The article is a review of literature on the prognosis and prevention of stroke in patients with atrial fibrillation (AF). It is noted that the simple CHA2DS2-VASc calculator is a good predictor of the risk of stroke in AF. Oral anticoagulants are recommended to patients with one or more risk factors for stroke according to CHA2DS2-VASc. There is data from large randomized trials showing that new oral anticoagulants (dabigatran, rivaroxaban, apixaban) can be as good as or better than warfarin in significantly reducing the risk of stroke, and are associated with lower risk of serious, particularly intracranial, bleeding. Positive experience related to the use of dabigatran (Pradaxa®), in a dose of 150 mg or 110 mg twice in patients with AF, is described. The introduction of new anticoagulants into the national neurological practice which do not require international normalized ratio control, will ensure wider use of anticoagulant therapy in patients with AF and reduce the incidence of cardioembolic stroke.

Medication-induced headache is a cephalgia continuing for 15 days or more per month for more than 3 months, and associated with regular excessive use of drugs for the symptomatic treatment of headache. Drug-induced headache develops in patients with a primary form of cephalgia, usually migraine or tension-type headache. Diagnosis of drug-induced headache is clinical, i.e. based on the complaints, history and diagnostic criteria of the International Classification of Headache Disorders. ICBG-3 beta was published in July 2013 which introduced the new criteria for drug-induced headache. The treatment includes behavioral therapy, withdrawal of the medication which induced headache, detoxification, if necessary, management of symptoms associated with withdrawal, and individual preventive treatment of the underlying headache. There is an overview of literature on the methods of treatment of drug-induced headache. Risks, causes of relapse and predictors of treatment failure are described. Focus is on Ketonal (ketoprofen) which is effective in relieving tension headaches and migraine prevention.

The article discusses the most common causes of pain and movement disorders in the shoulder joint. The pathogenesis and clinical pattern of various diseases of the juxta-articular apparatus of the shoulder joint are described. Current approaches to the treatment of periarticular pathology of the humeroscapular area are demosnatrated.

The article tells about diagnostic methods and treatment approaches to back pain, factors of the efficiency and safety of NSAID therapy, reasons of back pain refractory to NSAID. An algorithm for therapy selection based on the clinical manifestations of the disease is proposed.

The article highlights the approaches to the treatment of back pain. There is evidence-based data on the efficiency of non-steroidal anti-inflammatory medicines and B vitamins in nociceptive and neuropathic pain.

The article is a literature review on the treatment of metabolic polyneuropathy in patients with diabetes mellitus type 2 (DM2) and chronic alcohol intoxication. The most common form of diabetic neuropathy (30-50% of patients with diabetes) is diabetic polyneuropathy (DPN) characterized by intense, severe pain. Distal symmetrical sensory polyneuropathy (SDSP) develops in patients with type 2 diabetes and is marked by an intense neuropathic pain syndrome; it occurs in 20-30% of cases, and its frequency and representativeness increase as the disease progresses. Vitamins B1, B6, B12 enhance neurotropic activity, while the deficiency of each one leads to polyneuropathy. A combination of thiamine, pyridoxine and cyanocobalamin is good for relieving pain and eliminating sensitivity disorders. There is data on the high efficiency and practical value of group B vitamins (Neuromultivit) in the treatment of DPN in patients with type 2 diabetes and alcoholic neuropathy, which is the second most common somatic neuropathy (after diabetic).

The article details the pathogenesis of diabetic polyneuropathy (DPN) and tells about the stages and types of DPN presentation. The importance of timely differential diagnosis of neuropathic and ischemic forms of diabetic foot is emphasized. Particular attention is paid to the role of alpha-lipoic acid in the pathogenetic therapy of diabetic polyneuropathy.

This literature review outlines the role of glutamatergic disturbances in the pathogenesis of cognitive disorders. There is data on the effectiveness of the glutamate NMDA-receptors antagonist - memantine - in patients with various dementias: Alzheimer's disease, dementia with Lewy bodies, vascular and mixed dementia. The authors share own positive experience with the drug Akatinol Memantine at various dementias. Options for administration of the drug in patients with mild cognitive impairment are discussed; results of a multicenter regional study are provided. The efficacy and safety of Akatinol Memantine as a medication to improve cognitive function is highlighted.

The article discusses the clinical and diagnostic aspects of sleep disorders, behavioral and cognitive impairment in patients with insomnia, and insomnia correlation with somatic pathology. Current approaches to the treatment of sleep disorders, including principles of drug therapy selection, are presented.

The article provides a brief overview of the use of sertraline in general neeurology and psychiatry. Results of a study on the therapeutic efficacy of sertraline (Zoloft) in the treatment of anxious depression in patients of neurology unit at a general hospital are presented.

The article reviews several research works on asthenia. There is a classification and diagnostic criteria for asthenia. The prevalence of asthenic conditions, current therapeutic approaches and therapeutic effects are demonstrated. Particular attention is given to the therapy of asthenic disorders with the domestric drug Metaprot. There are results of studies that evaluated anti-asthenic and psychoactivating effect of Metaprot which can be used as metabolic cerebral protection in acute ischemic stroke; in the treatment of craniocerebral injury; treatment of patients with encephalopathy; multimodal treatment and rehabilitation of patients with hepatitis A; treatment of patients with chronic nonspecific respiratory diseases and ischemic heart disease. The experience of Metaprot use as part of multimodal therapy in the recovery phase of acute radiation syndrome is described.

The article details the risk factors, mechanisms of pathogenesis and progression of osteoarthritis. The role of chondroprotectors in the multimodal treatment of the disease is discussed; study results on the effectiveness of glucosamine and chondroitin sulfate are provided which evidence their value in the treatment of osteoarthritis.

NSAID is a key element in the treatment of acute pain and management of chronic pain. However, NSAIDs may cause serious complications in the gastrointestinal tract and the cardiovascular system. Pharmacologists have been trying to develop an "advanced" NSAID which does not affect the gastrointestinal tract, including coxibs, NSAIDs in combination with gastroprotective agents (misoprostol, H2 blockers, PPI), COX-2/LOX-2 inhibitors, and CINOD. All of these drugs have their limitations, some of them are being used, while others remained in the research phase or were ousted from clinical practice. Amtolmetin guacil is a new "advanced" NSAID based on the non-selective NSAID tolmetin, which posesses a number of gastroprotective attributes. It is specific for being able to increase the NO concentration in the gastrointestinal mucosa. The article describes the mechanism of action of the new drug, and shares the results of laboratory and clinical trials.

The article tells about the applicability of tyrosine kinase inhibitors in the treatment of rheumatoid arthritis (RA). The first drug from the new subgroup of targeted disease-modifying synthetic anti-inflammatory drugs is in focus - the oral inhibitor of Janus kinase Tofacitinib. There are results of ORAL START, ORAL SOLO and ORAL STEP studies which evaluated tofacitinib in three categories of patients: those who didn't undergo methotrexate (MTX) treatment in the past; patients without response to MT and other disease modifying anti-rheumatic drugs (DMARDs); patients with insufficient response to TNF-alpha inhibitors. The results show that Tofacitinib can be indicated either after failure of DMARD therapy and genetically engineered biologic drugs, or can be used as first-line therapy in RA. According to the author, Tofacitinib is a very promising medication which can become an essential element of the active treatment strategy for RA patients to achieve clinical remission. Nevertheless, further research is needed, as well as records of practical outcomes of the drug use.

The article is devoted to the use of a tumor-necrosis-factor-alpha inhibitor etanercept in patients with severe rheumatoid arthritis. The author examines various aspects of therapy with genetically engineered biologic drugs (GEBD), in particular the issues of efficiency and safety, the possibility of monotherapy, antidestructive effect of the drug, etc.

The article tells about types of pain at such rheumatic diseases as osteoarthritis and gout. The most common and socially significant clinical types of osteoarthritis - gonarthrosis and coxarthrosis, and approaches to treatment of pain in these pathologies, are described. The process of treatment of gout patient is described in detail. The main approaches to medicine-based treatment of pain syndrome at rheumatic disease are highlighted.

According to various authors, the prevalence of sensitive ataxia (due to proprioceptive dysfunction) in patients with diabetes mellitus (DM) equals 10 to 90% [1, 2]. The great variability of data from different studies suggests that the question is understudied. P.R. Cavanagh et al. found that patients with DM and distal symmetric sensorimotor polyneuropathy (DPN) have walking injuries 15 times more often (falls, fractures, sprained ankle, cuts and bruises) than diabetic patients without DPN [3]. Brach J.S. et al. noted the following factors leading to balance disorders in patients with DM: sensory deficit, decreased leg muscle strength and lesions of the CNS [4]. At the same time, balance disorder in patients with diabetes resulting from distal polyneuropathy received has been given much less attention compared with falls caused by autonomic neuropathy and orthostatic hypotension [5].

Целью исследования явился ретроспективный анализ историй болезни умерших в многопрофильном стационаре с наличием в анамнезе сахарного диабета 2-го типа.