Zh Nevrol Psikhiatr
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Zh Nevrol Psikhiatr · Jan 2009
Review[Models of neurosurgical service for patients with hemorrhagic stroke].
Authors have conducted an analysis of surgical treatment of patients with hemorrhagic stroke (HS) in Moscow neurosurgical in-patient clinics. In 2 most advanced neurosurgical departments out of 11 studied, only 61% of necessary neurosurgical care is carried out. ⋯ The causes of insufficient amount of surgical interventions in neurosurgical in-patient clinics are specified. The authors suggest the algorithm of HS patients' selection for surgery.
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Zh Nevrol Psikhiatr · Jan 2009
Review[Neurodegeneration and neuroprotection in multiple sclerosis].
Multiple sclerosis (MS) has neurodegenerative features including neuronal and axonal loss in demyelination lesions and widespread atrophy of the brain. The cause of this neurodegeneration has been largely attributed to inflammation but other mechanisms, including those associated with classic neurodegenerative disease, might also be involved in the MS pathogenesis. Certain noninvasive tests such as magnetization transfer imaging, diffusion weighted imaging and proton magnetic resonance spectroscopy might be superior in early detection of axonal loss. In the current review, the authors discuss the current understanding of the neurodegenerative mechanisms in MS, agents with neuroprotective properties and their possible application in the treatment of MS.
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Zh Nevrol Psikhiatr · Jan 2009
Randomized Controlled Trial Comparative Study[Vitamin B complex (milgamma) in the treatment of vertebrogenic lumbosacral radiculopathy].
An open controlled study of efficacy of the vitamin B complex (milgamma) has been performed in 38 patients with vertebrogenic lumbosacral radiculopathy suffered from moderate or severe pain during 1 month or longer. Patients have been randomized into 2 equal groups: in the main group milgamma has been prescribed in the combination with diclofenac; patients of the control group have received diclofenac only. Treatment efficacy has been assessed by clinical scales in the 10th and 24th days, and by the results of telephone interview after 3 and 6 months. ⋯ At the 3rd months, between-group differences were still significant (the pain was absent or minimal in 63% patients of the main group and 34% of the control one). The results revealed the potentiation of analgesic effect of diclofenac by the vitamin B complex. Using of milgamma in combination with NSAIDS leads to the rapid and long-standing regress of pain syndrome in patients with lumbosacral radiculopathy.
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Zh Nevrol Psikhiatr · Jan 2009
Review[Approaches to the treatment of malignant and progressive multiple sclerosis].
Disease-modifying therapy of multiple sclerosis (MS) with malignant and progressive course of the disease currently is not fully covered at present. Data on the use of some immunosupressors and cytostatics in the treatment of MS with rapid progression of disability are reviewed.
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Zh Nevrol Psikhiatr · Jan 2009
Comparative Study[Peculiarities of cognitive functions in patients with chronic back pain].
The authors have studied cognitive functions and influencing factors in 64 patients with chronic low back pain. All patients have been examined using neurologic, neuroorthopedic, pathopsychological and neuropsychological methods. Patients have been divided into 2 groups according to their age: group 1 (aged 30-50 years) and group 2 (aged 51-60 years). ⋯ Significant differences in neuropsychological testing, i.e. mental flexibility, delayed memory, psychomotor speed, which referred to the subtle cognitive impairment with executive function disturbances, were found in both groups of patients with chronic low back pain as compared to pain-free adults. Sensory-discriminative (pain intensity) and affective-emotional (negative emotions, in particular, anxiety) characteristics had the effect on cognitive functions in younger patients without depressive symptoms. Affective-emotional (anxiety, psychological distress) and cognitive characteristics (i.e. catastrophising) contributed to the cognitive disturbances in older patients.