[Optimizing the diagnosis and treatment of dorsalgia in real-world clinical practice: the secondary endpoint of the DORISS multicenter observational study].

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).

[Optimizing the diagnosis and treatment of dorsalgia in real-world clinical practice: the primary endpoint of the DORISS multicenter observational study].

Objective: To evaluate the impact of treatment with Ipigrix on the dynamics of clinical symptoms, neurological status, and quality of life in patients with dorsalgia of the lumbosacral spine based on the DORISS non-interventional multicenter observational study.

Material And Methods: A total of 3563 patients with verified diagnoses of low back pain in 200 clinical centers across the Russian Federation who received comparable baseline therapy according to nosological standards were examined, some of whom additionally received oral or staged administration of Ipigrix. The primary endpoint of the study was the description of clinical and sociodemographic parameters, the consumption of medical resources, and the search for optimization of dorsalgia diagnosis in contemporary Russian outpatient neurological practice.

[Compression of nerves and senses: ipidacrine as the light at the end of the tunnel].

Objective: To evaluate the efficacy of the AChE inhibitor ipidacrine when added to traditional therapy in outpatients with tunnel syndromes (TS) based on clinical, neurophysiological and psycho-emotional indicators.

Material And Methods: Ninety-two patients with a verified diagnosis of TS were randomized into a main group (MG), in which ipidacrine was added to the therapy (=50), and a control group (CG), which received conventional therapy (=42). Clinical neurological examination, provocative (Tinel, Falen, Goldberg finger compression, elevator and tourniquet) tests, pain questionnaires (VAS, DN4, PainDetect, Pain Disability Index), Beck's depression scale, the Spielberger Trait and State Anxiety Inventory, electroneuromyography (ENMG) were used.

VASCULAR ANOMALIES IN NEWBORNS: CLINICAL PRESENTATION, COMPLICATIONS, AND PECULIARITIES OF THERAPY.

Objective: The aim: To analyze cases of vascular anomalies in newborns retrospectively to study their main clinical signs and to determine indications for urgent treatment.

Patients And Methods: Materials and methods: A retrospective review of 281 pediatric vascular anomalies diagnosed between 2011 and 2019 was performed. The results of clinical examination, prenatal history, laboratory, sonography, and radiological data were evaluated.

[Disturbances of Autonomic Regulation of Cardiovascular System at Different Working Regimes with Night Shifts].

Aim        To study temporal and spectral characteristics of heart rhythm variability (HRV) in night shift workers.Materials and methods       Along with traditional risk factors, conditions of labor contribute to development of cardiovascular morbidity, including night shift work, which can be associated with disorders of the autonomic regulation detected by analysis of HRV. This study included 100 healthy men.

The peculiarities of the body's external structure and indicators of central hemodynamics of volleyball players of different positions.

Objective: The aim was to determine the main differences in the external structure of the body and the of central hemodynamics parameters in of high-level sports skills volleyball players of the juvenile age with the role of libero, hitters and setters.

Patients And Methods: Materials and methods: 116 volleyball players of high level athletic skill of the youth age from 16 to 20 years old. The control group included 140 practically healthy girls who were not engaged in sports of the corresponding age.

[An outpatient with hand numbness: old prejudices, new strategies of differential diagnosis and treatment].

Aim: To search for 'diagnostic masks' of tunnel syndrome (TS) of the upper limbs and evaluate the efficacy of the antiacetylcholinesterase agent ipidakrine in the treatment of TS in a polyclinic.

Material And Methods: An analysis of outpatient cards showed that 597 people had complaints of numbness in their hands (23.9% of all neurological pathology).

[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.

[A clinical efficacy of electrode pharmaphoresis in treatment of railway workers with low-back pain].

Objective: To evaluate clinical efficacy and tolerability of electrode pharmaphoresis using preparations xefocam and mydocalm-richter in railway workers with low-back pain.

Material And Methods: Authors carried out an open prospective noncomparative study of 16 patients, aged 21-82 years, with spinal osteochondrosis with root syndrome and radiculopathia of the lumbar/sacral spine with pain syndrome regardless of its duration. Treatment efficacy was assessed by the dynamics of pain syndrome severity based on the scores of a self-rated scale completed by the patient and the McGill Pain Questionnaire.

[POEMS-syndrome: a literature review and case reports].

POEMS-syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, and Skin Changes) is a rare nosological form occurred in patients with paraproteinemic hemoblastosis. Chronic progressive sensory-motor polyneuropathy is a key syndrome of the disease and it is a common reason for referral to neurologist. The paper presents data about POEMS-syndrome and own case reports with the analysis of disease features and results of examination.

[Piascledin in the treatment of chronic dorsalgia].

Piascledine is a plant drug which positively influences the metabolism of cartilage and bone tissues. The authors studied the therapeutic effect of the drug in outpatients with chronic nonspecific dorsalgia. Piascledine was administered in dose 300 mg daily during two months.

[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.

[Pathophysiological features of dorsalgia development among railway workers, connected with railway communication].

Dorsalgia's is an actual medical and social problem. It gains prominent significance among railway workers, connected with railway communication. Pain syndromes among this group of patients have different complex pathogenetic mechanisms of the development.

[Axonopathy in the pathogenesis of multiple sclerosis, peripheral diffuse and local motor neuropathies and motor neuron disease].

Two hundreds and seventy-six patients including 43 patients with multiple sclerosis, 24 - with acute inflammatory demyelinating polyneuropathy (AIDP), 144 - with chronic inflammatory demyelinating polyneuropathy (CIDP), 27 - with motor multifocal neuropathy (MMN), 38 - with lateral amyotrophic sclerosis (LAS) have been examined. Symptoms of axonal degeneration, manifested in denervation phenomena in both clinical and instrumental studies (electromyography, transcranial magnetic stimulation, MRT), were revealed in all groups of patients. The formation of excitation conduction blocks is an universal pathophysiological mechanism of the axonopathy development in AIDP, CIDP, MMN and LAS.

[Differential diagnosis of multifocal motor neuropathy and related diseases].

Multifocal motor neuropathy (MMN) is a rare disease of the peripheral nervous system pathogenetically related to local demyelinization and formation of excitation conduction blocks. MMN affect only those nerves and their segments that comprise excitation conduction blocks. Such blocks have a persistent character and show a mosaic pattern over motor fibres which accounts for the specific clinical picture of MMN.

The role of axonopathy in the mechanisms of development of demyelination processes in the central and peripheral nervous system.

The role of axonopathy in the development of demyelinating processes in the CNS and peripheral nervous system was addressed in studies of 43 patients with multiple sclerosis (MS) and 144 patients with chronic inflammatory demyelinating polyneuropathy (CIDPN). Patients with MS were found to have foci of reduced MRI intensity in the T1 regime ("black holes," present in 28%) and regional atrophy of the cerebral cortex (in 46%), which showed a significant association with the degree of invalidity on the EDSS (Kendall tau = 0.38 and 0.

[Mechanisms of development of secondary axonal failure in diffuse and local demyelinating neuropathies].

To estimate a qualitative and quantitative effects of axonal failure on the clinical and electromyographic (EMG) picture of diffuse and local demyelination, 24 patients with Guillain-Barre syndrome (GBS), 144 with chronic inflammatory demyelinating polyneuropathy (CIDP) and 27 patients with multifocal motor neuropathy (MMN) have been studied. All the patients underwent a complex clinical neurological and EMG examination. Along with significant association between muscular hypotrophies and weakness in the majority of patients (tau=0,51; p<0,001), in some cases weakness in extremities was found in the absence of amyotrophic syndrome specifying a "functional" axonopathy due to the disturbance of ionic transport and the blockade of potassium channels.

[Therapeutic effect of dexalgin on disturbances of vertebrogenic and nonvertebrogenic mechanisms in back pain].

To evaluate the effect of Dexalgin on dysregulation mechanisms in the complex therapy of dorsalgia, 39 patients have been studied. They were divided into 2 groups: with vertebrogenic (23 patients) and without vertebrogenic (16 patients) pain syndrome. Dexalgin was prescribed in dosage 75 mg daily during 5 days.

[Surgical treatment of thymomas in patients with generalized myasthenia gravis].

Experience in surgical treatment of 2977 patients with generalized myasthenia is presented, 386 (13%) of them have undergone surgeries for thymus tumors. Organo-specific tumors (thymoma) were diagnosed in 370 (95.9%) of them.

[Disorders of autonomic fibers of the peripheral nerves in polyneuropathies].

The conditions of postganglionic fibers and parasympathetic fibers of vagus nerve were studied in 102 patients with varioustypes of polyneuritis and in 43 healthy individuals. In the control group the amplitude of evoked cutaneous sympathetic potential (ECSP) on the hand was 330 +/- 102 microV with 1.42 +/- 0.

[Mechanisms of functional disorders of the autonomic nervous system in Lambert-Eaton myasthenic syndrome].

The authors have examined the status of sympathetic innervation of the skin structures (by measuring the amplitude and latent period of the appearance of the evoked skin sympathetic potential, ESSP) and the autonomic regulation of the cardiovascular system (by examining the R-R intervals of the ECG at rest and in various functional tests) in 9 patients with the Lambert-Eaton myasthenic syndrome, 10 normal subjects, and in 20 myasthenic patients (a control group). All patients examined before the treatment and 7 patients who were examined following the administration of corticosteroid therapy presented disorders of the latent period and/or the amplitude of ESSP, up to its total absence, as well as signs of cardiac arrhythmias indicative of a marked dysfunction of the cholinergic structures of the peripheral nerves. No correlation has been elicited between the depth of identified vegetative disturbances and the presence of clinical and electromyographic indicators of polyneuropathy.

[Clinico-electrophysiological analysis of mitochondrial myopathy].

Patients with mitochondrial myopathy have been subjected to clinical, electromyographic, mechanographic, morphological and ultrastructural examination. The main syndromes involving the neuromuscular system in these patients have been considered. The authors draw attention to a generalized character of changes in clinically local lesions.

[Strategy for using glucocorticoid preparations in neuromuscular diseases].

A total of 1630 patients with various neuromuscular diseases of autoimmune genesis were treated. Glucocorticoid drugs taken every other day were shown to be highly effective. On the basis of a large experience the authors propose recommendations for the management of patients in relation to the form, severity and course of the disease with the objective of achieving the maximum therapeutic effect.