[Nociceptive and mixed pains in patients with multiple sclerosis]. / Notsitseptivnye i smeshannye bolevye sindromy u patsientov s rasseyannym sklerozom.

Nociceptive and mixed pain syndromes (NMPS) whose pathogenesis is linked with the formation of plaques of demyelination in the CNS are commonly present in patients with multiple sclerosis (MS). NMPS of diverse locations, mechanisms and clinical features significantly worse patients' disability and impair their social adaptation. At the same time, clinicians do not pay enough attention to these syndromes in routine practice. Early diagnosis of NMPS may be important not only for early and appropriate NMPS' therapy and improvement of patients' quality of life, but, possibly, for the diagnosis of the onset or relapsing phase of MS, in cases when NMPS are the symptoms of MS and are the signs of active demyelinating process. This review addresses contemporary views of the main types of NMPS in MS (headaches, musculoskeletal pains, painful tonic spasms, pain with spasticity). Epidemiologic data, pathogenesis, clinical manifestations and diagnostic options of NMPS in patients with MS are described along with current views on MS and NMPS comorbidity theories. Existing approaches to treatment of NMPS based on randomized trials data are analyzed.

[Neuropathic pain syndromes in patients with multiple sclerosis]. / Neiropaticheskie bolevye sindromy u patsientov s rasseyannym sklerozom.

Among the numerous pain syndromes (PS) of various localizations and types, observed in patients with multiple sclerosis (MS), the greatest attention of researchers is attracted by neuropathic PS. Neuropathic PS are often present already in the early stage of MS, significantly reduce the quality of life, hinder the social adaptation of patients, poorly respond to therapy. Central neuropathic PS, which pathogenesis is closely related with plaques in the central nervous system, are most common in patients with MS. Diagnostics of neuropathic PS in MS is based mainly on typical clinical symptoms; MRI and neurophysiological methods data are of secondary importance. This review focuses on modern concepts of three main neuropathic PS in MS: ongoing extremity pain, trigeminal neuralgia and Lhermitte's sign. Clinical symptoms of neuropathic PS, current ideas about their pathogenetic mechanisms, MRI and neurophysiological techniques data and the existing approaches to conservative therapy and surgical treatment based on randomized trials data are presented.

NEW DIRECTIONS FOR IMPROVEMENT OF BREAST CANCER SCREENING.

Objective: to improve breast cancer diagnosis using an independent mammographic teleassessment by two radiologists. Material and methods. The results of a dual independent assessment of 3440 X-ray mammographic examinations were analyzed. The first assessment was made by a radiologist from a therapeutic-and-prophylactic establishment who had less than one year of practical experience in a mammography screening room. The second assessment was carried out by a radiologist with more than 5 years of experience from a specialized cancer institution. Results. According to the developed specialized interpretation software, recommendations and statistics for mammographic breast cancer screening, the investigators identified a group of 31 women who were recommended to be additionally examined at an oncology dispensary to verify the diagnosis of breast cancer. Eight of 17 (47%) women with morphologically confirmed cancers after dual assessments of X-ray mammographs were called again and referred to the oncology dispensary. Conclusion. Dual independent assessment of X-ray mammographs improved the diagnosis of BC with a maximum size of 1.5 cm or less, as well as that of malignant tumors manifesting as microcalcifications or imitating a benign process.

[Mitosis in the free-living flagellate Bodo saltans strain PS+ (Kinetoplastidea, Bodonida)].

The mitosis in the free-living flagellate Bodo saltans Ps+ with prokaryotic cytobionts in perinuclear space has been studied. The nuclear division in B. saltans Ps+ occurs by closed mitosis type without condensation of chromosomes. Two spatially separated mitotic spindles begin to form consistently at the initial stages of nuclear division. The spindle including about 20 microtubules appears first and later the second spindle with half the number of microtubules comes at the angle of 30-40 degrees. Both spindles rest their ends against the inner nuclear membrane and form 4 distinct poles. The microtubules of the first spindle are associated with 4 pairs of kinetochores, the microtubules of the second one are associated with 2 pairs of kinetochores. The divergence of the kinetochores towards the poles occurs independently in each spindle. The equatorial phase is not revealed in B. saltans Ps+. The poles of both spindles unite in pairs at the elongation phase of mitosis and form the integrated bipolar structure. At this stage of the nuclear division, the kinetochores reach the poles of subspindles and become indistinguishable. Then the nucleus takes the shape of a dumbbell. The inner nuclear membranes of just formed nuclei have layers of condensed chromatin characteristic of the interphase nuclei of kinetoplastidea. The daughter nuclei separate at the phase of reorganization. There are 1-2 prokaryotic endocytobionts in the perinuclear space of the interphase nuclei in B. saltans Ps+. The symbionts multiply during mitosis and their number reaches more than 20 specimens par nucleus.