the consequences of cerebral infarction treated with cortexin in the dose of 10 mg and mexidol in the dose of 5 mL of 5% solution intravenously during 15 days. RESULTS AND CONCLUSION: It has been shown that the use of this drug combination decreasescomplaints and neurological symptoms and significantly improves cognitive and emotional status as well. The more positive changes are related to attention, speed of mental reactions, anxiety and verbal activity. The complex therapy with cortexin and mexidoldecreased neurological deficit and improve cognitive functioning and psychoemotional status thus increasing quality of life and rehabilitation potential of the patients.

[Efficiency of mexidol in patients with endocrine polyneuropathy].

OBJECTIVE: To evaluate the efficacy of mexidol and necessity of using it in patients with endocrine polyneuropathies caused by primary hypothyroidism (PPHT). MATERIALS AND METHODS; We have examined 51 patients with confirmed diagnosis of PPHT and assessed their neurological status and indicators of metabolic homeostasis before and after treatment. Electroneuromyography (ENMG) was performed to assess the status of the peripheral nervous system. RESULTS: The results indicate the presence of endocrine disorders of obligate metabolic homeostasis in patients with polyneuropathies. Antioxidants, in particular, mexidol, in a complex with other drugs can be used in the treatment of these disorders. Worsening of ENMG-parameters, demonstrating a trend towards the normalization in response to treatment antioxidants, are characteristics of this pathology. CONCLUSION: The efficacy of mexidol in patients with PPHT has been confirmed.

[Syphilitic cerebral vasculitis: diagnostic possibilities].

We studied 1387 patients with different forms of syphilis for neurological deficiency. Thirty patients had vascular neurosyphilis. Two cases are described in detail. A 40-year-old man had recurring episodes of acute disturbance of the cerebral blood flow and progressive cognitive disorders. A 32-year-old patient presented with progressive dementia, hallucinatory symptoms and minor multifocal neurological changes. The diagnosis of neurosyphilis was verified by CSF-test results. The diagnosis of cerebral vasculitis was proved by the data of magnetic resonance imaging (MRI), magnetic resonance (MR) angiography, ophthalmological methods, and duplex scanning of brachiocephalic arteries, transcranial duplex scanning. Diagnostic criteria of syphilitic cerebral vasculitis were defined and presented.

[The impact of posterior atlantooccipital membrane on blood flow alterations in Chiari I malformation patients].

Chiari I malformation (CM) is usually associated with CSF flow disturbances at the level of craniovertebral junction. In current literature a few articles aim to demonstrate blood flow disturbances in Chiari I malformation patients. The paper discusses the role of posterior atlantooccipital membrane in vertebrobasilar insufficiency development and presents a case of successful treatment of blood flow alterations after decompression of craniovertebral junction and posterior atlantooccipital membrane resection.

[Effect of the direct electric stimulation of the spinal cord in the treatment of neurologic complications of cervical osteochondrosis].

The results of the treatment of 92 patients with neurologic complications of cervical osteochondrosis (26 patients with isolated persistent lesions of roots C4-C7 and 66 patients with the combination of root syndromes and cervical myelopathy) are presented. The combination of direct electric stimulation of the spinal cord with different methods of surgical treatment was used. The efficacy of treatment was assessed with the scale for measuring severity of neurologic complications of cervical osteochondrosis and by electromyographic data before treatment and 1 and 6 months after the surgery. The significantly higher (p<0,05) effect of surgical treatment in the combination with direct electric stimulation of the spinal cord was shown.

[The complex energy correction of chronic brain ischemia].

Considerable disturbance of all quality of life domains that worsens social adaptation and daily living and results in an asthenic-neurotic syndrome, along with neurologic and mnestic-intellectual disturbances, was revealed in patients with chronic brain ischemia (stages I, II, III). Based on the results of the double blind placebo-controlled trial, the high clinical efficacy of cytoflavin in patients with chronic brain ischemia has been shown. The treatment with cytoflavin decreases the severity of subjective symptoms and complaints thus increasing the working ability of patients, improves balance and gait, decreases the severity of asthenic and neurotic syndromes, improves cognitive and memory functions (information storage, reasoning and attention), positively effects on quality of sleep and all aspects of quality of life, in particular, on physical activity, self-rating of health and viability as well as social activity, mental health and emotional lability.

The potential of transcranial magnetotherapy in color and rhythm therapy in the rehabilitation of ischemic stroke.

A total of 116 patients with ischemic stroke were studied during the early recovery period. The patients were divided into four groups - three experimental groups and one control group. Of these, 87 patients in the first three groups received transcranial magneto- and/or color and rhythm therapy (TcMT, CRT) along with traditional treatment, while the 29 patients of the control group received basal treatment only. TcMT was performed using a bitemporal method, with a running field regime with a modulation frequency of 1-10 Hz. CRT consisted of an alternating scheme of stimulation of the left and right eyes with green and/or blue light with a period of 2-4 sec and an on time of 1 sec. Each of the three experimental groups (group 1 received TcMT, group 2 received CRT, and group 3 received TcMT + CRT) received two courses of treatment separated by 1.5 months. After treatment, all experimental groups, particularly group 3, showed more marked improvements than the control group. Regression of neurological symptomatology on the Lindmark scale in group 3 was 9.5% greater than that in controls; improvements in impairments to activity and self-care ability on the Barthel scale were greater by 8.8%; memory and intellectual changes were also seen on the MMSE and the Luriya and Schulte tests. Rheography and electroencephalography demonstrated significant improvements in hemodynamics and alpha-rhythm differentiation and a 14.6% reduction in the proportion of patients with dysrhythmia in group 3 compared with the control group. The best result on all measures were obtained in patients given the combination of TcMT and CRT; TcMT had the greater influence on hemodynamics, while CRT had the greater effect on psychoemotional status. Both treatments were well tolerated and produced no side effects.

[Possibilities of transcranial magnetic therapy and color and rhythm therapy in rehabilitation of ischemic stroke].

One hundred and sixteen post-stroke patients were studied in the early rehabilitation period. All patients were divided into 4 groups: 3 main and 1 control groups. Three main groups (87 patients) received transcranial magnetic therapy (TMT) and/or color and rhythm therapy (CRT) along with traditional treatment and the control group (29 patients) received only basic therapy. TMT was conducted using bitemporal technique, running regime with modulation frequency 1-10 Hz. In CRT, the alternating stimulation of the right and left eye with green and/or blue color with a period of 2-4 s and duration of luminescence 1s was applied. Each of 3 main groups received 2 treatment sessions with an interval of 1,5 month (1st - TMT, 2nd - CRT, 3rd - TMT + CRT). After the treatment, the marked positive changes were seen in all main groups, in particular in group 3. The improvement of neurologic symptoms on the B. Lindmark scale was higher by 9,5% in group 3 compared to the control one, on the Barthel index - by 8,8%, on MMSE and A. Luria and Schulte test - by 5,4 and 14,3%, respectively. Rheographic and encephalographic study revealed the significant improvement of hemodynamics and alpha-rhythm differentiation, decrease of patients with dysrhythmia by 14,6% in group 3 as compared to the control group. The best results were seen in the combination of TMT and CRT, TMT exerted a higher effect on the hemodynamics and CRT - on the psychoemotional state. Both therapies were well tolerated and had no side-effects.

[Assessment of the state of chromatin from whole blood leucocytes and lymphocyte population and the level of serum immunoglobulins in patients with acute and chronic cerebral ischemia].

A state of chromatin from whole blood leucocytes and lymphocyte population, using an automated method of cytological analysis flow cytofluorometry, and a level of serum IgA, IgG, IgM have been studied in patients with cerebral vascular disorders (chronic cerebral ischemia and cerebral infarction). An analysis of serum immunoglobulin levels did not reveal any significant changes in the groups studied. In patients with chronic cerebral ischemia, the increase of percentage of leucocytes and lymphocytes with activated chromatin, accompanied with the elevated synthesis of nucleic acids and the following elevated synthesis of proteins, including the active enzymes, was found that suggest the involvement of the immune system in the pathogenesis of cerebral ischemia. In patients with ischemic stroke, the percentage of leucocytes with activated chromatin was lower compared to control values that implied the occurrence of immunopathological reaction and role of peripheral blood lymphoid cells in the genesis of anti-inflammatory process in acute cerebral ischemia. The results obtained may be used in elaboration of new approaches to differential pathogenetic therapy of patients with different forms of cerebral blood flow disturbances.

[Clinical and immunological assessment of efficacy of mexidol in the treatment of lumbosacral radiculopathy].

Efficacy of mexidol in the complex treatment of lumbosacral radiculopathy has been analyzed. Comparing to the traditional treatment using clinical and immunological methods, this method proved to be superior.

[Neurovisualization methods in diagnostics of consequences in light craniocerebral trauma]. / Metody neirovizualizatsii v diagnostike posledstvii legkoi cherepno-mozgovoi travmy.

The purpose of the case study was to elucidate the frequency rate of pathological changes as registered by computer tomography (CT) and magnetic-resonance tomography (MRT) of the head in patients with chronic cerebral blood-circulation deficiency (CBD), functional disorders and vegetative nervous pathologies in presence (in their medical histories) of closed-type cranial trauma concomitant with concussion of the brain (CB) or without such trauma. A comparative analysis revealed a minor prevalence in the number of pathological changes in patients with CBD concomitant with CB. As for other nosological forms, the quantities of changes, expressed in percent, were virtually identical. A conclusion was made on the need to examine the patients of the discussed category by neurovisualization in the acute and remote periods of trauma.

[Results of a multicenter study of Rebif-22 mcg administration in Russia]. / Rezul'taty multitsentrovogo issledovaniia éffektivnosti preparata Rebif-22 mkg v Rossii.

The results of multicenter study of Rebif 22 micrograms in Russia have been reported. 167 multiple sclerosis patients have received Rebif 22 micrograms three times a week for 1 year. This study provides evidence for reduction of the relapse rate in patients with relapsing/remitting and secondary progressive multiple sclerosis. The tendency to the decrease of the severity of relapses, less need for steroid use and the decrease of EDSS score in patients with relapsing/remitting multiple sclerosis have been shown. In general Rebif 22 micrograms was tolerated well.