Migraine is one of the main causes of disability in modern world. Treatment of chronic refractory migraine (RCM) would be a challenge even for experienced physician. The aim of this study was to analyze the effect of combination therapy for RCM: greater occipital nerve’s (GON) pulsed radiofrequency (PRF) and botulinum toxin injections. We observed 6 female patients, suffering from RCM according to the European Headache Federation criteria. All patients had long history of migraine (5–44 years) with conservative treatment failure (at least three medication groups). Their migraine could be classified as refractory for long period of time (1–10 years). All of our patients passed a combination of PRF and BTA injection as consecutive 1-day treatments. Botulinum toxin type A injections were done in accordance to the PREEMPT protocol, followed by ultrasound-guided PRF of GONs bilateral. The observation period was 6 months after the procedure. We observed a positive response to treatment in all patients with dramatic reduction of pain intensity (from 7 ± 1 to 2 ± 2 on NRS scale) and significant decrease in the number of headache days (from 22 ± 5 to 4 ± 4) during first month after treatment. Two patients (30%) were pain free after the treatment until the end of the observation. No adverse effects were registered. Bilateral GON’s PRF followed by botulinum toxin therapy as 1-day treatment may be a useful option for the treatment of refractory chronic migraine. These interventional procedures are effective, minimally invasive, inexpensive, safe, and well-tolerated and can be performed on an outpatient basis.
Background. The aim of this study was to evaluate the potential of combined the greater occipital nerve’s (GON) pulsed radiofrequency (PRF) with botulinum toxin therapy procedures for treatment the refractory chronic migraine.Methods. We had 6 patients, all female, from 33 to 57 years old suffering from refractory chronic migraine (RCM) according to the European Headache proposed criteria. All patients had migraine from 5 to 44 years and refractory migraine from 1 to 10 years. Simultaneous one-day treatments were undertaken: first step - botulinum toxin type A injections in accordance with the PREEMPT protocol. Second step - the PRF stimulation on the bilateral GONs was performed under the guidance of ultrasound. The follow-up duration after the procedure was 6 months.Results. We had a positive response to treatment from all patients. As a result, we observed a dramatic reduction of pain intensity from 7±1 to 2±2 on NRS scale and, most importantly, a significant decrease in the number of days with headache from 22±5 to 4±4 during first month after treatment, with two patients (30% of patients) recording a complete regression of migraine attacks. None of the patients had any adverse effects.Conclusion. The simultaneous one-day use of PRF GON with botulinum toxin therapy may be a useful option for the treatment of refractory chronic migraine. The combined interventional procedures are effective, minimally invasive, inexpensive, safe, well tolerated and can be performed on an outpatient basis.
Problem and purpose. Digital transformation is a key trend of the economic development. Russia still lags behind countries leading in the digitalization. Insufficient development of relevant skills is one of the constraints. The share of Generation Z (born in 1996 and later) will achieve 25% of the labor force by 2025. This statement emphasizes the need to develop competencies for the younger generation that respond to the requirements of the digital economy. The purpose of the study is to assess the contribution of the Russian higher education system to the reproduction of the juvenile potential of the economy in the context of its digital transformation, to identify constraining factors and develop basic recommendations aimed at eliminating them. Materials and methods. The study is based on the use of economic and mathematical methods, including factorial, correlation and regression analysis. The dynamic series of indicators characterizing the state of the investigated sphere in 2001–2019 have been studied. For analytical data processing, the software capabilities of the Statistica package are used. Research results. The author's system of indicators has been developed, which makes it possible to assess the role and capabilities of the higher education system for the reproduction of the juvenile potential of the digital economy – 18 indicators characterizing the financial and material-technical, intellectual, educational potential, the coverage of young people with higher education programs, the effectiveness system of higher education. The formula for calculating the integral indicator of the juvenile potential is mathematically substantiated. Modeling of the dependence of the integral indicator on a set of influencing factors has shown that with an increase in the number of teaching staff by 1 sigma, the integral indicator of juvenile potential will on average increase by 1.758 sigma while fixing other exogenous variables at a constant average level; with an increase in the number of personal computers used for educational purposes by 1000 students per 1 sigma, the integral indicator of juvenile potential will, on average, increase by 1.078 sigma, while fixing other exogenous variables at a constant average level. Discussion and conclusion. The study showed that for the formation of the juvenile potential of the digital economy of the Russian Federation, it is necessary to develop the human resources of higher education and its digital environment. To solve the designated tasks, a system of measures has been developed.
The paper studies the performance of Samara fertility specialists. It is noted that in 2019 the Samara Region conducted twice as many successful IVF cycles as compared to 2012, when it was 1840 cycles. The clinical pregnancy rate in the region is 47%, which is significantly higher than the same indicator of 38.5% in Russia. The trends of scientific work of reproductologists in Samara are presented in the article. The purposes of their work are the correct choice of the in vitro fertilization protocol, the prevention of complications of induced pregnancy, the restoration of reproductive function after unsuccessful IVF attempts.
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