[Efficacy and safety of collagen biomaterial local application in complex treatment of the diabetic foot syndrome (final results of the multicenter randomised study)]. / Éffektivnost' i bezopasnost' mestnogo primeneniia kollagenovogo biomateriala v kompleksnom lechenii sindroma diabeticheskoi stopy (itogi mnogotsentrovogo randomizirovannogo klinicheskogo issledovaniia).

AIM: To evaluate the efficacy and safety of collagen biomaterial application during the 4-week follow-up of patients with diabetic foot syndrome. MATERIAL AND METHODS: 75 patients with diabetic foot (Wagner II (69.3%) and III (30.7%)) aged 30-80 years were included in the multicenter study, among them were 50.7% with the wound unhealed for 1.5-6 months and 49.3% over 6-48 months. Patients were randomized into 2 groups: 1) standard therapy (n=37), 2) the additional use of the collagen material Collost (n=38). Observation period was at least 4 weeks for each patient. The size of ulcers, results of general and biochemical blood tests, oximetry, microbiological testing, ultrasound of lower extremities vessels as well as a detailed medical history, social and functional status, level of cardiovascular comorbidity and ongoing therapy were estimated. RESULTS: Additional use of a collagen biomaterial has led to a significant reduction ulcers of all sizes from 13.5 to 2.1 cm2 (in the comparison group - from 12.5 to 7 cm2). The best dynamics have been registered in Wagner II (4.4-fold average wound area regress in Collost group, from 8.8 to 2.0 cm2; average wound area regress by 1.8 times, from 10 to 5.6 cm2 in the comparison group) than in Wagner III group (in the main group from 55 to 21.3 cm2; in the control group from 36 to 32.4 cm2) and in ulcers existing less than 6 months. Treatment with biological material Collost within standard therapy after 4 weeks led to increase of complete epithelialization by 2.6% (21.1% as compared to 14.7%), while decreasing the frequency of ineffective treatment by 4.1 (7.9% in primary and 32.4% in the comparison group). CONCLUSION: We have proved the efficacy and safety of collagen biomaterial topical application in a diabetic foot syndrome treatment.

Ipidacrine in combination therapy regimens of functional constipation.

AIM: Analysis of the treatment response rates of different therapy regimens of functional constipation, including Ipidacrine, a cholinesterase inhibitor, based on assessment of adaptation and compensatory mechanisms in the therapy forecast. MATERIALS AND METHODS: 77 functional slow-transit constipation patients were examined after therapy regimens of functional constipation, the mean age is 44.30±14.58 y.o. RESULTS: The treatment response rates of different therapies with Ipidacrine depends on the patient's initial adaptation and compensatory mechanisms (ACM index); certain aspects allowing to predict the expected result depending on the current mental state were identified; the severity of the state of functional constipation, ACM index and MMPI test psychometric indicators are correlated; adaptation and compensatory mechanisms of functional constipation patients were found to be reduced; the prognosis of the treatment response rates and, accordingly, the choice of the therapy regimen depend on the patient's adaptation potential (index). CONCLUSION: Therapy regimens for functional constipation patients should be selected on the basis of the original ACM index, behavioral pattern, degree of compliance and the patient's age.

[The first experience of using a single-layer intra-abdominal collagen plate].

UNLABELLED: The aim of this study was to define the possibility of using a collagen substance CollGARA as a protective barrier between the polypropylene mesh implant and abdominal organs. The drug is a sterile bioabsorbable membrane consisting of refolded equine collagen. Indications--use as barrier separating adjoining tissues and organs in the areas of the abdominal cavity, where the formation of adhesions. MATERIALS AND METHODS: Were performed 10 operations in patients with ventral hernias with different localization. 8 patients had postoperative hernia in 2--linea alba hernia. 8 patients were operated open, 2--laparoscopically. After intra-abdominal hernia repair was performed plastic mesh implant, delimiting it from the abdominal cavity membrane CollGARA. Serious complications from the abdominal cavity and the surgical wound wasnt observed. RESULTS: The first experience with intra-abdominal plastic polypropylene mesh implant coated with collagen plate indicates the possibility of applying this method in the future.

[Individual pharmacotherapy safety in the assessment of cytochrome P-450 3A4 (CYP3A4) isoenzyme activity].

Modern methods for the evaluation of drug interaction at the level of biotransformation system are discussed with special reference to the lidocaine test (MEGX) and measurement of cytochrome P-450 activity in patients with drug-induced oxidative processes in the liver. Interaction of atorvastatin with clopidogrel are shown to slightly reduce the desaggregative effect of the latter. It is concluded that MEGX test widens opportunities for personalization and safe pharmacotherapy.

[Prestarium treatment of essential hypertension]. / Ispol'zovaniie prestariuma u bol'nykh gipertonicheskoi bolezn'iu.

The aim of the study was to assess prestarium effects on central and renal hemodynamics, blood lipids in hypertensive subjects. Prestarium was given in a daily dose 4-6 mg to 30 patients with essential hypertension stage II free of cardiac decompensation and renal failure. Echocardiography, tetrapolar chest rheoplethysmography with assessment of hemodynamics, radionuclide tracing of renal blood flow, tests for cholesterol and blood electrolytes were made before treatment, on treatment weeks 2-3 and 12. It was found that prestarium lowers blood pressure and total peripheral vascular resistance. Myocardial conductivity was not affected, whereas renal circulation activated. Low-density lipoproteins cholesterol fell. No significant changes in electrolytes were seen. The drug was well tolerated. In view of good clinical effect and tolerance prestarium is recommended for treatment of essential hypertension stage II in the absence of cardiac decompensation and renal dysfunction.

[The possibilities of isoptin treatment of pulmonary hypertension in patients with chronic obstructive bronchitis]. / Vozmozhnosti lecheniia izoptinov legochnoi gipertenzii u bol'nykh khronicheskim obstruktivnym bronkhitom.

The study included 30 patients with COB coursing from 5 to 15 years, free of chronic cor pulmonale symptoms. All the patients had moderate obstructive impairment of pulmonary ventilation with hemodynamic disorders and defects in myocardial contractility indicating the presence of transitory pulmonary hypertension (PH). Patients of the control group received conventional therapy. It was combined with isoptin-retard (240 mg/day) in the study group. The treatment produced a positive effect in all the patients, but those of the study group exhibited more pronounced decrease in pulmonary artery pressure, achieved better hemodynamics and myocardial contractility. Isoptin-retard in daily dose 240 mg is recommended in COB patients to prevent onset of chronic cor pulmonale.