Anxiety and depressive disorders in patients with Parkinson's disease in the Republic of Bashkortostan

Depression and increased anxiety often accompany the main, motor, manifestations of Parkinson's disease (PD). The severity and range of anxiety and depressive symptoms in this disease varies widely. In our study shows that the clinical picture of depression in PD is dominated by somatic symptoms, and the least characteristic of suicidal thoughts and feelings of guilt. Men were significantly more common ’subdepression" and women - 'severe depression*. Revealed that, in general, with increasing severity of the disease, patients have more severe manifestations of depression and anxiety at the same time softer appearance. The presence of clinically diagnosed depression in PD patients increases the risk of high anxiety.Депрессия и повышенная тревожность часто сопутствуют основным, двигательным, проявлениям болезни Паркинсона. Выраженность и спектр тревожно-депрессивных проявлений при этом заболевании широко варьирует. В нашем исследовании показано, что в клинической картине депрессии при БП доминируют соматические симптомы, а наименее характерны суицидальные мысли и чувство вины. У мужчин достоверно чаще встречается «субдепрессия», а у женщин - «тяжелая депрессия». Выявлено, что, в целом, с увеличением тяжести заболевания у пациентов отмечаются более выраженные проявления депрессии и одновременно более мягкие тревожные проявления

Discogenic lumbosacral radiculopathy. Recommendations of the Russian Association for the Study of Pain (RSSP)

When examining a patient with lumbosacral pain, it is necessary to rule out the specific cause of the disease. The diagnosis of discogenic lumbosacral radiculopathy (DLSR) is based on clinical examination; magnetic resonance imaging (MRI) is of informative value in excluding other causes of radiculopathy and in evaluating disk herniation. If the signs of cauda equina and spinal cord compression are absent, and no epidural glucocorticoid injection or urgent surgical treatment is scheduled, there is no reason for early (within the first 4 weeks) MRI.It is recommended to inform the patient with DLSR about the possibility of disk herniation regression and natural recovery and about the advisability of maintaining physical activity. Epidural administration of local anesthetics and glucocorticoids and use of non-steroidal anti-inflammatory drugs are advisable to relieve acute pain. Anticonvulsants (pregabalin and gabapentin), muscle relaxants, and B vitamins can be used as additional methods for acute DLSR; psychological therapies (cognitive behavioral therapy), antidepressants, therapeutic exercises (kinesiotherapy), manual therapy, and acupuncture are effective in chronic DLSR. Consultation with a neurosurgeon for possible microdiscectomy is indicated in the presence of cauda equina syndrome (urgently) and in the absence of medical therapy effects within 4–8 weeks.Therapeutic exercises (kinesitherapy) with an educational program for prevention of strenuous physical activity and static and uncomfortable positions for a long time, as well as for teaching how to lift weights properly, etc. are recommended for preventive purposes