The article tells about prevention of ischemic stroke (IS) in patients after IS or transient ischemic attack (TIA) against a background of non-valvular atrial fibrillation (AF). Anticoagulation therapy variants for secondary IS prevention in AF are evaluated, such as vitamin K antagonist warfarin and novel oral anticoagulants: inhibitor of coagulation factor Xa rivaroxaban, apixaban, and the direct thrombin inhibitor dabigatran. There are results of a ROCKET AF subanalysis which compared rivaroxaban and warfarin in patients with AF after IS or TIA. It is noted that widespread clinical use of oral anticoagulants for atrial fibrillation could result in a significant reduction of IS morbidity and mortality in this country.

The article tells discusses the role of antiplatelet therapy in the prevention of atherothrombotic stroke. There is data from large randomized studies which compared the effects of clopidogrel and acetylsalicylic acid drugs in reducing the risk of stroke.

The article highlights the issues of safety when using triptans in the treatment of migraine and the risks of cardiovascular complications. Results of a large prospective population study are provided demonstrating that triptans in patients with migraine are not associated with a significantly increased risk of cardiovascular events.

In everyday clinical practice, patients with vertigo often receive erroneous diagnosis - dyscirculatory encephalopathy. Patients with dyscirculatory encephalopathy may complain of dizziness as they feel physically unstable due to white matter lesions in chronic cerebrovascular disease. However, in most cases vertigo is caused by other diseases such as stroke, transient ischemic attack and peripheral vestibular disorders. A detailed analysis of complaints and disease history, as well as clinical and instrumental examination, help to determine the cause of vertigo and avoid the risk of dyscirculatory encephalopathy overdiagnosis.

The article tells about the pathogenetic mechanisms of pain in migraine, principles of specific therapy and effects of drugs from different pharmacological groups in relieving migraine attack.

Hypertension plays an important role in the development and progression of cognitive disorders. Numerous epidemiological studies show that uncontrolled hypertension is a separate proven, potent risk factor for cognitive disorders, including severe lesions (dementia). The article discusses the pathogenesis, diagnosis and treatment of cognitive disorders in patients with hypertension.

The article highlights the pathogenetic issues in diabetic polyneuropathy (DPN), the relationship between metabolic and vascular factors and pathogenetic therapy of DPN based on the current understanding of the onset and progression.

The article is devoted to the treatment of diabetic neuropathy with Actovegin. Diabetes mellitus is widespread all around the world. Complications of the disease include nephropathy, retinopathy, and diabetic neuropathy. The most common and well known form of diabetic neuropathy is distal neuropathy. In recent years, new data was obtained on the effectiveness of treatment of distal neuropathy with neuroprotector Actovegin which exerts insulin-like effect and does not inhibit glucose transport. Actovegin was shown to be effective for distal neuropathy therapy, according to the two studies described. 6 months of Actovegin therapy demonstrated the following positive changes: effect on neuropathic symptoms, lower vibration sensitivity thresholds, higher peripheral nerve conduction velocity, reduced severity of pain and pain-free walking distance increase.

The article provides a detailed overview of the etiopathogenesis, diagnosis, surgical and conservative treatment of discogenic radiculopathy. Medications acting on the pathophysiological pain mechanisms in radicular syndrome are reviewed.

13 patients from the Moscow Multiple Sclerosis Center with remitting MS and not responsive to treatment with 1st line DMD were given Fingolimod (Gilenya) starting from January 2012. After one year of therapy, the group demonstrated a significant decrease in the frequency of exacerbations from 2,54 ± 0,97 to 0,15 ± 0,38 (p ≤ 0,0001) per year, and showed no disability progression according to EDSS. Other results were good tolerability and safety of therapy, no clinically relevant deviations in hematological state, no ophthalmic complications. In view of the possible risk of transient bradycardia, before starting fingolimid therapy MS patients were examined, and their heart was monitored for 6 hours after they were given first dose. The monitoring registered a decrease in heart rate within permissible range (not requiring medical intervention) in 30.76% of cases at 34th hour, and by 6th hour the heart rate returned to the baseline value.

The article is devoted to the treatment of patients with schizotypal disorder. Authors tell about their experience with atypical antipsychotics (sulpiride) in the treatment of patients with sluggish schizophrenia.

The effect of daily 30 mg dose of Afobazole was evaluated in 35 patients (26 women and 9 men) aged 18 to 60 years (mean age 44.7 years) with pathological anxiety. By the end of week 4 therapeutic remission was observed in 68.6% of patients: marked improvement in 22.9% of patients, and moderate improvement in 45.7% of patients. Afobazole therapy was not generally accompanied by side effects or sedation allowing patients to maintain usual daily activities and contributed to high level of adherence.

The article analyzes the causes of sleep disorders and options for therapy in elderly patients. Recent hypnotics are reviewed

Pain control is one of the major problems in clinical practice. The modern concept of analgesic therapy is based on an integrated approach, reliable knowledge of the pain pathogenesis and the use of medications with different mechanisms of action. First-line drugs here are nonsteroidal anti-inflammatory drugs (NSAIDs). In Russia, Nimesulide is considered to be the number one drug in its group which has been used in the domestic clinical practice for more than 15 years. Over the years, Nimesulide was thoroughly studied in numerous clinical trials which proved its efficacy and good tolerability. This review highlights the benefits of Nimesulide distinguishing it from other representatives of the NSAID group.

Osteoarthritis (OA) unites a group of diseases of the joints of various etiology causing deterioration and gradual loss of the articular cartilage. Osteoarthritis is the highest-ranking disease among the musculoskeletal diseases. According to WHO, osteoarthritis affects more than 4% of the world population, in 10% of cases causing disability, deterioration in the quality of life and social disadaptation of patients.

The article discusses clinical manifestations of reactive arthritis, problems of diagnosis and treatment. The role of rational antibiotic therapy in the treatment of various forms of reactive arthritis is emphasized.

The retrospective study evaluated the risk of using non-steroidal antiinflammatory drugs (NSAIDs) for the treatment of back pain in patients with cerebrovascular disease against a background of rheumatoid arthritis. Acute cardio-and cerebrovascular events were reported in 9.7% of subjects treated with NSAIDs. Adverse effects during treatment were associated with diclofenac and nimesulide. Overall risks were low in the group treated with etoricoxib, allowing for all patients to undergo scheduled courses of NSAID therapy, including upon follow-up visits.