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Introduction: Hepatobiliary disorders in alcohol dependent patients is the prevalent dual morbidity with steady upward trend of 15-30% annual increase. Therefore, development of new, more effective, integrated approaches to dual morbidity (alcohol dependence + alcoholic liver disease) treatment is quite relevant. Objectives: Research for creative task of innovative metamorphosis of integrated therapy for alcohol dependence, complicated by liver comorbidity, using essential synergistic anti-alcohol methods and differentiated choice of modern pharmacological hepatoprotective drugs. Methods: Modern complex of clinical and psychopathological pathopsychological, laboratory, electrophysiological, biochemical examination to identify dual comorbidity. Results:Anewmethod of integrated therapy for alcohol dependence complicated by liver comorbidity (patent 96702, UA) using conventional anti-alcohol and hepatoprotective pharmacotherapy has been proposed. Novelty of the utility model is provided by therapeutically combined anti-alcohol, hepatoprotective and psychotherapeutic agents: a) synchronous administration of intravenous and oral new-generation hepatoprotectors, adjuvantly affecting various pathogenic mechanisms of liver function alcoholic impairment: Lesfal 5.0ml intravenously (7-10 per course), Antral 1 tablet (0.2 g) 3 times a day (14-21 day per course); b) treatment against the background of nanotechnological membrane plasmapheresis ("Hemofenix" unit, 2-3 sessions of 750-850 ml blood plasma exfusion per session; c) psychotherapeutic mediating of the present visual signs caused by chronic alcohol intoxication with metabolic toxic (xenobiotic) contamination at plasma membrane plasmapheresis exfusion. Conclusions: Catamnesis of representative group of patients statistically objectified the increased treatment efficiency of dual comorbidity, primarily due to the quality of remissions, persistent Conclusions: Catamnesis of representative group of patients statistically objectified the increased treatment efficiency of dual comorbidity, primarily due to the quality of remissions, persistent. [ABSTRACT FROM AUTHOR]

Introduction: Contemporary international addictology, as a neuroscience, concentrated a large array of theoretical and applied knowledge about alcohol dependence pathogenetic mechanisms, exogenous and endogenous intoxication leading role, urgent states of alcohol genesis, decompensated detoxification mechanisms. This fact is of key importance in the development, testing and accumulation of numerous treatment modalities for alcohol dependence conditions and urgent relief in addictology practice. Unfortunately, not all proposed therapeutic programs stand the test of time for effectiveness. Objectives: Based on the analytical review of the principles of intensive elimination of post-alcohol disorders, to develop an innovative method of complex detoxification therapy for emergency conditions of alcohol genesis (withdrawal syndrome, dipsomania, pre-delirious and delirious conditions, etc.). Methods: International tests and scales for identification of alcohol dependence and its complications as emergency conditions. Follow-up control of laboratory, biochemical, electrophysiological and other studies. Results: An innovative method of complex detoxification therapy in emergency states of alcohol genesis (patent 20470, UA) by plasmapheresis method is developed, which is specific for membrane plasmapheresis with a dosed blood plasma removal volume of 600.0-1000.0 ml, and directly pre-treatment drip-feed intravenous administration of 200.0-400.0 ml Rheosorbilact or Sorbilact (by new prescription), 2.0-3.0 ml nicotinic acid intramuscularly, and medical oxygen inhalation for 5-10 minutes, every other 3 days procedure, 2-3 procedures tolally per treatment. Conclusions: The proposed detoxification method quickly and effectively reduces emergency clinical manifestations (eg., alcohol withdrawal syndrome with predilirious condition after prolonged binge drinking) and normalizes laboratory, electrophysiological and other parameters (middle weight molecules content, malondialdehyde level). [ABSTRACT FROM AUTHOR]

Introduction: Intensive elimination of intoxication factors is an essential component of therapeutic programs for emergency states common enough among the drug addicts. However, most of the known detoxification methods are insufficiently effective. Objectives: The creative task was to develop considerably and improve intensive detoxification treatment modality in emergency states of narcotic genesis. Methods: International scales and tests for identification of drug dependence and relieving emergency states of narcotic genesis. The study monitored the dynamics of the main biochemical, major clinical laboratory and electrophysiological parameters. Results: Aiming to increase significantly detoxification efficiency, our utility model "Method of intensive detoxification therapy in emergency states of narcotic genesis" (patent 24574, UA) provides membrane plasmapheresis (MPP) at minimized conventional pharmacotherapy with dosed 600.0-1000.0 ml blood exfusion, and hyperbaric oxygen therapy (HBO) 12-14 hours after the procedure, with 1.2-1.3 atm oxygen pressure in the chamber, and 45-60 minutes exposure; every 3 days MPP procedure re-treatment (2-3 courses totally for a course), and a 3-5 session course of daily HBO. It has been proved that MPP pathogenetically provides intensive extracorporeal exfusion of toxic substances from circulating blood plasma. Hyperbaric oxygen promotes generalized detoxification, improves metabolic, detoxification processes, promotes elimination of hypoxic factor, positively influences (stimulates functional activity of the cardiovascular system, including capillary), adding synergistic preconditions for plasmapheretic exfusion of toxins and harmful metabolites excreted in circulation. Conclusions: The phenomenon of synergistically combined two best methods of detoxification (MPP + HBO) statistically significantly increases the treatment effectiveness for emergency conditions of narcotic genesis. [ABSTRACT FROM AUTHOR]

Introduction: Availability and further positive evolution of treatment modalities for relieving pain syndrome (PS) is the most urgent addictological clinical therapeutic issue. Clinical picture of opioid dependence specific PS is pathogenically caused by exogenous and endogenous intoxication syndromes, that prevents narcotization discontinuation. International addictological analgesic relieving programs are mostly ineffective enough. Objectives: To develop and propose new addictology treatment modality based on scientific analysis of international and own scientific and clinical experience concerning differential diagnostic clinical and pathogenic features of PS in opioid addicts, targeted improvement of conventional, search for new therapeutic analgesic programs. Methods: Pain intensity was determined by most widely used, valid one-dimensional scales: Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), Visual Analogue Scale (VAS) (Breivik H., Borchgrevink R., Allen S., et al.). Results: Our method for relieving recurrent pain syndrome in opioid dependence (Patent 53586, UA) technology: membrane plasmapheresis performed at minimized conventional therapy. Heparin 10,000 U; sodium chloride 0.9% 1400.0 ml; blood preservative Glugicir (sodium citrate) 200.0 ml are used; 600.0-900.0 ml plasma is removed while a session. Blood intravascular laser irradiation with red spectrum (wavelength 0.63 µm), power 1.5-2.0 mW, exposure 20-30 minutes) is carried out 12-14 hours after membrane plasmapheresis. Laser therapy is combined with 1.0 ml Ketanov solution intramuscular injection. Conclusions: Representative clinical observations and approbation of the proposed method of relieving recurrent PS in opioid dependence with complex membrane plasmapheresis, intravascular laser therapy, Ketanov intramuscular injection demonstrated effective detoxification and analgesic effects, reduced period, increased quality of relieving therapy. [ABSTRACT FROM AUTHOR]

Introduction: The emergency states caused by periodic forms of compulsive craving for alcohol (the so called "dipsomania alcohol abuse", "heavy drinking bouts"), while which patients completely lose their conscious ability for determined will efforts over quantitative and situational self-control use of alcohol toxic megadoses, are considered one of the urgent issues of clinical addictology. It is a risk factor for severe mental, behavioral, somatoneurological disorders, disability and mortality. Since the pathogenesis and clinical manifestations of dipsomania are complex, addictology uses comprehensive pharmacological and other treatments, mostly insufficiently effective. Objectives: Innovative improvement of relieving method for heavy drinking states in alcohol abusers aiming at rise of efficiency, reduction of side effects and complications. Methods: Valid clinical-diagnostic, laboratory, biochemical, electrophysiological, psychological (scaling, testing) methods of dipsomaniac alcohol dependence statistical identification. Results: A new way of relieving alcohol intoxication (patent, 41156, UA) using pharmacological therapy (detoxifying, general tonic, thymolytic, tranquilizing, neuroleptic) has been proposed, characterized by intramuscular 1 ml Galapril (Ukrainian analogue of international Haloperidol) 3-7 days, once-twice daily, carried out against the background of:) intravascular/transdermal laser therapy (0.63 µm wavelength, 2 mW radiation intensity, 30-40 min exposure, once daily for 3-5 procedure course), b) oral administration of sorbent Enterosgel (15 g single dose, three times daily 1.5-2 hours before or 2 hours after meals and taking medications, a course of 7-14 days). Membrane plasmapheresis is also pathogenetically grounded (patent 41156, UA). Conclusions: The treatment method was statistically significantly more effective compared to the conventional therapeutic approach. [ABSTRACT FROM AUTHOR]

Introduction Pain syndrome is integral acute sign of drug addiction at psychoactive substance deprivation and is a severe urgent state. Objectives and aims To work out integrated approaches to pain syndrome cessation with combined pharmacotherapy and non-pharmaceutical methods. To study dynamics of pain syndrome reduction at application of the developed methods. Methods One hundred and eighty-nine opioid addicts (cessation state) were examined. The treatment efficiency was evaluated with visual analogue scale; Roland-Morris questionnaire; pain numeric rating scale. Results Four innovative options of modified therapy for pain authorized with the patents of Ukraine were proposed (with membrane plasmapheresis, medical electrophoresis, laser therapy and standard pharmacotherapy): – pain syndrome cessation in opioid addicts is provided with Tramadol (up to 600 mg i/m), at intravascular laser hemotherapy (wavelength 0.63 mcm, power 2 mW, 30–40 min exposure, 3–4 days course); – recurrent deprivation pain syndrome cessation is realized by membrane plasmapheresis with intravascular laser blood irradiation and i/m 1.0 mL Ketanov solution 2–3 days; – pain syndrome treatment in drug and alcohol addicts is provided with Analgin and Sibazon by electrophoresis, current 1.5–5 mA, exposure 25–30 min, 1–2 procedures daily; – pain syndrome cessation in drug addicts is performed by injection of 0.5% Seduxen solution (up to 4.0 mL), paracetamol – (up to 0.4 g), 10% solution of sodium caffeine benzoate – 1.0–2.0 mL subcutaneously, at night – 0.5% seduxen 2.0–4.0 mL, paracetamol – 0.2–0.4 g. Conclusions Monitoring and statistical processing data proved that the proposed methods give 1.5–2-fold growth in efficiency of treatment for pain syndrome in drug addicts. [ABSTRACT FROM AUTHOR]

Introduction Distinctness of tremor in abstinent disorders at alcohol and drug addiction are polymorphous in expressiveness degree, localization, typical dynamics of growing from latent, subclinical to big swing tremor of fingers. Aims and objectives To elaborate the differentiated diagnosis method for tremor in drug addicts to solve examination and medical problems in clinical narcology. Method The new method of expert diagnosis of latent tremor in narcology with complex examination of the respondent's capacity to complete test tasks for the precisement of purposeful sensorimotor movements and operations coordination with laser test was introduced. Laser beam pointer visual manual guidance at 2–3 meter distance standard target and the beam fixation at the centre (“top ten”) reveals the patient's capacity within 5–10 seconds. Laser light spot trembling appearance out of “top ten” circle while twice-thrice completing the test is considered the positive result and tremor severity is evaluated depending on the beam vibration amplitude. Results Twenty-five alcohol and 25 drug addicts were examined. Visually, tremor presence and severity coincided with testing results entirely. Ability to keep beam in “top ten” area demonstrated tremor absence; laser spot vibration over “top ten”–the latent tremor; laser spot trembling within circles 9–10 – the moderate tremor; within the 6th–4th circles – medium severity; from 3rd–1st and 0th circle – the severe tremor is identified. Conclusions The method allows to increase the diagnosis efficiency and tremor identification at narcological diseases that gives opportunity to solve definite differential diagnostic problems in the expert centers for intoxication states examination. [ABSTRACT FROM AUTHOR]

Introduction Statistical data prove that the most traffic accidents happen at the traffic lights controlled crossings predominantly due to decreased attention at permanently changing traffic lights triad and narrowing traffic parameters panoramic view. Aims and objectives To develop method optimizing human psychophysiological functions (perception, attention, peripheral vision, operative memory) as integral base for most intellectual functions. Method The new approach for psychophysiological functions activation consists of addition of the traffic lights complete color gamut to the famous Schulte test (1–25 numbers depicted in black at consequently changing red, yellow and green background in cells). Results Two groups each of 25 respondents were examined. New technology on modified Schulte table (once-twice a day 25–30 min exercise repetition for 7–10 days) was used in the main group. Traditional (black-and-white) Schulte tables were applied in control group. Training efficiency in the main group 2.1 times exceeded this in control group. Thus, the main group respondent's ability for high operation speed in attention (average evaluation) was reached after the 3-day training while in the control group–by 6th day. Considerably quicker the main group could demonstrate the ability for panoramic perception of traffic lights color analogues and identification of ordinal numbers in modified Schulte table. It has been established that modification of Schulte tables improves intensity, volume, concentration, stability, distractability of attention and mobilization of memory. Conclusions The elaborated method allows to concentrate at information aspects of traffic, isolate the external stimuli, control the own activity in anti-accident paradigm and traffic safety. [ABSTRACT FROM AUTHOR]

Introduction The work presents HIV PLEDGE project cooperative results of Kharkov Medical Academy of Postgraduate Education (KhMAPE) and the United Nations Office on Drugs and Crime (UNODC) in Ukraine which correspond the Law of Ukraine “On the Higher Education” requirements. Objectives and aims The project is aimed at the reduction of HIV-infection, tuberculosis and other comorbid disorders in drug addicts in Ukraine. The results are expected to be introduced into postgraduate training for doctors narcologists of Ukraine at the resource training centre (RTC) created under UNODC aegis according to innovation international education and technology standards criteria adapted for all forms of postgraduate training including medical residency. Methods Clinical, laboratory, epidemiological methods, statistical monitoring were applied for modern drug addiction conditions. Results The research allowed: – to increase abilities of KhMAPE departments to provide up-to-date epidemiological information for narcological diseases, pathophysiology, treatment, prevention, rehabilitation, HIV-linked medical and non-medical services integration in routine practice; – to approach renewed academic programs, distance training courses, certification, special modern software, computer technologies, internet resources; – to increase the postgraduate education efficiency and quality; – to apply up-to-date information concerning treatment; – to provide tuition and online training. RTC was equipped with special software, valid educational and diagnostic tests, e-libraries, research analytical reports, Tritnet educational and information materials, presentation setup. RTC provides monitoring system of academic efficiency “Smart Senteo”, distance training module program, database server “Osvita”. Conclusions RTC efficiency and prospects of new form of postgraduate medical training for doctors narcologists in residency have been grounded. [ABSTRACT FROM AUTHOR]

Introduction Among drug addicts cohort in Ukrainian population, the phenomenon of codeine narcotic effect intensification and prolongation with antibiotic levomycetin simultaneous combined dose was identified. Current narcology encounters the insufficiently studied problem of drug addicts who lost vision due to levomycetin abuse at chronic codeine intoxication. Continuous levomycetin abuse was proved to cause optic nerve neuritis followed with eyesight loss. This is connected with discrete loss of eyesight pathogenesis in opioidaddicts. Aims and objectives To elaborate integrated method of treatment considering main pathogenic links of this narcotic addiction. Method It is based on combined therapy at traditional detoxication and includes membrane plasmapheresis 2–5 times at once every 3 days. Everyday 2.0 mL pyridoxin hydrochloride 5% solution for 15 days. Capillary stabilizer l -lysine aescinat in drops once in 24 h for 5–8 days. Transorbital medicinal electrophoresis (thiamine bromide 2.5% solution), 15–20 min exposure, daily, 10–12 procedures. Peroral retinol acetate, 1 capsule 3–4 times daily, for 7–10 days. Enterosorbent atoxil, 10–12 g daily, for 3–5 days. Results Five codeine addicts with neuro-ophtalmic disorders due to levomycetin abuse as a narco-associated phenomenon were examined. The addicts explained additional levomycetin composition in individual narcotization schemes by the aim to intensify and prolong codeine effects maintaining its stable dose. Combined comprehensive therapy restored the eyesight partially; renewed capacity to move independently, the patients’ disability was ceased. Conclusions Membrane plasmapheresis in the proposed method integrates in therapy the prescribed pharmaceuticals and corresponds numerous tasks of detoxication at continuous combined codein and levomycetin abuse. [ABSTRACT FROM AUTHOR]

Quality of life has already been investigated in elderly patients with alcohol dependence. Indicators were deteriorated with long-term experience of alcohol and somatic diseases. Practice of Reamberin, Cytoflavin, Cycloferon has improved quality of life and physical status of elderly patients.

The possibilities are shown of using officinal glycerin as a polyatomic alcohol in the treatment of alcoholism, in particular, alcohol abstinent syndrome. The theoretical basis of using glycerin is the possibility of replacing ethanol by a substance with a similar chemical structure not possessing euphoric and narcotic effect. Clinical results showed the rationality of using glycerin as an antialcohol substance.

The authors analyzed the history and follow-up findings and studied neurologic, somatic and psychopathologic status as well as the adaptive function of the olfactory and cutaneous-algesic analyzers and constructive praxis in 175 patients with chronic alcoholism. The regularities of social decompensation are considered and the technique for its objective evaluation and classification is offered. Also specified are both unfavourable and favourable prognostic indicators of the rehabilitation of such patients.