[STRESS-INDUCED DEPRESSION IN OLD AGE: CLINICAL CHARACTERISTICS, PECULIARITIES OF THE PSYCHOGENIC SITUATIONS AND OF RELATIONSHIPS SYSTEM].

In the context of increasing life duration the issue of prevention and treatment approaches to the basic forms of pathology, in particular--neuropsychic, becomes more important. One of these forms widely spread is depression, which is often triggered by stressful situations. The aim of this work was to study the features of stress-induced depression in old age group and to carry out the content analysis of such situations and specific system of relations in this group of patients.

[Treatment of myofascial pain syndrome].

Objective: To study different methods of treatment of patients with myofascial pain syndrome (MFPS).

Material And Methods: We evaluated the efficacy of complex treatment in 152 patients with chronic tension-type headache (СЕЕР) and 96 patients with facial MFPS. The treatment included standard methods (reflex therapy of СЕЕР and local injections of a combination of local anesthetics with small doses of steroids in trigger points in patients with facial MFPS.

[Possibilities for the instrumental monitoring of neuralgia therapy].

Aim: To study the possibility of using a paired (test) H-reflex recovery test in the expert assessment of the intensity of acute pain syndromes and in the control of performed therapy.

Subjects And Methods: The authors analyzed 40 patients treated for radicular pain syndrome (RPS) caused by disk protrusion or herniation at the lumbar spine with the pain intensity of up to 9 points on digital rank scale of pain. As a clinical model they used a pathogenetically sound therapeutic blockade method including glucocorticosteroids for the therapy of acute neuralgia and basic medical therapy with Arcoxia 120 mg/day.

[Local invasive treatment of chronic pain].

The literature on methods of invasive local treatment of chronic pain was analyzed. We reviewed 14 publications including meta-analyses and systematic reviews. The use of regional anesthesia conducted by anesthesiologists in pain clinics demonstrated the evidence based efficacy of different types of peridural injections of local anesthetics with steroids in patients with root pain syndromes at cervical and lumbar levels.

[Odontogenic pain syndrome: integrated approach in analgesia].

The article deals with the study of 96 patients (69 women and 27 men) with odontogenic facial pain syndrome. All patients received complex neurodentist examination with radiological assessment of maxillofacial area and additional functional methods. Patients were divided into two groups, 48 patients in each group.

[Treatment and rehabilitation of patients with pain syndrome in surgical clinic].

Though the progress of modern medicine in understanding the mechanisms of pain and its treatment is significant, the problem of organizing help to the patients with pain syndrome is still actual and undecided. The issue highlights the general types of pain among surgical patients, as well as the integrative approach to the treatment and rehabilitation.

[The necessity and possibilities of the antipain help organization in multyprofile clinics].

The personal work experience of the department of pain syndrome and analysis of foreign algologic service clearly demonstrated the necessity of similar adequate hierarchical medical service for treatment of chronic pain. The following principles should build the backbone of the service: multidisciplinary approach, usage of both traditional and alternative medicine, availability of help and stable feedback with tertiary hospitals. The algologic service should perform diagnostic, advisory and expert functions.

[The methodology on the study of blink reflex and its normative parameters].

The study of blink reflex is a modern and high informative method of electroneurophysiological diagnosis. The data of clinical studies are controversial that confirm the actuality of the problem and indicate the necessity of universal approaches to methodology and interpretation of obtained results. We studied peculiarities of reflex electromyographic (EMG) components of blink reflex of the circular eye muscle during the electric stimulation of the supraorbital nerve in 31 healthy people.

[Autonomous component in cervicocranial pains and grounds for its pathogenetic treatment].

An analysis of an autonomous component of the pain syndrome has been performed in 484 patients with neck and head pain syndromes. The frequency of autonomous disorders in this cohort reaches 84,7%. Autonomous dysregulation in different nosological groups as assessed with the A.

[Chronic pain management in non-cancer patients].

Chronic non-cancer pain management is an urgent global problem. To set up pain clinics is a promising and economically sound approach. There are pain clinics operating in Russia; however, there are no unified approaches to solving their organizational, therapeutic, and educational-and-methodological problems.

[Therapeutic blockades and reflexotherapy in the complex treatment of tension headache].

The analysis of treatment effectiveness was carried out in 138 patients with tension headache. Patients of group 1 received fluoxetine in dose 20-40 mg/day during not less than 3 months and tizanidini in dose 4-8 mg/day during not less than 2 weeks. Patients of group 2 were assigned to therapeutic blockades of the occipital nerve and trigger points of cervico-cranial area using local anesthetics (2.

[Use of anesthesiological technologies in the complex treatment of cervicocranial pain syndromes].

Four hundred and eighty-four patients with pain syndromes of cervicocranial localization, such as migraine, exercise-induced headache, cervicogenic headache, trigeminal neuralgia, trigeminal neuropathy, and occipital neuralgia were observed. The patients were randomized by the type, intensity, and duration of the pain syndrome and subdivided into two subgroups in each of the study nosological entities. The patients from control groups received the conventional complex therapy including drug (nonsteroidal anti-inflammatory drugs, central myorelaxants, anticonvulsants, and antidepressants depending on the type of a pain syndrome) and non-drug (physiotherapy, massage, and therapeutic exercises) ones.

Efficacy of neuroprotectors in patients with tension headaches.

Studies were performed on 126 patients with chronic tension headache (CTH). Patients were divided into two groups - an experimental group (64 patients) and a control group (62). Control patients received standard treatment (tizanidine, fluoxetine, vinpocetin, and manual acupressure of active points in the trapezius muscles and the temporomastoid area of the head); the experimental group also received Mexidol.

[Study on the quality of life of elderly patients with recurrent depressive disorders].

This article presents results of special science research on problem of quality of life of patients suffering from recurrent depressive disorders in advanced age. The authors emphasize the influence of some clinical characteristics of depression and type of personalities upon the rates of quality of life.

[Pain: clinical picture and objective criteria of therapy adequacy].

The paper is dedicated to electroencephalographic monitoring in the therapy and rehabilitation of patients with acute radicular pain syndromes of the disc etiology. Spontaneous electromyograms (EMG) of the shin muscles in healthy and affected legs and stimulation electroneurograms were registered in 52 patients; the readings were subsequently processed on the basis of Fourier analysis for the 4-sec maximal muscle contraction. The studies made it possible to detect the degree of destructive changes in the neuromotor apparatus and to monitor its functional recovery in pharmacotherapy, central and peripheral blocks, artificial correction of movements and in acupuncture.

Heterotopic nociceptive EMG-reactions in M. masseter.

Peculiarities of EMG-reactions of m. masseter to noxious homo- and heterotopic stimulation were studied on healthy volunteers. Homotopic noxious electrical stimulation of n.

[Electrophysiological approaches to pain evaluation in clinical practice].

The basic principles of instrumental estimation acute and chronic pain syndrome are presented. Electromyography and restoration of H-reflex permit to estimate the pain and carry out dynamic control during therapeutic procedures for vertebrogenic pain syndrome. The methods mentioned are the components of complex approach to diagnosis of pain syndrome.

[Ropivacaine (naropin), local anesthetic of choice for epidural blockade].

The purpose of this study, carried out in 132 patients with intense acute radicular pain, was search for an optimal local anesthetic to be used in combination with a steroid for therapeutic epidural blockade. Comparative analysis of analgesia attained by epidural injections of 5 ml 2% lidocaine, 4 ml 0.5% bupivacaine, and 4 ml 1% ropivacaine showed the advantages of the latter drug in stable arrest of radicular pain immediately after injection.