Клинические портреты «типичных» пациентов в практике невролога
Клинические портреты «типичных» пациентов в практике невролога
Екушева Е.В. Клинические портреты «типичных» пациентов в практике невролога. Consilium Medicum. 2019; 21 (9): 131–135. DOI: 10.26442/20751753.2019.9.190646
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Ekusheva E.V. Clinical portraits of “typical” patients in the practice of a neurologist. Consilium Medicum. 2019; 21 (9): 131–135. DOI: 10.26442/20751753.2019.9.190646
Клинические портреты «типичных» пациентов в практике невролога
Екушева Е.В. Клинические портреты «типичных» пациентов в практике невролога. Consilium Medicum. 2019; 21 (9): 131–135. DOI: 10.26442/20751753.2019.9.190646
________________________________________________
Ekusheva E.V. Clinical portraits of “typical” patients in the practice of a neurologist. Consilium Medicum. 2019; 21 (9): 131–135. DOI: 10.26442/20751753.2019.9.190646
Боль в спине и нарушение памяти являются наиболее частыми жалобами пациентов на приеме у врачей разных специальностей. Широкая распространенность, снижение качества жизни и дезадаптация лиц трудоспособного возраста определяют актуальность перечисленных клинических проблем в большинстве развитых стран мира. Вместе с тем пациенты с представленными патологическими состояниями нечасто получают своевременно и в полном объеме необходимую терапию с доказанной эффективностью. Применение эффективных, патогенетически оправданных лекарственных средств является залогом успешной терапии, снижения дезадаптации этой категории больных и улучшения качества их жизни.
Ключевые слова: боль в спине, дорсопатия, нарушение памяти, когнитивные нарушения, ибупрофен замедленного высвобождения, Бруфен СР, холина альфосцерат, Церепро.
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Back pain and impaired memory are the most common complaints of patients at the reception of doctors of different specialties. The widespread prevalence, decline in the quality of life and the maladaptation of people of working age determines the relevance of these clinical problems in most developed countries of the world. At the same time, patients with the presented pathological conditions infrequently receive the necessary therapy in time and in full with proven effectiveness. The use of effective, pathogenetically justified drugs is the key to successful therapy, reducing the maladaptation of this category of patients and improving their quality of life.
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2. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2017; 390: 1211–859.
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18. Apkarian A, Sosa Y, Sonty S et al. Chronic back pain is associated with decreased prefrontal and thalamic gray matter density. J Neurosci 2004; 24 (46): 10410–5.
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20. Moriarty O, McGuire BE, Finn DP. The effect of pain on cognitive function: a review of clinical and preclinical research. Prog Neurobiol 2011; 93 (3): 385–404.
21. Weiner DK, Rudy TE, Morrow L et al. The relationship between pain, neuropsychological performance, and physical function in community-dwelling older adults with chronic low back pain. Pain Med 2006; 7 (1): 60–70.
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________________________________________________
1. Atkinson JH. Chronic back pain: searching for causes and cures. J Rheumatol 2004; 31: 2323–5.
2. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2017; 390: 1211–859.
3. Shmagel A, Foley R, Ibrahim H. Epidemiology of chronic low back pain in US adults: data from the 2009-2010 National Health and Nutrition Examination Survey. Arthritis Care Res (Hoboken) 2016; 68 (11): 1688–94.
4. Schmidt C, Raspe H, Pfingsten M et al. Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey. Spine 2007; 32 (18): 2005–11.
5. Tavee JO, Levin KH. Low Back Pain. Continuum (Minneap Minn) 2017; 23 (2): 467–86.
6. Isaikin A.I., Shevtsova G.E., Rozhkov D.O. et al. Rol' myshechnogo faktora v razvitii poiasnichnoi boli. Nevrologiia, neiropsikhiatriia, psikhosomatika. 2017; 9 (2): 95–101 (in Russian).
7. Ekusheva E.V., Voitenkov V.B. Ostraia bol' v spine v praktike nevrologa. RMZh. 2017; 9: 632–6 (in Russian).
8. Chou R, Deyo R, Friedly J et al. Systemic pharmacologic therapies for low back pain: a systematic review for an american college of physicians clinical practice guideline. Ann Intern Med 2017; 166 (7): 480–92.
9. Knaggs R. Low back pain clinical guidelines: similarities and divergent views across the pond. British J Pain 2017; 11 (2): 70.
10. Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ 2006; 332: 1430–4.
11. Rofail D, Myers L, Froggatt D. Treatment satisfaction and dissatisfaction in chronic low back pain: a systematic review. J Psychol Psychother 2016; 6: 260.
12. Ekusheva E.V. Optimal'nye podkhody k kupirovaniiu pristupa migreni: proshloe, nastoiashchee i budushchee. RMZh. 2012; 10: 522–6 (in Russian).
13. Hodkinson DJ, Khawaja N, O’Daly O et al. Cerebral analgesic response to nonsteroidal anti-inflammatory drug ibuprofen. Pain 2015; 156 (7): 1301–10.
14. Instruktsiia po meditsinskomu primeneniiu preparata Brufen SR (in Russian).
15. Rasquin SM, Lodder J, Visser PJ. Predictive accuracy of MCI subtypes for Alzheimer`s disease and vascular dementia in subjects with mild cognitive impairment: a 2-year follow-up study. Dement Geriatr Cogn Disord 2005; 19 (2/3): 113–9.
16. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. (DSM-5, DSM-V). Washington, DC: London: American Psychiatric Association, 2013.
17. Naser P, Kuner R. Molecular, cellular and circuit basis of cholinergic modulation of pain. Neurosci 2018; 387: 135–48.
18. Apkarian A, Sosa Y, Sonty S et al. Chronic back pain is associated with decreased prefrontal and thalamic gray matter density. J Neurosci 2004; 24 (46): 10410–5.
19. Apkarian AV, Hashmi JA, Baliki MN. Pain and the brain: specificity and plasticity of the brain in clinical chronic pain. Pain 2011; 152 (3 Suppl): S49–64.
20. Moriarty O, McGuire BE, Finn DP. The effect of pain on cognitive function: a review of clinical and preclinical research. Prog Neurobiol 2011; 93 (3): 385–404.
21. Weiner DK, Rudy TE, Morrow L et al. The relationship between pain, neuropsychological performance, and physical function in community-dwelling older adults with chronic low back pain. Pain Med 2006; 7 (1): 60–70.
22. Mutso AA, Radzicki D, Baliki MN et al. Abnormalities in hippocampal functioning with persistent pain. J Neurosci 2012; 32 (17): 5747–56.
23. Eccleston C. Chronic pain and distraction: An experimental investigation into the role of sustained and shifting attention in the processing of chronic persistent pain. Behav Res Ther 1995; 33 (4): 391–405.
Авторы
Е.В. Екушева
1 ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий ФМБА России», Москва, Россия;
2 Клиника головной боли и вегетативных расстройств им. акад. А.М. Вейна, Москва, Россия ekushevaev@mail.ru
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Eugenia V. Ekusheva
1 Federal Research Center for Specialized Types of Medical Assistance and Medical Technologies, Moscow, Russia;
2 Wayne Clinic of Headache and Autonomic Disorders, Moscow, Russia ekushevaev@mail.ru