Vol 4, No 3 (2014)

Objective — we evaluated frozen databases from two 52‑week randomized placebocontrolled clinical diabetic neuropathy trials testing two doses of acetyl-l-carnitine (alc): 500 and 1,000 mg / day t. i. d.

Research design and methods — intention-to-treat patients amounted to 1,257 or 93 % of enrolled patients. Efficacy end points were sural nerve morphometry, nerve conduction velocities, vibration perception thresholds, clinical symptom scores, and a visual analogue scale for most bothersome symptom, most notably pain. The two studies were evaluated separately and combined.

Results — data showed significant improvements in sural nerve fiber numbers and regenerating nerve fiber clusters. Nerve conduction velocities and amplitudes did not improve, whereas vibration perception improved in both studies. Pain as the most bothersome symptom showed significant improvement in one study and in the combined cohort taking 1,000 mg alc.

Conclusions — these studies demonstrate that alc treatment is efficacious in alleviating symptoms, particularly pain, and improves nerve fiber regeneration and vibration perception in patients with established diabetic neuropathy.

Spinal pain is of great socioeconomic significance as it is widely prevalent and a common cause of disability. However, the diagnosis of its true causes frequently leads to problems. A study has been conducted to evaluate the accuracy of a clinical diagnosis and its coding in conformity with the International Classification of Diseases. The diagnosis of vertebral osteochondrosis and the hypodiagnosis of nonspecific and nonvertebrogenic pain syndromes have been found to be unreasonably widely used. Ways to solve these problems have been proposed, by applying approaches to diagnosing the causes of spinal pain in accordance with international practice.

The article describes a clinical case of spasticity and its treatment with botulinum toxin type A in a patient with the consequences of acute stroke. Given a comprehensive assessment of patterns of spasticity and muscle involved in the syndrome. Described in detail and the result is the introduction of a technique. It is concluded that the effectiveness and feasibility of using Botox to treat spasticity of the lower limb.

The article represents the clinical observation of the patient with post-stroke spasticity of the lower limb. The efficacy and safety of botulinum toxin treatment is evaluated, recommendations on examination of patients and ultrasound control of injections used to increase the efficacy of the therapy are presented.