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The prevalence of drug-induced headache (DIHA) in the population is about 7%, and the relapse rate of DIHA after successful treatment is about 40% within 5 years.Objective: to analyze the risk factors for recurrence of DIHA and to develop a prognostic model for the probability of relapse after treatment.Material and methods. The characteristics of 117 patients with DIHA were analyzed on the basis of clinical data and questionnaire data using headache scales (MMAS-8, MIDAS, HALT, HIT-6, mTOQ-5), psycho-emotional profiles (PCS, Spielberger-Hanin Anxiety Scale, PHQ-9, BIS-11, TAS-26, SAGE test, LDQ) that were performed at the time of admission to the clinic and 9 months after the start of therapy. All patients enrolled in the study received a complex treatment that included an educational conversation, “detoxification” and symptomatic therapy during the withdrawal period along with a preventive treatment for chronic migraine (CM).Results. It was shown that there is still a low level of diagnosing of CM and DIHA. By creating a prediction model for the likelihood of recurrence of DIHA, we were able to identify the most important factors for an unfavorable course and recurrence of excessive analgesics use: frequency of analgesic use per day (OR 15.8; 95% C113.1—23.4), degree of alexithymia (score on TAS-26 scale: OR 11.3; 95% CI 6.3—18.1), frequency of combined analgesic use per month (OR 7.1; 95% CI 4.3—11.7), degree of pain catastrophizing on the PCS scale (OR 4.7; 95% CI 1.2—7.3), duration of symptomatic drug abuse (OR 3.2; 95% CI2.1—5.7).Conclusion. A high level of concomitant psychoemotional disorders, especially alexithymia and impulsive behaviour, is a significant risk factor for relapse and should be considered in the treatment of comorbid pathologies. It can be assumed that monoclonal antibodies against calcitonin gene-related peptides, botulinum therapy or combined treatment may be the treatment of choice in cases of ineffective prevention and detoxification attempts in the past as well as in cases of prolonged analgesic abuse.

Migraine is a chronic neurological disorder that is associated with considerable disadaptive effect on patients. Despite the development of pharmacotherapy strategies for migraine, only one third of patients are satisfied with their overall treatment. Many migraine patients turn to complementary and alternative medicine (CAM), which is not usually considered a part of conventional medicine and is not always evidence-based. In practise, however, they are often used to improve the effectiveness of standard therapy or to provide alternative treatment. In addition, in CAM methods, the patient is actively involved in the choice of treatment strategies, and they have good adherence. The basic principles and approaches of CAM are increasingly being introduced into clinical practise. This review discusses the principles of CAM in the treatment of migraine as a holistic approach using lifestyle strategies and selected non-pharmacological treatments that have been shown to be effective and rational.

Introduction. In most cases, dural arteriovenous fistulas of the brain can be effectively treated endovascularly. However, rare fistulas with an isolated segment of the venous sinus may be difficult to treat surgically. Hybrid surgical interventions (combination of open surgical access to the sinus and puncture embolization in hybrid operating room) can significantly increase the effectiveness of surgical treatment of patients with this pathology.The objective was to improve the results of surgical treatment of patients with cerebral dural arteriovenous fistulas with isolated segment of the venous sinus by using a hybrid surgical intervention.Methods and materials. 2 surgical interventions were performed using microsurgical and endovascular methods. Surgical interventions were made in hybrid operating room.Results. Radical occlusion of dural arteriovenous fistulas was achieved in both cases. The postoperative period was favorable in both cases with positive dynamics in the neurological status.Conclusions. Hybrid interventions combining microsurgical and endovascular methods make it possible to achieve radical occlusion of “complex” cerebral dural arteriovenous fistulas with isolated segments of the venous sinus.

On December 24, 2022, in Moscow an interdisciplinary Council of Headache Experts, held under the auspice of the interregional public organization “Russian Society for the Study of Headache”, discussed the key problems of effective treatment of a migraine attack and the possibilities of a specific drug Kaporiza® (rizatriptan). Despite the development of strategies for the relief of migraine attacks and the effectiveness of triptans as first-line therapy, the choice of a specific drug in accordance with the individual clinical profile of the patient is difficult due to the existence of drugs in various forms (standard tablets, oral dispersible forms, injections, nasal sprays, rectal suppositories). Rizatriptan in the form of an orally dispersible tablet (ODT) has a number of advantages: high bioavailability, fast onset of action, and ease of use. Therefore, Kaporiza® (rizatriptan ODT) may be recommended as a priority therapy for all migraine patients who prefer the dispersible tablet form and who experience symptoms of nausea and vomiting, as well as for patients who have experience of poor efficacy and/or poor tolerability of other triptans. The Expert Council recommends to include rizatriptan ODT in the next edition of the clinical guidelines for the diagnosis and treatment of migraine as a first-line agent with Level A evidence.

This consensus reviewed the main current issues of clinical application and integration into everyday practice of a new targeted preventive therapy for migraine using monoclonal antibodies (mAbs) to the calcitonin gene related peptide (CGRP) ligand or receptor. These recommendations are based on current scientific and clinical studies and an analysis of the results of several years of clinical use. The main purpose of the consensus is to assist practitioners in prescribing effective prophylactic treatment of migraine using anti-CGRP mAbs and to improve care for patients with various forms of the disease.

The Russian experts’ guidelines on evaluation and treatment of medication-overuse headache are based on evidence-based medicine, the latest revision of the International Classification of Headache Disorders. Basic information about epidemiology, risk factors, pathophysiological mechanisms, evaluation, and the most effective pharmacological drug and non-pharmacological approaches to managing patients with medication-overuse headache are presented.

Migraine is the second leading cause of maladjustment, and the burden of migraine is determined by its impact on work ability, social activity and family relationships.Objective: to identify the patterns of behavior of Russian patients with migraine, factors affecting their quality of life, and the level of awareness of the disease based on a semantic analysis of messages in Web 2.0.Patients and methods. The study is based on the results of semantic processing (automated analysis of natural language texts, taking into account their meaning) of anonymized messages from 6566 unique authors (patients and their relatives) from social networks and forums (over 73 thousand messages over 10 years, 2010–2020). In addition, the study was carried out exclusively according to the data indicated in the messages. In this regard, complete data for several parameters was not available for analysis. No personal data about the authors of the messages was collected or used. The sex was determined based on the text of the analyzed message. For the study, only open data from the Internet from social networks and forums was used.Results and discussion. A landscape of problems of persons complaining of migraine issues was formed. Factors affecting the quality of life were grouped into four main groups (“Lifestyle restrictions by triggers of migraine attacks”, “Loss of opportunity to work”, “Serious psychological problems”, “Family planning issues”); additional, rarer, but acute problems were also identified. The analyzed messages show that the average number of days with migraines is 9.4 per month; 21.8% of patients report daily migraines. Moreover, most patients have been suffering from attacks for 10 years or more, and 9% of patients – for 30 years or more. The analysis of diagnostic patterns showed that in most cases, patients independently resorted to additional examination methods, while only 13.1% of patients had experience of adequate preventive therapy.Conclusion. The study demonstrated the presence of a wide range of unmet needs, quality of life problems both in patients themselves and their caregivers, as well as a significant social and economic burden of this disease (including a long-term burden on the economy, which can be used as arguments for reimbursing the cost of migraine therapy) based on the text messages on migraine in open sources on the Internet.

Migraine is a common disease in pediatric practice. Its manifestations are extremely diverse in children. Pediatric migraine equivalents are a group of different disorders that are closely related to migraine and are more common in children long before the manifestation of migraine headache. Their verification presents significant difficulties in clinical practice, and this often predetermines the use of inadequate management strategies for these patients. Meanwhile, the diagnosis of and approaches to treating pediatric migraine equivalents have their own characteristics, the knowledge of which can significantly determine quality of life in patients. The paper considers modern ideas about pediatric periodic syndromes and data on their relationship to migraine and discusses the issues of their diagnosis and treatment.

Migraine is one of the most common types of headache, which can lead to a significant decrease in quality of life. Researchers identify migraine with aura, migraine without aura, and chronic migraine that substantially reduces the ability of patients to work and is frequently concurrent with mental disorders and drug-induced headache. The complications of migraine include status migrainosus, persistent aura without infarction, migrainous infarction (stroke), and a migraine aura-induced seizure. The diagnosis of migraine is based on complaints, past medical history, objective examination data, and the diagnostic criteria as laid down in the International Classification of Headache Disorders, 3 rd edition. Add-on trials are recommended only in the presence of red flags, such as the symptoms warning about the secondary nature of headache. Migraine treatment is aimed at reducing the frequency and intensity of attacks and the amount of analgesics taken. It includes three main approaches: behavioral therapy, seizure relief therapy, and preventive therapy. Behavioral therapy focuses on lifestyle modification. Nonsteroidal anti-inflammatory drugs, simple and combined analgesics, triptans, and antiemetic drugs for severe nausea or vomiting are recommended for seizure relief. Preventive therapy which includes antidepressants, anticonvulsants, beta-blockers, angiotensin II receptor antagonists, botulinum toxin type A-hemagglutinin complex and monoclonal antibodies to calcitonin gene-related peptide or its receptors, is indicated for frequent or severe migraine attacks and for chronic migraine. Pharmacotherapy is recommended to be combined with non-drug methods that involves cognitive behavioral therapy; progressive muscle relaxation; mindfulness; biofeedback; post-isometric relaxation; acupuncture; therapeutic exercises; greater occipital nerve block; non-invasive high-frequency repetitive transcranial magnetic stimulation; external stimulation of first trigeminal branch; and electrical stimulation of the occipital nerves (neurostimulation).

The paper deals with the actual problem of managing patients with drug-induced headache (DIH) in patients with primary headaches. It describes a clinical case of extremely severe DIH in a patient with chronic tension headache (TH). The paper analyzes the typical and atypical manifestations of DIH and discusses the role of prolonged stress in the development of TH. Special attention is paid to the problems with therapy and compliance during a long-term follow-up of the patient. Based on the clinical features of pain syndrome in the described patient, the authors suggest for the first time that the use of extremely high number of daily doses of combined narcotic analgesics for many years can result in recurrent DIH statuses. The paper discusses whether it is expedient to introduce the concept “DIH severity” and whether an additional clinical parameter “the number of doses of painkillers per month” can be of informative value, which has not been proposed yet in the literature. All the issues given in the paper are conjectural and are raised by the authors for further investigation of the DIH problem.

To manage patients with drug-induced headache (DIH) is an unsolved problem of modern neurology in developed countries, since DIH is becoming a common cause of temporary disability and leads to lower quality of life in patients. Patients with primary headache (for example, those with tension headache or migraine) frequently take symptomatic headache relief medications uncontrollably, which can result in the higher frequency and intensity of DIH episodes. In turn, new headache attacks make the patients take the increasing number of symptomatic medications, which leads to the development of DIH.The International Classification of Headache Disorders, 3 rd Edition, defines DIH as a distinct form of secondary headache. To date, there is no consensus on the tactics of DIH treatment and prevention. The paper discusses different approaches to DIH prevention and treatment, the effectiveness and appropriateness of their use, as well as factors influencing illness course and possible outcomes. Particular attention is paid to the management of patients during the withdrawal period, risk factors for DIH recurrences, and ways of their prevention.

Cervicogenic headache (CH) is a syndrome of referred pain that originates in the neck structure. Despite the apparent simplicity of its determination, there is still no consensus on diagnostic criteria for cervicogenic headache amongst physicians of various specialties. In what cases is headache concurrent with neck pain a consequence of the pathology of the neck region, and in what cases is neck pain a consequence of a migraine attack?The review deals with the diagnosis, differential diagnosis, and therapy of CH.

In the described clinical case we presented features of a clinical presentation, difficulties of textiloma diagnosis which resulted in acute intestinal obstruction in several years after surgery. The high diagnostic value of an ultrasonic method in diagnostics of foreign bodies was shown.

Medication overuse headache (MOH) is defined as a secondary/symptomatic headache when HA occurs on 15 or more days per month, when the therapeutic agent is used excessively for three or more months. MOH is often combined with chronic forms of primary HA (chronic migraine and chronic tension headache). About 1% of the population periodically receives about 10 tablets of various analgesics per month. Due to high prevalence, high social and economic costs, high rates of recurrence, MOH represents a significant problem for both the health care system and practitioners. The review discusses issues of epidemiology, mechanisms of formation, diagnostic criteria and the most effective approaches to the treatment of MOH.

In Alzheimers disease (AD) the EEG changes are rather diffuseand most expressed in moderate and severe cognitive disorders.Pathological changes of spectral power and EEG coherence areassumed to be related with the degree of cognitive deficit. Theaim of this study: comparative analysis of spectral power andEEG coherence and their reactivity during functional tasks inAD patients with mild and moderate dementia and in agematchedhealthy control subjects. Twenty two AD patients withmild-to-moderate dementia and 25 controls were examined. Allpatients underwent EEG recordings with analysis of spectralpower of the main rhythms, as well as with analysis of intra- andinter-hemispheric coherence and their dynamics during functionaltasks. We found an increase in slow-wave activity (deltaand theta rhythms) and a decrease in alpha activity in frontal,parietal and temporal regions of the brain. Intra- and interhemisphericcoherence was significantly lower in frontal, parietaland temporal regions in AD patients compared to controls.EEG pattern was more obvious after functional tests. One mayconclude that changes of spectral power and EEG coherenceseem to be a sensitive indicator of cognitive decline at very earlystages of neurodegenerative process.

Medication-induced headache (MIH) is a variety of chronic daily headache (HA). MIH belongs to secondary (symptomatic) HA, develops as a complication of pre-existing primary cephalgia, and is caused by the overuse of drugs to relieve HA. The role of drug dependence syndrome and behavioral and emotional disorders in the development of MIH, which may be associated with dysfunction of certain brain systems that control these functions, has been recently discussed. The paper reviews the literature dealing with studies of the role of behavioral and emotional disorders and orbitofrontal cortical dysfunction in the development of drug dependence syndrome in patients with MIH. The importance of analyzing these aspects of MIH is determined by the prospects for applying alternative approaches to managing these patients.

According to epidemiological studies, in developed countries from 1 to 2% of the population suffering from headache associated with the abuse of analgesics. The lack of a structured understanding of the abuse headache pathogenesis, the difficulty of well-timed diagnostics and choice of effective treatment resulting of the relapse in 30-50% within 1-5 years. The aim of the study was to investigate the clinical and psycho-physiological characteristics of abuse headache and during the period of withdrawal abuse medication with "detoxification" therapy. According to the study, most patients with abuse headache abused combined analgesics (88%). We are observed a statistically-valid higher level of drug dependence, reactive and personal anxiety, depression and sleep disorders in patients with abuse headache. Development of drug withdrawal period was different in the groups with migraine and tension-type headache (lower intensity of headache was observed in the group with migraines), as well as in groups with one-stage and gradual drug withdrawal (headache course with one-stage withdrawal clinically was more easily). Increase in the overall amplitude response N75/P100, with an emphasis in the period of drug withdrawal and lack of habituation N75/P100 in patients with AGB were detected. This may indicate the increase in cortical excitability due to reducing the inhibitory thalamo-cortical and intracortical influences. Analysis of the results proves the effectiveness of the usage «detoxification» therapy in the acute phase of abuse drug withdrawal, and gives reason to recommend it to practical use in conjunction with the prescription of preventive treatment.

The brief description of the automatic measuring complexes PARSEC and some results of their ten years operation have been reported in the paper.

We propose to create a system for quick search and analyses of astronomical events and objects in plate archive of the Ukrainian Main astronomical observatory of NAS. The proposed idea of effective restoring of astronomic information is based on the treatment of the digitized plate archive as whole. The plates will be digitized by commercial scanner with optical resolution of 20 mkm and resolution on amplitude of 4096 grey levels. Such scanning parameters give the opportunity to receive the plate image les of the reasonable sizes suitable enough to identify the required object and to define its precise photometric characteristics. Connection of the system to Internet will allow a remote user to have access to plate images archive and to work with it. Modular structure of the system basic software and standard format of the plate image les allow future development of problem-oriented software for special astronomical researches by means of the cooperative projects.

Investigations of a relationship between migraine and hypertension are being continued. In spite of numerous studies, the association of some types of migraine (migraine with aura and migraine without aura) with hypertension has not been fully elucidated. This issue is particularly relevant since these forms differ both clinically and pathophysiologically. Of even greater importance are the analysis and prediction of associations between migraine and cardiovascular diseases (ischemic stroke, myocardial infarction, coronary heart disease). The review deals with the clinical and pathophysiological features of the relationship between hypertension and migraine. There is evidence for the anatomic and functional correlation between the antinociceptive system and blood pressure (BP) regulation control. It has been speculated that the increase in pain threshold is not the result of just hypertension as a disease, but it is caused by elevated BP-related hypalgesia. The efficacy of antihypertensive drugs is the fact that supports the association between hypertension and endothelial dysfunction. Identification of groups of patients having migraine and a high cardiovascular risk will allow timely early primary prevention and therapy. Introduction of a stratification approach at diagnostic stages may cause a reduction in cardiovascular morbidity and mortality rates.

The analysis results of treatment and quality life of 154 patients (elderly and senile age) with acute cholecystitis, who was operated buy different method is carried out. Fanlike laparolift using has allowed to expanding of indications to endovideosurgical operations and improvement treatment results and quality life of patients with high anesthesiology-operations risk.

Objective: to study the structural bases of natural defense mechanisms of the human brain against chronic ischemia. Materials and methods. To accomplish this, histological, immunohistochemical (NSE, calbindin, NPY, p38) and morphometric examinations of intraoperative biopsy specimens were performed to determine the reorganization of excitatory and inhibitory neurons in the ischemic penumbra of the temporal cerebral cortex (CC). Morphometric analysis was made using the specially developed algorithms to verify neurons and their elements in the ImageJ 1.46 program. Results. The reduction in the total numerical density of neurons and synapses in chronic ischemia was ascertained to be accompanied by the compensatorily enhanced expression of NSE, calbindin, p38, and NPY in the remaining CC neurons. There were signs of hypertrophy of inhibitory CC interneurons and growth of their processes. In consequence, the impact of inhibitory CC interneurons on excitatory neurons was likely to enhance. Conclusion. In chronic ischemia, the human brain is anticipated to respond to damage to some cells via compensatory excitatory and inhibitory neuronal reorganization directed towards its natural defense against excitatory damage and towards better conditions for compensatory recovery of the structure and function of CC.

In 1996 "Carl Zeiss Jena" and Centre of Astronomical and Medico-Ecological Investigations had mounted new 2-m RCC telescope, named as ZTT (Zerkalny Telescop v Terskole). The general review of the telescopes and buildings on the hiltop Terskol (3100m) are given. The basic design of ZTT are described. The results of first engineering tests of the new 2-m RCC telescope have been discussed.

More and more data suggest that ovarian cancer (OC) is an immunogenic tumor. Clinical trials dealing with immunotherapy based on activated natural killer (NK) cells and dendritic cells (DC) are under way. Mononuclear cells (MNCs) from both peripheral blood and lymph nodes (LN) are proposed to be used as a source of immunity effectors. This paper characterizes peripheral blood and LN effector cells in patients with OC. The peripheral blood displayed T cell subpopulations: T helper cells, cytotoxic T lymphocytes, and NK cells. LN showed virtually no expression of NK cell antigens, but exhibited the expression of markers of DC and T regulatory cells at the same time. The cytotoxic activity of MNCs against autologous tumor cells was higher than that against the K562 cell line. OC tissue samples were observed to contain low tumor-infiltrating lymphocyte counts.

Abstract. Eosinophils are regarded as major cell population directly involved into late phase of allergic inflammation of nasal mucosa. We performed a comparative study, measuring the amounts of eosinophils and eosinophilic cationic protein (ECP) in nasal secretions and serum samples of thirty-three patients with persistent allergic rhinitis (PAR), and twenty-five persons with chronic infectious rhinitis (CIR), to determine diagnostic significance of these parameters. Eosinophil counts in nasal secret were carried out by exfoliative cytology analysis. Sampling of nasal secretions was performed by absorption method. The samples were standardized by concentration of urea in nasal secretions and sera. ЕСР levels in nasal secretions and serum were determined by chemiluminescence assays (UniCAP 100, Phadia, Sweden). Mean scores of eosinophils in nasal secret of PAR patients were 4.6 times higher, than in the patients with CIR. Median ECP values in serum and nasal secretions of PAR patients were, resp., 30.5±28.0 μg/l and 402.7±326.9 μg/l. In patients with CIR, ECP values were 12.4±11.5 μg/l in serum and 86.9±137.4 μg/l in nasal secretions. The appropriate differences have been significant (р < 0.05). No correlations were found between ECP levels in serum and nasal secretions, as well as between ECP levels and eosinophil counts in nasal secretions. The technique of ECP determination in nasal secretions was the most sensitive approach, whereas counting of eosinophils proved to be the most specific method. ECP levels in nasal secretions well characterize an active phase of allergic inflammation and may be used as quantitative parameter for estimation of PAR severity.

Abstract. Oral allergy syndrome (OAS) is defined as a set of clinical manifestations caused by IgE-mediated allergic reactions that occur at oral and pharyngeal mucosae in the patients with pollen sensitization after ingestion of certain fruits, vegetables, nuts and spices. OAS arises from cross-reactivity between specific pollen and food allergens, due to similarity of a configuration and amino acid sequence of allergenic molecules. OAS is considered as class II food allergy, being caused by thermo- and chemolabile allergens, and it is rarely combined with generalized manifestations of food allergy. Prevalence and spectrum of the causal allergens depend on a kind of pollen sensitization. In Moscow region, as well as in Northern Europe, allergic sensitization most commonly occurs to the pollen of leaf trees, whereas OAS is mostly connected with ingestion of fruits from Rosaceae family and nuts. Since last years, a newly developed technique of component-resolved molecular diagnosis (CR diagnostics) allows of more precise detection of OAS-causing allergen molecules. These data are of extreme importance for administration of adequate nutritional therapy and prediction of SIT efficiency. (Med. Immunol., 2011, vol. 13, N 1, pp 17-28)

The AZT-22 telescope, equipped with the ML09000-65 CCD camera, has shown to be capable of obtaining high-quality images of astronomical objects and thus solving a wide range of observational tasks. Diffraction-limited telescope optics together with the excellent seeing conditions at Mt. Maidanak Observatory allows recording images with the seeing quality better than 0.6 arcsec. The accuracy of differential photometry for an isolated star is 0.002 stellar magnitude. Automatic guiding system of the telescope provides obtaining long exposures with reliable recording of objects down to 24 stellar magnitude.

Pediatric neurologists often have to prescribe drugs off-label in children, according to individual approach to every patient and weighing possible benefits and risk of side-effects. Multidisciplinary approach to migraine and tension-type headache treatment in children, including correction of comorbid psychiatric and somatic disorders, is a critical point in decrease of frequency and severity of headaches and normalization of everyday children’s activity. In the second part of the article the authors discuss the problems of symptomatic (episodic drugs taking in order to arrest a headache attack) and preventive (regular prolonged drug taking directed on decrease of frequency and severity of headaches) medical treatment of migraine and tension-type headaches in pediatric practice.

Headache is one of the most common complaints of children and adolescents. The most often causes of cephalgia in children are primary headaches (mainly migraine and tension-type headache). Recently there has been a significant increase in prevalence of primary headaches, which can be due to the changes of children’s way of life. The lack of the strict recommendations on symptomatic and preventive treatment of primary headaches in children in Russia often leads to erroneous indications. Inappropriate treatment can result in migraine and tension-type headache course aggravation with the formation of chronic daily headache, development of medicine-induced headache and other undesirable side-effects. The literature review covers the questions of therapy of the main forms of primary headaches in children: migraines and tension-type headaches. In the first part of the article the issues of diagnostics, algorithm of treatment and non-medicinal methods of treatment of headaches are discussed.

Cervicogenic headache (CH) is a common form of cephalgias. Despite the progress in understanding the mechanisms of CH, the clinical diagnosis and effective therapy of this condition present considerable difficulties. The prevalence of CH in the population is as high as 20%. Pathological changes in the upper cervical spinal segments form the basis of the neuroanatomy of CH. Its diagnosis is based on the diagnostic criteria of the Cervicogenic Headache International Study Group and on the criteria of the International Classification of Headache Disorders, 2nd Edition (2004). Effective therapy for CGP is possible when a comprehensive approach and combined use of drug and nondrug treatments, including local anesthetic blocks, are employed.