No 19 (2015)

Osteoporosis after stroke is not only a medical, but also a significant socially problem. Additional fracture risk of bearing parts of the skeleton, particularly the proximal femur is associated with severe disability, high mortality of patients and a heavy financial burden for the national health system. The article highlights the pathogenic mechanisms of bone metabolism disorders, developing after stroke. The article demonstrates the role of the endocrine system, nutritive factors, degree of immobilization and concomitant drug therapy in the development of osteoporosis. We discuss the possible non-drug methods and medicines for the treatment of these patients.

This review article discusses some of the issues about the linkages between osteoporosis and cardiovascular diseases, common pathogenetic mechanisms and therapeutic options.

The article presents the results of the analysis of the clinical efficacy of the therapy of articular syndrome in patients with osteoarthrosis (OA) through the development of pathogenetically substantiated treatment regimens with a differentiated inclusion of drug Chondrogard (chondroitin sulfate) in complex therapy. The study included 76 patients with primary OA who had received only NSAIDs as pathogenetical therapy. In all patients, controlled monitoring of the clinical manifestations of the disease, account of subjective and objective parameters of internal organs and systems were performed within the first 3 days after admission, at 8-10 day, 28-30 day of treatment and 3 months after. Patients were divided into groups: the first group included 46 patients. The second group of a similar age, length and severity of the disease included 30 patients. First group of patients received injected Chondrogard each alternate day intramuscularly over 2 months (№ 30) in addition to conventional treatment. The first three injections were performed at a dose of 1 ml (100 mg), subsequent - at a dose of 2 ml (200 mg). Second group of patients received only conventional therapy. Comparative evaluation of the dynamics of functional parameters of articular syndrome, such as Lequesne index, WOMAC index, indicators of morning stiffness in points and minutes in OA patients under the influence of a combination therapy with Chondrogard and traditional drugs and only traditional therapy clearly show the benefits of a combined treatment regimen with inclusion of Chondrogard.

Episodes of back pain usually resolve within 6 weeks, but due to lack of adequate treatment and prevention pain syndrome become chronic and recurrent in most patients. The results of own authors’ experience of management of patients with back pain demonstrate the need for comprehensive treatment that includes effective and safe pharmacological pain relief and subsequent prevention of recurrence of pain and rehabilitation with concomitant use of medication and physical therapy methods, including active exercise.

This review is devoted to the analysis of the mechanisms of action of different classes of drugs on the pathogenesis of osteoarthrosis. The main advantages and disadvantages of selective and nonselective cyclooxygenase inhibitors are discussed. It is shown that, in contrast to non-steroidal anti-inflammatory drugs, the drug Zeel T has a dual mechanism of action (act both on cyclooxygenase and lipoxygenase). The review presents the results of studies confirming that such a dual inhibition allows to stop the pain and inflammation while avoiding lesions of structures of the digestive tract.

The article presents the description of the unique clinical case of treatment of esophageal achalasia by intrasphincter endoscopic ultrasonography-guided injection of botulinum toxin type A, previously not described in Russia (publications on similar manipulations in the domestic literature are not found).