Практические вопросы ведения пациентов с хронической мигренью. Рекомендации российских экспертов

The world medicine has achieved considerable advances over the last years in understanding of causes and pathogenesis as well as in specification of diagnostics criteria and studies of therapeutic approaches at chronic migraine (CM). Meantime this widespread disease is badly recognized by the physicians and diagnosed seldom. In addition, there is no generally accepted document, regulating the treatment of patients with CM, who are peculiar by their express deadaptation due to high frequency of severe attacks of the headache (HA), co-morbid psychic and somatic disorders, frequent abuse of analgetic drugs and low adherence to preventive therapy. The specialists of our country, like in other countries, gained their own unique expertise in management of such patients, who are hard to cure, including by botulinum A toxin – representative of the state-of-the-art generation of the registered drugs with the proven efficiency against CM. The article sets out the Recommendation from the Russian specialists as to management of the patients with CM, approved by the meeting of CM Expert Board (on November 12, 2014, Moscow), including with respect to time of treatment, rules of withdrawal and replacement of drugs and some other features, in compliance with modern world concepts on pathogenesis and treatment of such disease and expertise gained in managing patientswith CM in our country.последние годы достигнуты значительные успехи мировой медицины в понимании причин и механизмов развития, а также в уточнении диагностических критериев и изучении терапевтических подходов при хронической мигрени (ХМ). В то же время это широко распространенное заболевание плохо распознается врачами и редко диагностируется. Кроме того, отсутствует общепринятый документ, регламентирующий лечение пациентов с ХМ, отличающихся выраженной дезадаптацией вследствие высокой частоты тяжелых приступов головной боли (ГБ), коморбидных психических и соматических расстройств, частого злоупотребления обезболивающими лекарствами, а также низкой приверженностью к профилактической терапии. В нашей стране, как и в других странах, специалистами накоплен собственный уникальный опыт по лечению таких труднокурабельных пациентов, в том числе ботулиническим токсином типа А – представителем новейшего поколения зарегистрированных лекарственных средств с доказанной эффективностью при ХМ. В статье представлены Рекомендации российских специалистов по ведению пациентов с ХМ, согласованные на Совете экспертов по ХМ (12 ноября 2014 г., Москва), в том числе по срокам лечения, правилам отмены и замены лекарственных препаратов и некоторым другим особенностям, в соответствии с современными мировыми представлениями о патогенезе и лечении данного заболевания, а также накопленным опытом по ведению пациентов с ХМ в нашей стране

DEPRESSION AND COGNITIVE DISTURBANCES: EXPERIENCE OF VORTIOXETINE USE IN NEUROLOGIC PRACTICE

The article provides an experience of use of the new antidepressant with the precognitive action – Vortioxetine. High therapy compliance was demonstrated. The drug is effective in relief of depression, improves cognitive functions in neurologic patients and presumably has pain-killing action

SLEEP DISTURBANCES IN ALCOHOLIC DISEASE. DIAGNPSTICS AND THERAPY

The article deals with possibilities of therapy and prevention of sleep disturbances in patients with alcoholic addiction

English Language Teachers’ Attitudes Towards the Incorporation of Gay- and Lesbian-Related Topics in the Classroom: the Case of Greek Cypriot EFL Teachers

The English as a foreign language (EFL) classroom is composed of a mixture of people with various backgrounds and identities. Sexuality is increasingly recognised as a form of identity similar to other categorical forms such as class, gender and ethnicity. Based on the idea that ‘otherness’ related issues should be treated in the foreign language classroom as a means to achieve existential competence, the present study investigates the attitudes of Greek Cypriot EFL teachers towards the inclusion of gay- and lesbian-related topics in the EFL classroom. A 15-item questionnaire was designed and data was collected from 58 English language teachers in Cyprus. The results indicated that EFL teachers tended to have positive attitudes towards the use of gay- and lesbian related topics in the classroom. Positive attitudes seemed to be caused by the belief that students would find such topics interesting and on the condition that they are part of the course-book. Negative attitudes seem to be formed because EFL teachers believe that they were ill-equipped to deal with the use of such topics and homophobia in the classroom. As it is generally teachers who play a large part in determining what constitutes allowable discourses in the classroom, their role becomes even more significant in evoking insights, enriching students’ educational experiences and creating an accepting classroom environment towards the discussion of gay- and lesbian-related topics