Vol 19, No 2-3 (2017)


Blood pressure indices and sleep quality in elderly patients with chronic cerebral ischemia and arterial hypertension on the background of treatment with Pantocalcin (gopanthenic acid). The results of the PLATON noninterventional observational program

Kamchatnov P.R., Azimova Y.E., Ostroumova O.D.


Purpose of the study - a study of the efficacy and safety of Pantocalcin (gopanthenic acid) in elderly patients with chronic cerebral ischemia on the background of arterial hypertension I-II stage. Material and methods. In an open, non-comparative non-interventional study, 862 patients aged 65 to 75 years (mean 69.07±2.97 years, 608 to 70.5% women) were treated with Pantocalcin 1500 mg/day for 3 months. Sleep quality indicators (Lida questionnaire), blood pressure (BP) level were monitored and evaluated, as well as a neuropsychological examination of the state of cognitive functions, which included testing using scales and tests (Brief scale of assessment of mental status, battery of tests for assessing frontal dysfunction, test drawing hours) and the subjective evaluation of the effectiveness of therapy was determined (according to the Scale of General Clinical Impression and Improvement of the State). Results and discussion. There was a violation of sleep quality in patients with inadequate control of blood pressure. Course appointment of 1500 mg/day dose of Pantocalcin contributed to improving the quality of night sleep and improve cognitive function. In patients with initially elevated blood pressure, following recommendations of the main antihypertensive therapy and taking Pantocalcin in doses of 1500 mg/day, the systolic and diastolic BP values were reduced to the target values. The conclusion. The use of Pantocalcin in patients with chronic cerebral ischemia and hypertension increases the quality of BP control, positively affects the state of cognitive functions, is effective and safe.
Consilium Medicum. 2017;19(2-3):8-14
pages 8-14 views

Features of pharmacological action and the use of dipyridamole for secondary prevention of ischemic stroke

Tairova R.T.


The review presents modern data from domestic and foreign studies on the efficacy and safety of dipyridamole for the prevention of ischemic stroke. It is shown that dipyridamole is an effective complex action drug with a good safety profile and the ability to have a positive combined antiplatelet and vascular action, which makes it very promising for the prevention of the repeated development of acute cerebrovascular accident. Modern clinical approaches and indications for mono-and combination therapy with antiplatelet agents in the secondary prevention of cerebral stroke are considered.
Consilium Medicum. 2017;19(2-3):15-18
pages 15-18 views

Pharmacopuncture application in a complex rehabilitation of patients in the early recovery period of cerebral stroke

Drobyshev V.A., Shpagina L.A., Gudkova E.V., Shashukov D.A., Gribacheva I.A., Maryanovsky A.A., Petrova E.V.


The aim of the scientific research was to study during the placebo-controlled trial the severity and speed of relief of cephalgia, parameters of the cerebral hemodynamics and cognitive performance in patients in the early recovery period cerebral stroke. Treated 96 patients (57 women and 39 men) with an average age of 62.4±2.9 years, complaining of headaches impaired concentration and memory, emotional exhaustion, divided into 4 groups: 1st (n=25) received basic medical complex, complemented by pharmacopuncture Cerebrum compositum; 2nd (n=24) - basic package and the pharmacopuncture Placenta compositum; 3rd (n=24) - basic package in combination with pharmacopuncture saline (placebo); in the 4th (n=23) - uses only the basic medical complex. The examination included assessment of: cognitive function on a Mini-Mental State Examination scale (1975), pain by visual analogue scale (1986); ultrasonic duplex scanning of the extracranial divisions of the main arteries of the head of the device, Logic-400 (USA). In the dynamics of therapy in patients in the 1st and 2nd groups showed a more rapid (after 7 minutes) and expressed as (4.5 and 3.8 times by 15-day observation, respectively) reduction in the intensity of cephalgic syndrome than in the 3rd and 4th groups. The best results were identified in patients in the 1st group, where the medical complex was supplemented with pharmacopuncture Cerebrum compositum. Patients of the 1st and 2nd groups revealed an increase in volumetric blood flow rate is 1.3 times, the parameters of resistance index decreased by 1.2 and 1.3 times, respectively, pulsating index is 1.3 times that significantly differed from the same values in the 3rd and 4th groups. The best results in the parameters of cerebral hemocirculation was achieved with the use of pharmacopuncture drug Placenta compositum, whereas positive shifts from the cognitive indicators - Cerebrum compositum. Thus, the inclusion in the complex treatment of patients in the early rehabilitation period of ischemic stroke of pharmacopuncture complex Cerebrum compositum and Placenta compositum causes a rapid and marked reduction in the intensity of cephalgic syndrome, contributes to the correction of parameters of cerebral hemodynamics, has a positive impact on the state of cognitive functions, which increases the effectiveness of treatment.
Consilium Medicum. 2017;19(2-3):19-22
pages 19-22 views

Serum neuron-specific enolase and S-100 protein levels in children with some forms of symptomatic epilepsy as reflection of disregulative pathology of central nervous system

Pugolovkin K.A., Dombrovskaya E.A.


Forming of pathological epileptic brain system accompanied by specific failure of cellular architechtonic, damages of membrane's excitability and cascade of neurochemical changes. Neuron-specific proteins perform a lot of integrative functions at the same time. Also they are the markers of structural damage. The aim of this investigation was searching of laboratory parameters which reproduce the grade of activity of pathologic process in central nervous system on different stages of epileptic syndrome. Materials and methods. There were examined 18 children 8 months to 11 years old. There were analyzed 44 species of serum for concentrations of NSE and S100 protein. Laboratory tests were made on stage of active course of epileptic syndrome, then on the stage of reduction of seizures and partial remission, and on stage of persistent remission. The investigation includes young patients with different types of symptomatic epilepsy. The ethiologic factors of epilepsy were perinatal hypoxia and ischemia, inborn malformations of brain, genetic syndroms. The patients were classified in 3 groups depending on stages of epileptic syndrome. Concentrations of serum NSE and S100 protein were analyzed in these groups. Conclusions. The results of measurements and its correlations were compared in each group of patients. The importance of complex assessment of NSE and S100 for children with epilepsy was identified. Laboratory data enable to characterize the stages of epileptic syndrome from the point of activity of pathologic process caused by disfunction of haemato-encephalic barrier among children with symptomatic epilepsy. Accounting the activity of pathologic (disregulative) process the improvement of therapeutic strategy becomes possible.
Consilium Medicum. 2017;19(2-3):23-27
pages 23-27 views

School disadaptation in pediatric and neurologiс practice

Nesterovskiy Y.E., Zavadenko N.N., Shipilova E.M., Suvorinova N.Y.


School disadaptation is a condition in which a child who finds himself in the new environment of a school can not adapt himself completely, and this leads to cognitive, behavioral, emotional and psychosomatic disorders. The reasons for this can be both delayed formation (immaturity) of adaptation mechanisms or production of insufficient response to the process of school education in a child. The manifestations of school disadaptation are described including it’s several components (cognitive, emotional-evaluative, behavioral, physiological), as well as abnormalities of socio-psychological adaptation. The interrelations of school disadaptation with anxiety disorders, fatigue manifestations and tension type headaches are discussed. Data on the positive effects of Nooclerin (deanol aceglumate) indicated as preventive therapy of tension type headaches are given. This medication additionally decreases the severity of co-morbid disorders: fatigue, anxiety disorders, sleep disturbances.
Consilium Medicum. 2017;19(2-3):28-33
pages 28-33 views

The somnological aspects of the patient's stay in the resuscitation and intensive care unit

Belkin A.A.


Sleep in the physiological sense is an important element of the circadian rhythm. Depends on it vegetative stability, and most importantly - psycho-emotional state of a person. The quality of sleep reflects almost any pathological condition, in particular, requiring a stay in the intensive care unit and intensive care. The mode of round-the-clock activity, noise of equipment, application of sedating medications are only obvious factors of development of so-called resuscitation insomnia, i.e. sleep disorders due to being in the resuscitation and intensive care unit. Extremely little research is devoted to this problem, which is understandable, since the use of the reference method of polysomnography under specific conditions of the intensive care unit is technologically difficult. From the review of the literature it becomes obvious that the sleep architecture is disrupted in almost all patients of resuscitation, superimposing on a premorbidly existing or as a new syndrome. Undiagnosed and developing manifestations of insomnia prevent early recovery and can become a source of long-term consequences. The article contains excerpts from the clinical recommendations "Rehabilitation in intensive care", aimed at preventing the development of resuscitation insomnia.
Consilium Medicum. 2017;19(2-3):34-37
pages 34-37 views

Moderate cognitive disorders: the role of Pronoran in their correction

Pilipovich A.A.


The article is devoted to the problem of moderate cognitive impairment, their prevalence, etiology, pathogenesis peculiarities, the principles of therapy and prevention of dementia development. The data on the efficacy of cognitive disorders therapy with the dopamine receptor agonist - piribedil (Pronoran®).
Consilium Medicum. 2017;19(2-3):38-42
pages 38-42 views

Back pain: epidemiology, etiology, treatment

Kotova O.V., Akarachkova E.S.


At any time, 18% of the world's population may experience pain in the lower back, and 38% of people will experience such pain within 1 year. Back pain is one of the most costly health problems. After an acute episode of pain in the lower back, 1/3 of patients experience a second episode, and approximately 1/2 of them will seek medical help. The article presents the main causes of back pain and the principles of therapy. To date, the priority direction of patient management with pain in the back is the earliest possible relief of pain syndrome. For the relief of acute back pain, non-steroidal anti-inflammatory drugs have been most widely used. To this end, both selective inhibitors of cyclooxygenase type 2 and nonselective inhibitors of cyclooxygenase of two types are used. Advantages of administration of nimesulide (Nise), a representative of the class of selective inhibitors of cyclooxygenase-2, are presented.
Consilium Medicum. 2017;19(2-3):43-47
pages 43-47 views

Chronic low back pain and sleep disturbance

Tkachev A.M., Akarachkova E.S., Smirnova A.V., Iljushin A.V., Archakov D.S.


Sleep disturbance is one of the most common consequences of chronic non-specific low back pain. A high prevalence а sleep disorders in patients with low back pain can indicate that either pain leads to the impairment of sleep or sleep disorders lead to pain syndrome chronification. At present there is no doubt that sleep disturbance is a risk factor of morbidity and worsens the outcome. Chronic low back pain is associated with a decreased quality of sleep, prolonged time to sleep onset, decreased sleep efficacy, abnormal activity during sleep, decreased sleep duration and different abnormalities during polysomnography (decreased period of slow-wave sleep) and electroencephalography (impairment of arousal reaction). These syndromes are frequently associated with anxiety and depression, which may adversely affect the treatment outcome.
Consilium Medicum. 2017;19(2-3):48-52
pages 48-52 views

Possibilities of the quantitative sensory testing in chronic pelvic pain

Sharov M.N., Zaycev A.V., Ratchin A.P., Fishenko O.N., Nakhrapov D.I., Prokofieva Y.S.


Objectives. This work is devoted to the syndrome of chronic pelvic pain and the possibilities of the method of quantitative sensory testing. This method allows to evaluate the interest of A-delta and C-fibers, which are responsible for carrying out pain impulses. Methods. The sensor examined the zones: vagina anterior and right vulva posterior and left vulva posterior. Cold and warm temperature sensitivity was assessed. The presence of hypoesthesia or hyperesthesia was determined from the vulva with a difference of more than 3ºC. In this study were examined 50 patients with a diagnosis of chronic pelvic pain. All patients had duration of the disease more than 3 years, and all were women. Patients were divided into groups by nosology. A group of patients with interstitial cystitis, the second group included women with chronic pelvic pain syndrome after surgical treatment of endometriosis, the third group included patients with chronic pelvic pain syndrome with myofascial pain syndrome. Results. As a result of the study, it was shown that in most patients A-delta and C-fibers are affected, which indicates their involvement in the chronic pelvic pain syndrome. The heterogeneity of the damage to these sensory pathways was noted, the A-delta fiber was most often affected, which requires further study. However, there was no clear difference in three groups. So we can speak of a single mechanism for the development of chronic pain in the process of pelvic pain. It was shown that the method can be used to detect the involved of A-delta and C-fibers and to confirm the presence of a chronic process, with the purpose of prescribing appropriate treatment.
Consilium Medicum. 2017;19(2-3):53-55
pages 53-55 views

Back pain: selection of therapy in terms of safety and efficacy

Pilipovich A.A.


Back pain (dorsalgia) is one of the most common pathologies. The prevalence of pain in the lower back reaches 40-80%. Back pain can be observed in the clinical picture of both neurological and somatic diseases, and the pains of non-vascular nature are most commonly observed, being characteristic for diseases of the musculoskeletal system and connective tissue of the region of the spine (dorsopathies). Treatment of dorsalgia includes fighting acute bouts of pain and supporting, preventive treatment during the inter-attack period. The earlier treatment is initiated and the adequate analgesic effect is achieved more quickly, the less likely the chronic pain is and the overall prognosis is better. Perspective in terms of therapy of pain syndrome is the drug group of selective activators of neuronal potassium channels - flupirtine. Due to the unique mechanism of action, flupirtine opens a number of additional therapeutic possibilities and advantages: the effect on central pain mechanisms and the possibility of preventing chronicity, the muscle relaxant effect in the area of pain, the possibility of neuroprotective action, the absence of a number of side effects characteristic for opioids and nonsteroidal anti-inflammatory drugs.
Consilium Medicum. 2017;19(2-3):56-62
pages 56-62 views

Methodology of diagnosis in neurosurgery

Likhterman L.B., Okhlopkov V.A., Likhterman B.L., Spiru M.A.


The widespread approach of specialized care to the population, the spread of methods of bloodless express-visualization of the pathology of the brain and spinal cord sharply accelerated the rate of diagnostic progress in neurosurgery. To replace the passive (establishing the diagnosis by observation) came an active, immediate diagnosis. Effective use of its capabilities requires the approach to the patient clinical thinking, implementing a methodologically productive system, approach to the phenomenon from the perspective of a holistic organism - the basis of dialectics in a neurosurgical diagnosis. Practical implementation of the presented principles of diagnosis is very relevant, otherwise the negative components of the influence of the scientific and technological revolution on the development of neurosurgery can be manifested and strengthened. The methodology of the modern clinical diagnosis in the pathology of the brain and spinal cord is substantiated in the context of the possibilities of non-invasive neuroimaging. The main provisions of the examination and diagnosis in neurosurgical patients are formulated. They include the principles of syndromology, topography, nosology, visualization, age, phase approaches, sufficiency and integration of data, an individual approach. A set of criteria for an ideal method for diagnosing diseases of the central nervous system is described. The advantages of the system approach from the perspective of a holistic organism to the dialectic of a neurosurgical diagnosis are shown.
Consilium Medicum. 2017;19(2-3):63-68
pages 63-68 views

Modern approaches to diagnosis and choice of pharmacotherapy in occupational chronic lumbosacral radiculopathy

Babanov S.A., Budash D.S., Baykova A.G., Baraeva R.A.


The article is devoted to modern approaches to diagnostics, differential diagnostics, examination of the connection of disease with the profession, examination of professional suitability, medical and social expertise, disability criteria and the choice of pathogenetically grounded pharmacotherapy in occupational chronic lumbosacral radiculopathy using modern nonsteroidal anti-inflammatory drugs.
Consilium Medicum. 2017;19(2-3):69-77
pages 69-77 views

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