[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.

[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.

[Features of a cerebral hemodynamics at military men with initial exhibitings of cerebral circulation insufficiency of the pre-existing initial manifestations].

During the epidemiological survey of the military men of the Republic of Karelia with the pre-existing initial manifestations of cerebral circulation insufficiency were established it's main etiological reasons (somatoform autonomic dysfunction--35.2%, cervical osteochondrosis--34.3%) and risk factors (hereditary tainted cardiovascular event, north climate, stress, social habits, peculiarities of military service). Clinical characteristic of labile cerebrastenic syndrome and its peculiarities in compliance with etiological reasons of disease in the presence of autonomic disorders of suprasegmentary character and absence of significant nidal marks in neurological status was given. Complex program for expert diagnosis of the pre-existing initial manifestations of cerebral circulation insufficiency and methods of its propaganda (school, questionary, jotting) were developed and introduced into the practice of neurologist.

[The patterns of the bioelectrical activity of motor units in different forms of parkinsonism]. / Patterny bioélektricheskoi aktivnosti dvigatel'nykh edinits pri raznykh formakh parkinsonizma.

The correlation between the motor units activity patterns and clinical forms of parkinsonism has been investigated by means of surface electromyography. Grouped electromyogram, characteristic of parkinsonism shaking was found to be generated on the basis of double, triple discharges of the motor unit (doublets and triplets), or long-term synchronization of motor units discharges as well as by means of simultaneous recruitment of both above mechanisms. Stationary electromyogram, characteristic of akinetic-rigid form, was shown to correlate with asynchronous, stable activity of the motor units that impulse at the frequencies 9-10 Hz. Mixed forms of parkinsonism (shaking-rigid and rigid-shaking) were characterized by large amount of the motor units that impulse with high variability of interspike intervals and have a tendency to form doublets (unstable motor units). Different combinations of doublets, triplets and long-term synchronization of motor units with stable, asynchronous motor units activity were also found in mixed forms of parkinsonism.