[Results of evaluation of the effectiveness of the drug Cellex in patients with small vessel disease]. / Rezul'taty otsenki effektivnosti primeneniya preparata Tselleks u patsientov s bolezn'yu melkikh sosudov.

OBJECTIVE: To study the effect of the drug Cellex on the severity of cognitive impairment in patients with small vessel disease (SVD). MATERIAL AND METHODS: A non-interventional observational controlled prospective observational study in parallel groups was conducted. 118 patients with CHEM who received unified therapy were under observation. Group 1 consisted of 40 patients who, in addition to basic therapy, received 10 injections of Cellex subcutaneously (0.2 ml 1 time/day), group 2 - 39 patients who received 2 courses of injections of Cellex subcutaneously (0.1 ml 1 time/day) with an interval of one month, patients 3-both groups (n=39) received only basic therapy. The examination included an assessment of the clinical status and neuropsychological testing (the MOS questionnaire and the clock drawing test - TRCH), analysis of the results of MRI of the brain. The blood levels of homocysteine (HC), C-reactive protein (CRP), asymmetric dimethylarginin (ADMA), and von Willebrand factor (FW) were determined in dynamics. RESULTS: A statistically significant improvement in the performance of the MoCA and TRP questionnaire tests in groups 1 and 2 was demonstrated, with a more pronounced and persistent effect in patients who received repeated courses of treatment. Clinical improvement was accompanied by normalization of the concentration of studied markers of inflammation (CRP) and endothelial dysfunction (HC, ADMA, FW) in the blood, while the dynamics was most pronounced in patients of group 2. The treatment was characterized by good tolerability, low frequency and insignificant severity of adverse events. CONCLUSION: The drug Cellex has demonstrated significant effectiveness in the treatment of patients with SVD with cognitive impairment, against the background of treatment, there was a decrease in markers of inflammation and endothelial dysfunction, therapy was characterized by good tolerability.

[Formation of neurology in the Daghestan (to the 85th anniversary of the Department of Nervous Diseases, Medical Genetics and Neurosurgery, Daghestan State Medical University)]. / Stanovlenie nevrologii v Dagestane (k 85-letiyu kafedry nervnykh boleznei, meditsinskoi genetiki i neirokhirurgii Dagestanskogo gosudarstvennogo meditsinskogo universiteta).

The article describes the history of the Department of Nervous Diseases, Medical Genetics and Neurosurgery of the Daghestan State Medical University on the basis of literature data and archival sources introduced into scientific circulation for the first time. The department, created in 1936, has gone through a difficult path in its formation and development. The authors reconstruct the history of the formation of this department of the university, dwelling on the problems faced by its first employees. Special attention is paid to the work of the department during the Great Patriotic War, when its staff was reduced to a minimum. The authors describe the appearance, stages of development and successful functioning of the scientific school for the study of thermoregulation under the guidance of Associate Professor V.A. Liechtenstein. The formation of the teaching of neurosurgery, as well as the work of the department in recent years, is described.

[Choosing of therapy for a patient with dorsalgia].

Dorsalgia is one of the most common skeletal muscle syndromes. Dorsalgia often develops in patients of older age groups with polymorbidity that requires the appointment of a large number of medications. In these conditions, the choice of effective and safe therapy is a difficult problem. Discusses management of a patient suffering dorsalgia with comorbidities, the risks of complications of therapy, possible safety treatment, in particular, through the use of combination therapy.

[Clinical/epidemiological characteristics of ischemic stroke in Dagestan]. / Kliniko-épidemiologicheskie kharakteristiki ishemicheskogo insul'ta v Respublike Dagestan.

OBJETIVE: To analyze risk factors and course of acute ischemic stroke (IS) based on hospital register data. MATERIAL AND METHODS: Ninety-seven patients (38 women and 59 men, mean age 65.4±12.8 and 61.2±18.8 years, respectively) with acute IS admitted in 2016 to the Clinical hospital of Makhachkala were examined. Medical history and severity of neurological deficit (the British Medical Council Scale, The Glasgow Coma Scale, MMSE) were assessed. RESULTS: The severity of neurological deficit was comparable in men and women though cognitive impairment was more frequent in women (p<0.05). At admission, symptoms of inflammation and hyper coagulation were more frequently identified in women (p<0.05). The high prevalence of chronic cerebral ischemia preceding IS, insufficient efficacy of preventive treatment and late hospitalization were noted. CONCLUSION: The results should be confirmed in a large-scale long-term study. They can be used to improve quality of medical care of patients with IS.

[Capsaicin in treatment of neuropathic pain].

Treatment of neuropathic pain (NP) is a serious medical problem. Antiepileptic drugs and antidepressants, used to relief pain, act on the central pain mechanisms and cause several side-effects, thus substantially restricting possibilities of their clinical application.At the same time, NP often has a peripheral component. Ligand-associated channels, including vanilloid receptors TRPV1, play a key role in the development of regional NP syndromes. Capsaicin, a component of chili pepper and several other plants, is a highly selective ligand of TRPV1 receptors and has long been used in treatment of pain syndromes. However, its using is limited by short-term action and relatively low efficacy. Recently it has been shown that the local use of single high doses of capsaicin during 30-60 min causes a marked stable(> 12 weeks) effect. The decrease in NP (>50%) is seen in about half of patients. Current studies will allow to single out groups of patients with the maximal treatment effect of capsaicin.

[Alpha-lipoic acid in treatment of nervous system diseases].

The results of experimental studies and clinical trials of alpha-lipoic acid drugs are presented. Antioxidant and neuroprotective effects provide the efficacy of these drugs in patients with different diseases of the central and peripheral nervous systems. Good tolerability and possibilities of using in combinations with other drugs give grounds for a wide application of the drug in neurological practice.

[Efficacy of cereton in acute ischemic stroke: results of the trial SOLNTSE].

We studied 95 patients with acute (no later than 24h after onset) carotid ischemic stroke. Patients of the main group (50 patients) received cereton in dose 4 ml (1000 mg) intravenously during 10 days in the combination with traditional treatment; 45 patients of the control group received only traditional treatment. Neurological deficit on NIHSS and vigilance on The Glasgow Coma Scale were assessed at baseline and in 5th, 7th and 19-21th days. The Barthel index was used to measure functional independence of the patient at the discharge from a hospital (21th day). The "cost-effectiveness" ratio, the cost of one score on the NIHSS and Barthel scales were calculated. The reduction in neurological deficit (p<0.05) and higher extent of functional independence were seen in the main group compared to the controls. Based on the "cost-effectiveness" analysis, the use of cereton was shown to be more effective for treatment of patients with acute ischemic stroke: the cost of the achievement of positive effect in patients of the control group receiving only traditional treatment was significantly higher (p<0.05).

[Peculiarities of the course of ischemic stroke in patients with diabetes mellitus type 2].

Two hundreds and eighty-seven patients, aged from 46 to 78 years, mean age 60.2 +/- 9.4 years, with confirmed diagnosis of ischemic stroke have been studied. The correlations between glycemia and severity of neurological deficit in the 1st (r = -0.433; p < 0.001) and the 21st days (r = -0.289; p < 0.05) of hospitalization were found. The glucose concentration in the venous blood plasma on an empty stomach was significantly higher in the fatal cases compared to the survived patients in the 1 (9.8 +/- 0.6 mmol/l and 5.7 +/- 0.4 mmol/l; p < 0.01), 3rd (9.1 +/- 0.4 mmol/l and 5.6 +/- 0.4 mmol/l; p < 0.05) and 5th days of stroke (9.3 +/- 0.4 mmol/l and 5.5 +/- 0.5 mmol/l; p < 0.01). The level of glycemia on an empty stomach was significantly correlated with the fatal outcome (r = 0.367; p < 0.01). The correlation between the development of lacunar infarction and the presence of previously developed diabetes mellitus type 2 (r = .0.756; p < 0.01) was also noted. The results obtained suggest a significant effect of diabetes mellitus type 2 on the course of ischemic stroke and the necessity of correction of glycemia in these patients.