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Introduction. The issues of dynamic and functional anatomy of the neck are of considerable practical and theoretical interest. This is due to the peculiarities of the displacement of the musculofascial layers when changing the position of the head in space, the description of which presents significant difficulties. Particular practical importance has therefore the study of dynamic phenomena of this area as well as the analysis of morphological and biomechanical changes leading to the development of somatic dysfunction of the neck. Aim. Based on the topographic and anatomical studies, as well as with the help of finite element modeling, to study the patterns of displacement of the muscular-fascial layers of the neck when turning the head by 20º and 50º. Materials and methods. The topographic and anatomical study used the results of 18 MRIs, the analysis of which was carried out using the Vidar Dicom Viewer software. To build a finite element model, data from a CT study of a patient were used, which has not any pathological changes in the organs and musculoskeletal system of the neck. As a result of the subsequent processing of the CT study data, a personalized anthropomorphic finite element model of the neck region was constructed, with the help of which a series of virtual topographic and anatomical studies were performed, repeating in general terms the topographic and anatomical part of the work. Results. 1. The values of rotational and angular displacement of all fascia of the neck are nonlinear. 2. The fascia of the neck are displaced relative to each other when turning the head due to the difference in the values of angular displacement. 3. The magnitude of the angular displacement of the 2nd fascia of the neck at the level C2-C3, C3-C4 and C4-C5 when turning the head 20º, as well as at the level C4-C5 when turning the head 50º exceeds the value of the angle of rotation of the head relative to the trunk. 4. The direction of rotational and angular displacement for all fasciae at the level C6-C7 corresponds to the direction of rotation of the head, with the exception of the dorsal part of the 4th fascia of the neck, which at this level, together with the esophagus, shifts in the opposite direction relative to the axis of symmetry. 5. Fasciae located at a greater distance from the center of the intervertebral disc are characterized by large values of angular and rotational displacement. 6. The rate of change in the ratio of rotational and angular displacements is higher at the level of the lower segments. 7. The results of measurements of the rotational displacement of the fascial layers of the anthropomorphic finite element model demonstrate a positive correlation with the data of the topographic and anatomical study. Conclusion. The patterns of displacement of the neck musculofacial layers should be taken into account when modeling somatic dysfunction of the neck, as well as in the process of diagnosis and planning of osteopathic effects.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a structurally diverse group of drugs with a common mechanism of action (reversible inhibition of cyclooxygenase). They are widely used due to their analgesic, antipyretic and anti-inflammatory properties; available both as prescription and over-the-counter medications; available as individual pharmaceuticals, compound painkillers. The methods of treatment of acute and chronic pain are different. For acute pain, analgesics such as nonsteroidal anti-inflammatory drugs and opiates are commonly used, sometimes in combination with regional anesthesia such as peripheral nerve blockade or peridural local anesthesia. A systematic review and meta-analysis of the efficacy and safety of nimesulide published in the sources MEDLINE/PubMed, Embase, Cochrane Library and China National Knowledge Infrastructure. The efficacy and safety of the use of nimesulide in clinical practice is shown. In particular, in the treatment of acute musculoskeletal pain (dorsopathy of the cervical-thoracic and lumbar region), as well as migraines, due to a decrease in the release of calcitonin- gene related peptide (CGRP) and prostaglandin E2 (PGE2) from the trigeminal ganglia, while other NSAIDs have shown a lack of efficacy. Noncompliance with international guidelines, irrational use of NSAIDs among all groups of drugs is one of the leading causes of hospitalizations associated with side effects, which increases health care costs. The article presents an overview of the safety and efficacy of medicines containing nimesulide, as well as recommendations for patients and prescribers of this drug.

Introduction. The use of mathematical modeling methods in clinical practice will make it possible to identify the pathogenetic forms of dorsopathies and thus reasonably use the concept of targeted treatment in the management of patients of this category.Aim. To evaluate the possibilities of finite element segmental analysis of the cervical spine for personalized treatment and prediction of the course of dorsopathies.Material and methods. Based on the combined data of computed and magnetic resonance imaging of the patient (female, born in 1951), a model of the C5 – C7 segment was generated, including: vertebrae C5, C6, C7, IVD, anterior and posterior longitudinal ligaments, two pairs of facet joints, spinal cord, nuchal ligament. Computer modeling and finite element method were used to analyze the stress-strain state of the cervical spine of a patient with degenerative-dystrophic changes in the C2 – C7 segments. In the Abaqus/CAE 6.14 software, finite element analysis of the C5 – C7 stress-strain state was carried out in the state of flexion, rotation and compression. The data obtained during compression were compared with previous experiments in silico and in vitro for the norm.Results. For each state, stress and displacement diagrams, load-displacement curves, stress profiles in the MPD were obtained. The axial mobility of the segment under compressive load is two times lower compared to the norm under the same boundary conditions and material models. The degree of involvement of the spinal cord in conflicts with the surrounding anatomical structures was studied. When the model was rotated to the right, conflicts were observed between the spinal cord roots and the bone structures of the vertebrae in the foraminal zones, as well as at the level of the C5 – C6 and C6 – C7 discs with the left posterolateral surfaces of the fibrous rings. When the model was turned to the left, conflicts of the spinal cord were observed in all foraminal zones, as well as at the level of the C6 – C7 disc with the left posterolateral surface of the fibrous rings. Based on the data on stresses in the studied segment, further development of dorsopathies and degenerative changes in the cervical spine was predicted.Conclusions. The use of finite element segmental analysis of the cervical spine creates objective prerequisites for the formation of a combined personalized treatment and prediction of the course of dorsopathies.

Introduction. In the structure of the total mortality of the population, cerebral stroke ranks second and leads among the causes of disability. Despite the huge number of patients with diabetes and stroke, the mechanisms underlying this predisposition remain poorly understood. Morphological changes of the brain in diabetes-induced neuroinflammation are practically not described anywhere.Objective. To establish the patterns of pathomorphological changes of the brain associated with neuroinflammation in patients with type 2 diabetes mellitus who have suffered a stroke.Materials and methods. On the sectional material, changes in the brain and arteries were studied in 27 stroke deaths (6 men and 21 women), aged 60 to 97 years, average age 75 ± 7.2 years, who had type 2 diabetes mellitus, the comparison group consisted of 32 stroke deaths (14 men, 18 women) with dyscirculatory encephalopathy without type 2 diabetes aged 42 to 100 years (average age 68.5 ± 14.2 years). Light-optical and electron microscopic examination of the brain, immunohistochemical reactions were performed: indirect immunoperoxidase reaction with gliofibrillary protein, vimentin and macrophage immunophenotyping markers – CD-68, CD-163, CD-21, CD-23, CD-11c, HAM.Results. It has been established that neuroinflammation is characterized by macrophage-microglial activation, penetration of antigen-presenting cells through the damaged blood-brain barrier, damage to neuronal and glial cell pools. Pronounced macrophage infiltration was revealed using immunohistochemical methods of investigation with CD-68. Monocytic macrophages and antigen-presenting cells are located perivascularly, migrating through the damaged blood-brain barrier and expressing the CD-11c receptor. There is a phenomenon of changing the phenotype of macrophages from M2-type, with sanogenetic activity, to M1-type, responsible for inflammatory damage.Conclusions. Pronounced infiltration of brain tissue in stroke patients with type 2 diabetes mellitus by both resident macrophages and monocytic macrophages is associated with progressive neuroinflammation.