Management of a patient with low back pain: the problems of efficiency and safety

Low back pain (LBP) is a common condition occurring in the population in different age groups; it is characterized by a tendency to relapse.Acute pain may transform to chronic pain, causing patient disability. The goal of LBP treatment is to timely relieve painful sensations so that the patient can return to his/her normal life as soon as possible. The patient is required to participate in the therapeutic process. Ketonal that shows high efficacy and good tolerability is widely used to treat patients with LBP. The medication is available in different dosage forms, which makes it possible to individualize the therapeutic process and to reduce drug load due to its possible topical application

Хроническая поясничная боль: возможности предупреждения и лечения

Low back pain (LBP) is a very common syndrome that is associated with the extremely high rate of temporary disability and the development of chronic pain syndrome. In addition to structural changes in the locomotor system, psychological and social factors contribute to the development and maintenance of chronic pain. Drug therapy for chronic LBP frequently gives rise to complications. A physician’s important task in this situation is to prevent pain chronization and to reduce the risk of side effects of treatment. One of the ways to solve this task is to use the vitamin B complex (milgamma) along with analgesics and myorelaxants. The review considers the possible effects of combination therapy in patients with LBP and discusses whether it should be used.Поясничная боль (ПБ) – чрезвычайно распространенный синдром, развитие которого связанно с исключительно высокой частотой временной утраты трудоспособности и формированием хронического болевого синдрома. Помимо структурных изменений опорно-двигательного аппарата, развитию и поддержанию хронической боли способствуют психологические и социальные факторы. Лекарственная терапия пациентов с хронической ПБ часто ведет в развитию осложнений лечения. Важной задачей врача в данной ситуации является предупреждение хронизации боли и снижение риска побочных эффектов лечения. Один из способов решения данной задачи – применение наряду с противоболевыми препаратами и миорелаксантами комплексов витаминов группы В, в частности мильгаммы. В обзоре рассматриваются возможные эффекты комбинированной терапии пациентов с ПБ, обсуждается целесообразность ее применения

Ведение пациента с поясничной болью – проблемы эффективности и безопасности

Low back pain (LBP) is a common condition occurring in the population in different age groups; it is characterized by a tendency to relapse.Acute pain may transform to chronic pain, causing patient disability. The goal of LBP treatment is to timely relieve painful sensations so that the patient can return to his/her normal life as soon as possible. The patient is required to participate in the therapeutic process. Ketonal that shows high efficacy and good tolerability is widely used to treat patients with LBP. The medication is available in different dosage forms, which makes it possible to individualize the therapeutic process and to reduce drug load due to its possible topical application.Поясничная боль (ПБ) – распространенное в популяции состояние, встречающееся в различных возрастных группах, характеризующееся склонностью к рецидивированию. Острая боль может трансформироваться в хроническую, вызывая инвалидизацию больного. Задача лечения пациента с ПБ – своевременно купировать болевые ощущения, чтобы он максимально скоро вернулся к привычному образу жизни. Обязательным является участие самого больного в лечебном процессе. При лечении пациентов с ПБ широко используется кетонал, характеризующийся высокой эффективностью и хорошей переносимостью. Препарат выпускается в различных лекарственных формах, что позволяет индивидуализировать лечебный процесс и снизить лекарственную нагрузку за счет возможности местного применения

Превентивная химиотерапия у детей из очагов туберкулеза с множественной лекарственной устойчивостью возбудителя

The objective of the study: to assess the safety and efficacy of preventive anti-tuberculosis treatment of children exposed to multiple drug resistant tuberculosis (MDR TB) using different combinations of anti-tuberculosis drugs.Subjects and methods. 150 children at the age from 1 to 17 years old inclusive were enrolled in the study, they all had a high risk of being infected with MDR M. tuberculosis. All children had been exposed to MDR TB and had no clinical or X-ray signs of active disease. The average age of children made 9.5 ± 4.1 (median 10) years old, girls and boys made 46.6% and 53.4% respectively. Children were divided into two groups of observation: the main one included 100 children who were prescribed with preventive anti-tuberculosis treatment, while the control group consisted of 50 children who did not receive any preventive treatment for various reasons. In the main group, children received various regimens of preventive chemotherapy: pyrazinamide and ethambutol (ZE) – 30 people; pyrazinamide and prothionamide (ZPt) – 40 patients; three drugs – pyrazinamide, ethambutol, and prothionamide (ZEPt) – 30 children. The combination of drugs was based on the drug resistance of the intended source of infection. Treatment was prescribed for 3-4 months.Results: the use of a combination of first line (pyrazinamide and ethambutol) and second line (prothionamide) drugs demonstrated lower toxicity of the regimen consisting of pyrazinamide and ethambutol compared to pyrazinamide and prothionamide regimen: OR = 0.3; 95% CI – 0.2-0.6.In Z + Pt and Z + E + Pt regimens, adverse events occurred in 22.5 and 20% of cases, respectively, and in Z + E regimen – only in 6.6% of cases (p < 0.05).Цель исследования: оценить безопасность и эффективность превентивного противотуберкулезного лечения детей из очагов туберкулеза с множественной лекарственной устойчивостью возбудителя (МЛУ-ТБ) с применением различных комбинаций противотуберкулезных препаратов.Материалы и методы. В исследование вошло 150 детей в возрасте от года до 17 лет включительно с высоким риском инфицирования M. tuberculosis с МЛУ. Все дети без клинико-рентгенологических признаков заболевания были из контактов с МЛУ-ТБ. Средний возраст детей составил 9,5 ± 4,1 (медиана 10) года, соотношение девочек и мальчиков 46,6 и 53,4%. Дети разделены на две группы наблюдения: основная – 100 детей, которым назначали профилактическое противотуберкулезное лечение, контрольная ‒ 50 детей, не получавших его по разным причинам. В основной группе дети получали различные схемы превентивной химиотерапии: пиразинамид и этамбутол (ZЕ) – 30 человек; пиразинамид и протионамид (ZPt) – 40 пациентов; три препарата – пиразинамид, этамбутол и протионамид (ZEPt) – 30 детей. Комбинацию препаратов составляли с учетом лекарственной устойчивости предполагаемого источника инфекции. Лечение назначали на 3-4 мес.Результаты: применение комбинации препаратов первого ряда (пиразинамид и этамбутол) и второго ряда (протионамид) свидетельствует о меньшей токсичности схемы, включающей пиразинамид и этамбутол, в сравнении со схемой пиразинамид и протионамид: OШ 0,3; 95%-ный ДИ 0,2-0,6.При схемах Z + Pt и Z + E + Pt нежелательные явления встречались в 22,5 и 20% случаев соответственно, при схеме Z + E – только в 6,6% случаев (p < 0,05)

Preventive chemotherapy in children exposed to multiple drug resistant tuberculosis

The objective of the study: to assess the safety and efficacy of preventive anti-tuberculosis treatment of children exposed to multiple drug resistant tuberculosis (MDR TB) using different combinations of anti-tuberculosis drugs.Subjects and methods. 150 children at the age from 1 to 17 years old inclusive were enrolled in the study, they all had a high risk of being infected with MDR M. tuberculosis. All children had been exposed to MDR TB and had no clinical or X-ray signs of active disease. The average age of children made 9.5 ± 4.1 (median 10) years old, girls and boys made 46.6% and 53.4% respectively. Children were divided into two groups of observation: the main one included 100 children who were prescribed with preventive anti-tuberculosis treatment, while the control group consisted of 50 children who did not receive any preventive treatment for various reasons. In the main group, children received various regimens of preventive chemotherapy: pyrazinamide and ethambutol (ZE) – 30 people; pyrazinamide and prothionamide (ZPt) – 40 patients; three drugs – pyrazinamide, ethambutol, and prothionamide (ZEPt) – 30 children. The combination of drugs was based on the drug resistance of the intended source of infection. Treatment was prescribed for 3-4 months.Results: the use of a combination of first line (pyrazinamide and ethambutol) and second line (prothionamide) drugs demonstrated lower toxicity of the regimen consisting of pyrazinamide and ethambutol compared to pyrazinamide and prothionamide regimen: OR = 0.3; 95% CI – 0.2-0.6.In Z + Pt and Z + E + Pt regimens, adverse events occurred in 22.5 and 20% of cases, respectively, and in Z + E regimen – only in 6.6% of cases (p < 0.05)

Effect of surface relief on solid phase joining of heat-resistant nickel superalloys

Pressure welding (PW) is an advanced method for obtaining solid phase joints (SPJs). Using physical and finite element modelling (FEM) it is shown that PW under superplasticity conditions provides SPJs between dissimilar cast single-crystal intermetallic and deformed polycrystalline heat-resistant Ni-based superalloys. Special attention is paid to exclude the stagnant zones in the solid phase joining region using surface relief. The results of physical modelling and FEM are in qualitative agreement. It is revealed that the surface relief can decrease the stagnant zone and increase localisation of deformation in the joining region, which helps to improve the joining quality. A monotonous change in microhardness in the joint zone is shown