Zh Nevrol Psikhiatr
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Zh Nevrol Psikhiatr · Jan 2015
[Alcohol use disorders: current approaches to diagnosis and treatment].
Alcohol abuse and alcoholism are the leading causes of disability, health worsening and increased mortality. Diagnosis of alcohol use disorders is based on the formal criteria of ICD-10 and DSM-V. Sobriety-oriented therapy has extremely low efficiency. ⋯ Serious expectations in addressing unsatisfactory efficiency of alcoholism treatment are associated with WHO reducing alcohol consumption strategy. Nalmefene is the first and still only drug registered as a medicine for reducing alcohol use. Recent studies show that the decrease of alcohol consumption using nalmefene creates opportunities for significant lessening of alcohol-related morbidity, injuries and deaths.
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To analyze the results of examination and treatment of patients with poststroke shoulder pain. ⋯ Dysfunction of nervous system plays the main role in this pain syndrome. The efficacy of the drugs in the early/late recovery period was estimated as follows: nonsteroidal anti-inflammatory drugs - 33%/12%, amitriptyline - 24%/42%, gabapentin - 10%/13%, lidocaine - 95%/100%, tizanidine - 29%/33%. Seventy-six percent of patients were free of pain after treatment using a regimen suggested by the authors.
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Migraine is a common disease characterized by severe headache with nausea, vomiting and hypersensitivity to sounds, light, smell. Neurological symptoms during aura period develop in 25% of patients. Genes responsible for migraine development have been identified. ⋯ It was described the syndrome of migraine-like headache occurring due impaired serotonin metabolism in patients with celiac disease. Celiac disease is a chronic polysyndrome disease, enteropathy. Arteriopathies associated with migraine are cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (syndrome CADASIL), retinal vasculopathy with cerebral leukodystrophy (RVCL), hereditary systemic angiopathy (HSA), mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS).