The application of statins in cardiology aimed at reduction of the risk of cardiovascular problems has noticeably increased over the last years. In this regard, it has been assumed that statins can be effective in the primary and secondary prevention of cerebral infarction and transient ischemic attack. The recent studies have provided contradictory data on the issue, which reduces the assignability of this group of drugs by neurologists. This review covers the characteristic features of statins in angioneurology.
Objective: to evaluate the effectiveness of palliative care in patients with malignant neoplasms of II and IV clinical groups in terms of the changes of the quality of life indicators regardless of the stage of the development of the disease and the degree of its malignancy. Material and methods. 61 patients of the Palliative Care Ward suffering from malignant neoplasms of II and IV clinical groups were examined at the beginning (day 2) and at the end of the treatment course (day 14). The patients' psychoemotional condition, characteristics of pain syndrome and clinical mobility were analyzed. The effectiveness of the palliative care course was evaluated using the standardized questionnaires and scales: visual-analog pain scale, DN4, Pain Detect, Rivermid Mobility Index, Beck Depression Inventory, Spielberger-Hanin Anxiety Scale (assessment of situational and personal anxiety). The Garkawi Adaptation Intensity Index was used to calculate the body's reactivity to the disease at the beginning and upon completion of the palliative care course. The Calf-Caliph leukocyte index was calculated twice to assess the dynamics of endogenous intoxication.Results. The course of the inpatient palliative treatment has showed its effectiveness by improving the category of clinical mobility on the Rivermid scale and the psychological condition of the patients with malignant neoplasms of II and IV clinical groups: there was a decrease in anxiety and depression, some decrease in the degree of pain syndrome. The Garkawi and Calf-Caliph indices were not effective tools for the assessment of the short treatment course.Conclusion. Inpatient palliative care for patients with malignant neoplasms of II clinical group reduces undesirable effects of radical treatment, thus improving the quality of life, and it relieves the suffering in the patients of IV clinical group in whom the application of radical methods is not possible.
В статье проведен аналитический обзор литературы по теме влияния микробиоты человека на возникновение болевых синдромов различной этиологии и модальности. Исследования взаимоотношений по оси «микробиом – кишечник – головной мозг» показали их двунаправленный характер. Микроорганизмы кишечника регулируют обмен нейромедиаторов, работу иммунной системы, отношения по гипоталамо-гипофизарно-адреналовой оси. Основными путями, обеспечивающими взаимовлияния между микробиотой и организмом, являются волокна и образования вегетативной нервной системы, неокортекс. Влияние микробиоты на возникновение многих неврологических заболеваний и формирование болевого синдрома не вызывает сомнений и открывает перспективы разработки эффективных способов лечения. Приведены новые терапевтические стратегии лечения хронического болевого синдрома, основанные на современных знаниях о микробном разнообразии организма человека. The article presents an analytical review of the literature on the influence of the human microbiota on the occurrence of pain syndromes of various etiologies and modalities. Studies of the relationships along the microbiome – gut – brain axis have shown their bidirectional nature. Intestinal microorganisms regulate the exchange of neurotransmitters, the work of the immune system, and the relationship along the hypothalamic-pituitary-adrenal axis. The main pathways that provide interaction between the microbiota and the body are the fibers and formations of the autonomic nervous system, the neocortex. The influence of the microbiota on the occurrence of many neurological diseases and the formation of pain syndrome is beyond doubt and opens up prospects for the development of effective treatment methods. New therapeutic strategies for the treatment of chronic pain syndrome, based on modern knowledge about the microbial diversity of the human body, are presented.
Cerebral vascular diseases are a most topical problem of modern neurology. The article reflects views of a practicing neurologist on the questions of pathogenesis, clinical picture, diagnosis and treatment for vascular cognitive disorders.
Objective. To evaluate the effectiveness of using the “Painmetrica” software for the diagnosis and selection of treatment for pain in degenerative diseases of the spine. Materials and methods. Software “Painmetrica” was developed for the diagnosis and selection of treatment for pain in degenerative diseases of the spine. Through a bidirectional nonrandomized controlled trial, its effectiveness was evaluated using telephone interviews with 42 patients. For comparison, a telephone interview was conducted with 47 patients for whom the Panimetrica program had not been used in the treatment.Results. The effectiveness of using “Painmetrica” software for the diagnosis and selection of treatment for patients with back pain was demonstrated. In the main group, the decrease in pain syndrome tended to differ due to an increase in the number of patients in whom pain was relieved by more than 50% and completely disappeared (p = 0,09 according to the two-tailed Fisher’s exact test). Patients treated with Painmetrica algorithms experienced sleep recovery due to a decrease in pain: changes persisted in 12 cases (28,6%), while in the comparison group, sleep changes remained in 24 patients (51,1%) (p=0,05 according to two-tailed Fisher’s exact test). Against the background of effective pain relief in patients who used Painmetrica, there was a decrease in the use of non-steroidal anti-inflammatory drugs (NSAIDs) (17 patients (40,5%) of the main group versus 36 patients (76,6%) of the control group, p = 0,001 according to the twotailed Fisher’s exact test ). At the same time, only 8 patients (19.1%) in the main group and 30 patients (63.8%) in the comparison group (p < 0.001 according to Fisher’s two-sided exact test) indicated the need to consult a neurologist.Conclusion. The effectiveness of the use of “Painmetrica” software for the diagnosis and selection of treatment of patients with degenerative diseases of the spine on an outpatient basis in relation to the need for patients to use nonsteroidal anti-inflammatory drugs, the need for additional consultation of a neurologist, as well as effective relief of sleep disorders caused by pain were demonstrated.
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