[Optimizing the diagnosis and treatment of dorsalgia in real-world clinical practice: the secondary endpoint of the DORISS multicenter observational study]. / Optimizatsiya diagnostiki i lecheniya dorsalgii v usloviyakh real'noi klinicheskoi praktiki: vtorichnaya konechnaya tochka mnogotsentrovogo nablyudatel'nogo issledovaniya DORISS.

OBJECTIVE: To evaluate the efficacy of Ipigrix in the complex treatment of patients with dorsalgia (DA) of the lumbosacral spine based on the results of the DORISS observational non-interventional multicenter study. MATERIAL AND METHODS: Overall 3563 patients with verified diagnoses of DA at 200 clinical centers within the Russian Federation who received comparable baseline therapy according to nosological standards were examined, some of them additionally received oral or staggered treatment with Ipigrix. Baseline therapy for DA was given to 376 patients (treatment group 1), combination of baseline with oral Ipigrix was given to 1026 patients (group 2), and combination with staggered prescription of ipidacrine - to 2161 (group 3). Secondary endpoint of the study included analysis of the improvement of clinical symptoms, values of pain NRS and DN4 scales together with Roland-Morris questionnaire during the period of observation depending on the therapy with an assessment of its safety. RESULTS: The results of the analysis of covariance allowed to exclude the influence of confounders (age and initial indicators of the utilized scales) on DA outcomes and demonstrated the greatest pain reduction in patients who additionally received Ipigrix via the staggered scheme. The inter-group comparison aligned by pseudorandomization showed statistically significant benefits of combined therapy regardless of the type of Ipigrix administration concerning main vertebral syndrome manifestations, sensory and motor disturbances, relief of pain, as well as neuropathic symptoms, improvement of neurophysiological parameters and restoration of life functioning without serious drug related adverse events. CONCLUSION: Ipigrix (ipidacrine) can be considered an effective and safe adjuvant analgesic in the treatment of DA.

[Peculiarity of autonomic functions regulation remodeling in human adaptation to extreme conditions in labor activities].

In modem society, professional activity in conditions of extreme factors occupies a growing place. Of particular note is the work related to night shifts involving up to 20% of the population. In some cases, this work may lead to a breach of the adaptation processes of the body and increase the risk of diseases. The necessity to search criteria of dysregulation changes in the human body during adaptation to extreme conditions in labor activities is the actual problem from the standpoint of preventive health care of the working population health and providing safety in professional activities conditions. In our work, we attempted to identify early signs of autonomic function's dysregulation by analyzing the heart rhythm variability in locomotive operators and doctors on duty. It was revealed that these groups of people with different levels of intensity of professional activities may be the model for observation of the stages of dysregulation process. It is also shown that the earliest markers of autonomic regulation remodeling are indicators of the spectral analysis of heart rhythm variability, reflecting the activity of the total power regulation (TP) and parasympathetic part (HF).

[Work with night shift as a factor dysregulation of autonomic nervous system of locomotive drivers].

Work with night shift is an obligate necessity of modem industrial urban society. In developed countries in the work on the night shift use up to 20%. These categories of workers are definitely the locomotive drivers. The consequence of a regular work with night shifts is a violation of human circadian rhythms, which, through dysregulation of the autonomic nervous system, is reflected in a greater risk of disease and transport accidents. The need to find ways and criteria of preventive monitoring dysregulatory changes in the human body is an urgent and challenging issue in terms of the health of the working population, disease prevention, and transportation security.