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The article provides a brief outline on the history of the first clinic of the nervous system diseases in Russia that was organized  in 1969 in Moscow  New Catherine  hospital,  and also presents  information  about its leaders — A.Ya. Kozhevnikov, G.I. Rossolimo, A.A. Kornilov, L.O. Darkshevitch, I.Yu. Tarasevitch.

The examination of a patient with acute low back pain (LBP) includes the clarification of complaints and history data, brief physical and neurological examinations, and an assessment of danger symptoms. The diagnosis of acute nonspecific (musculoskeletal) LBP is based on the exclusion of a specific cause of pain (a potentially dangerous disease), discogenic radiculopathy, and lumbar spinal stenosis. If there is typical musculoskeletal pain and no danger symptoms, radiography, X-ray computed tomography, and magnetic resonance imaging are not recommended in the first 4 weeks of disease. Whether it is expedient to perform these techniques is considered when LBP persists over this time period. A patient with acute nonspecific (musculoskeletal) LBP should be informed about the favorable outcome of the disease and the need to maintain physical and social activities, to avoid bed rest, and, if possible, to continue professional activities. The lowest effective dose of nonsteroidal anti-inflammatory drugs for short-term duration, as well as muscle relaxants (the medium level of evidence) can be used to relieve pain. It is recommended that one should use an educational program (to prevent over-exercising and prolonged standing or sitting in static and awkward positions; to lift weights properly; etc.) to prevent recurrent LBP, as well as therapeutic exercises during a non-exacerbation period.

The main manifestation of joint and spine diseases, such as osteoarthritis, nonspecific back pain, and soft tissue rheumatic disorders, is musculoskeletal pain (MSP). It leads to considerable morbidity as well as temporary and permanent disability in millions of people of our country. These people need adequate medical care and most significantly a prompt and maximally complete analgesia. Unfortunately, serious problems are being faced in this field of medicine. The lack of a unified approach or continuity in the therapeutic process, inadequate knowledge of the pathogenesis of MSP and of the possibilities of its therapy may substantially hamper the work of practitioners. The meeting of Russian experts who were represented in different medical specialties and discussed the optimization of MSP treatment policy was held in Moscow on 20 June 2015. According to the results of the meeting, the authors identified the main points regarding the theoretical and practical aspects of MSP and also proposed an algorithm for the treatment of this pathology. It seems that the use of this algorithm will be able to facilitate the work of practitioners and to enhance the efficiency and safety of analgesic therapy.

Хроническая алкогольная миопатия – одно из наиболее тяжелых и распространенных проявлений хронической алкогольной интоксикации. При алкогольной миопатии наблюдается глубокая атрофия локомоторных мышц, затрагивающая, главным образом, волокна, экспрессирующие изоформы миозина II “быстрого” типа. В то же время, на ранней стадии заболевания не всегда наблюдается развитие атрофических изменений. В экспериментах на алкоголизированных крысах и при исследовании мышц пациентов ранее было показано поражение анаболических сигнальных путей и нарушение белкового синтеза в скелетных мышцах. В настоящей работе впервые были исследованы протеолитические сигнальные механизмы у больных алкогольной миопатией с различной выраженностью атрофии мышечных волокон. На ранних стадиях заболевания наблюдалось существенное увеличение экспрессии Е3-убиквитин-лигаз. Однако уровень убиквитинизации мышечных белков у обследованных не изменился, что можно связать с увеличением экспрессии белков теплового шока, обладающих защитным действием по отношению к мышечным белкам.

В работе анализируется значение нейробиологических, психологических и социальных факторов в патогенезе хронической боли. Хроническая боль рассматривается не как симптом повреждения тканей, а как самостоятельная болезнь, возникающая вследствие неоптимальной нейропластической реорганизации систем, осуществляющих регуляцию болевой чувствительности. В ажнейшая роль в развитии и поддержании хронической боли отводится первичному генетически детерминированному и/или вторичному нарушению взаимодействия ноцицептивной и антиноцицептивной систем на различных уровнях — от периферического нейрона до центральных структур, обеспечивающих восприятие боли и формирование болевого поведения.

The effect of the dopamine receptor antagonist mirapex on emotional disorders (anxiety, depression), cognitive disturbances and sleep disorders has been studied in 66 patients with Parkinson's disease. Mirapex has been administered in addition to levodopa and other antiparkinsonian drugs in dosage 3,5 +/- 1,1 mg daily to 36 patients with emotional and cognitive disorders and in dosage 2,9 +/- 0,96 mg daily to 30 patients with sleep disorders. Patient's state has been assessed using a number of psychometric scales and neuropsychological tests. The effectiveness of Mirapex in all disorders studied has been shown.

32 patients (21-55 years old) with multiple sclerosis (MS) were treated. Remittent form of the disease was observed in 24 patients, secondary progressive one--in 8 individuals; the degree of disability was characterised as scores 0-3 (the first group) and scores 5-6 (the second one) according to scale EDSS. Betaferon was administered subcutaneously in the dose of 8 MIU every other day during the period from several months to 1 year and more. Improvement of the state was observed in 5 patients with remittent form, stop of the development of disease (absence of either aggravations or signs of MS progression) was found in 26 cases (21 with remittent form, 4 with secondary progressive form). The conclusion was made: betaferon cannot cure but can stop progression of the disease. Indications and contraindications for betaferon therapy were established and recommendations were given concerning regimen of the treatment prophylaxis and therapy of side-effects.