[Results of a randomized double-blind multicenter clinical trial of the efficacy and safety of riamilovir in the treatment of COVID-19].

AIM: To evaluate the efficacy and safety of riamilovir in the treatment of COVID-19 in adults. MATERIALS AND METHODS: The study included 180 patients with a laboratory-confirmed diagnosis of COVID-19 which fully meet the criteria for inclusion, non-inclusion and exclusion, signed a voluntary informed consent to participate in a clinical trial. RESULTS: The efficacy, good tolerability and safety of the drug riamilovir in the treatment of COVID-19 have been established. CONCLUSION: As a result of a multicenter randomized double-blind clinical trial, the effectiveness of the drug riamilovir for therapeutic use in patients with COVID-19 according to the 1250 mg/day scheme (250 mg capsules 5 times per day) for 10 days was established. The drug riamilovir in a daily dose of 1250 mg for 10 days does not differ in safety from placebo.

[Pharmacoepidemiological research of COVID-19 in the Russian Federation EGIDA-2020].

AIM: An analysis of coronavirus infection in Russia and evaluation of different AVT regimens effectiveness. MATERIALS AND METHODS: The study involved a retrospective analysis of 1082 patient records with laboratory-confirmed COVID-19 in 17 regions of Russia. The number of men and women was equal, mean age 48.718.1 (median 50). Patients with moderate COVID-19 (85%) versus mild COVID-19 (15%) were characterized by higher age (median 54 vs 21 years; p0.001), higher body mass index (27.8 vs 23.4; p0.001), prevalence of chronic diseases (75.3% vs 8.5%; p0.001), including circulatory system diseases (37.8%). Moderate COVID-19 characterized higher intoxication (10.86.1 vs 4.22.7 days; p0.001) and catarrhal symptoms duration (10.25.4 vs 6.14.1 days; p0.001). RESULTS: During hospitalization 92% of the patients received AVT, 77% antibiotics, and 16% corticosteroids. Umifenovir therapy resulted in a significant reduction of intoxication (8.75.5 vs 11.75.5 days; p0.001) and catarrhal symptoms duration (8.85.1 vs 12.04.9 days; p0.001) compared to the group without AVT. The usage of INF reduced intoxication symptoms compared with the group without AVT (8.97.5 vs 11.75.5; p0.05). Therapy with hydroxychloroquine, imidazolylethanamide pentandioic acid, and lopinavir + ritonavir combination did not affect the course of COVID-19. Most of adverse reactions were related to antibiotics. CONCLUSION: Umifenovir therapy and inclusion of interferon in AVT regimens was associated improvement in the clinical manifestation of the disease among patients.

[Experience of olokizumab use in COVID-19 patients].

Most subjects with the COVID-19 experience mild to moderate symptoms, but approximately 10% of cases suffer from severe course of disease. IL-6 inhibitors are actively used to neutralize and prevent the cytokine storm. Olokizumab is a humanized monoclonal antibody belonging to the G4/Kappa immunoglobulin isotype that selectively binds to human IL-6 and effectively neutralizes it. AIM: To evaluate the efficacy and safety of Artlegia (olokizumab) for the treatment of subjects with a disease caused by the SARS-COV-2 virus in a real-world clinical setting. MATERIALS AND METHODS: The analysis included data of 610 subjects aged 55.0812.68 years who received olokizumab at a single dose of 160 mg/mL 0.4 mL subcutaneously as a preemptive anti-inflammatory therapy. The comparison group included 511 subjects aged 55.2311.23 years who received standard therapy without IL-6 inhibitors. Control Endpoints: 1. Positive clinical changes on Day 7. 2. Changes in the CRP levels on Days 1, 2, and 7. 3. Duration of oxygen therapy. 4. Number of days in hospital. 5. Number of adverse events. 6. Disease outcome. RESULTS: If a cytokine storm occurs, immune regulatory events will trigger the development of either a protective immune response or an exacerbated inflammatory response. The use of preemptive anti-inflammatory therapy has both a short-term and, most importantly, a long-term effect on the T and B parts of the immune process. These aspects definitely require further research and observation. CONCLUSION: The use of olokizumab to treat the new COVID-19 coronavirus disease has demonstrated a positive effect on clinical and laboratory parameters. Primarily, it affects the severity of clinical parameters by improving the general condition already on the first day of observation, and decreasing body temperature to normal values. The changes in the C-reactive protein levels show a significant effect of the IL-6 inhibitor on the systemic inflammatory response.

[The activity of enzymes in lymphocytes of children and adults with chronic viral hepatitis B and C].

It is established that in patients with chronic viral hepatitis B and C the intensity of reaction is increased in lymphocytes of children as compared with adults. The study also established the limitation of turning out of substrates for macromolecular synthesis and the decrease of activity of reactions of tricarbonic acid cycle at the expense of decreasing of substrates flow from amino-acid metabolism included. Under chronic hepatitis C, in lymphocytes the levels of activity of enzymes involved in functioning of main metabolic paths and glutathione system of antioxidant defense of are decreased in children as compared with adults.

[The role of immunopathological factors in severe forms of insulin-dependent diabetes mellitus]. / Rol' immunopatologicheskikh faktorov pri tiazhelykh formakh insulinozavisimogo sakharnogo diabeta.

Immunogrammes of 31 patients with grave forms of insulindependent diabetes mellitus were reviewed. The illness has been characterized as a systemic immunopathologic process combining autoimmune and infectious-and-allergic components realized by organ and tissue abnormalities; it evolves against the manifest background of allergy of both delayed anl immediate types, impairement of the humoral and cell-mediated immunity function, pathogenetic activity of endogenous proteases, the complement system components and interferon.

[Role of hereditary factors in the formation of secondary insulin dependence in patients with type II diabetes mellitus]. / Rol' nasledstvennykh faktorov v formirovanii vtorichnoi insulinzavisimosti u bol'nykh sakharnym diabetom II tipa.

A total of 389 patients with diabetes mellitus were examined. A genetic analysis has shown a most high possibility of diabetes in the sibs of patients with type II diabetes and secondary insulin dependence. The authors put forward a hypothesis that secondary insulin dependence formation in diabetics with type II condition results from interactions of two gene complexes with a recessive effect, responsible for types I and II diabetes mellitus development. They suggest a model of age-dependent epistasis with an 'insulin-dependence' gene quantitative effect.

[Short- and long-term results of intensive insulin therapy in patients with severe forms of diabetes mellitus type I]. / Neposredstvennye i otdalennye rezul'taty intensivnoi insulinoterapii bol'nykh s tiazhelymi formami sakharnogo diabeta I tipa.

Short- (3-4 week) and long-term (1-4 yrs) results of the use of intensive insulin therapy schemes were used in 37 patients with severe forms of type I diabetes mellitus. Its beneficial effect on metabolism, remaining secretory beta-cell function, the frequency and expression of hypoglycemic reactions, manifestations of peripheral and visceral neuropathy, diabetic encephalopathy was proved.

[Role of the time factor in the pancreatic and extrapancreatic mechanisms of action of glibenclamide]. / Znachenie vremennogo faktora v realizatsii pankreaticheskogo i vnepankreaticheskogo mekhanizmov deistviia glibenklamida.

A study was made of the effect of short- and long-term administration of one of the sulfanilurea derivatives of the 2nd generation--glibenclamide on pancreatic beta-cell function and the sensitivity of peripheral tissues to insulin under clinical and experimental conditions. The authors established time correlation of the mechanisms of glibenclamide hypoglycemic action: beta-cytotropic action in acute administration of the drug and extrapancreatic influence in chronic administration. An idea of predominant significance of the postreceptor level in the realization of the extrapancreatic effect of long-term administration of glibenclamide was substantiated.

[Age-related pathomorphism of diabetes mellitus]. / K voprosu o vozrastnom patomorfoze sakharnogo diabeta.

Insulin supply of the body, activity of hormonal and nonhormonal insulin antagonists were studied and compared in subjects of different age with disordered carbohydrate tolerance. The role of hormonal and non-hormonal antagonists in the genesis of glucose intolerance was found to be different in different age periods in the presence of hyperinsulinemia and the reduced insulin-glucose index common to all the groups examined. Young age is marked by a distinct increase in glucocorticoid and, to a less degree, in androgenic functions of the adrenals. The elderly manifest activation of the angiotensin-renin-aldosterone system and more pronounced hypercholesterolemia and triglyceridemia in the presence of the changed body sensitivity to insulin. It is suggested that age-associated changes in the mechanisms of the glucose homeostasis control may be of importance in the formation of the features of individual patterns of diabetes mellitus.

[Clinical characteristics and hormonal-metabolic homeostasis in patients with insulin-dependent diabetes mellitus with stable and labile courses]. / Osobennosti kliniki i gormonal'no-obmennogo gomeostaza u bol'nykh insulinozavisimym sakharnym diabetom pri ego stabil'nom i labil'nom techenii.

Combined examination of 117 patients with insulin-dependent diabetes mellitus revealed the clinical and hormonal features of stable and labile diseases. Emphasis is laid on the complexity of the lability phenomenon; evidence is given for the necessity of differentiating between genuine lability and that of the iatrogenic type. The importance of hormonal shifts (depletion of the secretory capability of the insulin-producing apparatus and reduction of contrainsular effects) for the origin of destabilization of glucose homeostasis is discussed.

[Adrenal cortex glucocorticoid function in the early stages of the development of different forms of diabetes mellitus]. / Gliukokortikoidnaia funktsiia kory nadpochechnikov na rannikh stadiiakh razvitiia raznykh form sakharnogo diabeta.

An increase in the basal cortisol level in the blood plasma or the adrenal cortex reaction to insulin hypoglycemia was seen in patients in the early periods of diabetes mellitus (latent, initial manifest type). No considerable differences were found between the adrenals of juvenile and adult diabetic patients. Combined diabetes mellitus and obesity led to a significant rise in the indices studied. An intensification of the adrenocortical glucocorticoid function is not accompanied by an enhancement of the hypophysis adrenocorticotropic function.

[Various characteristics of energy metabolism in diabetes mellitus]. / Nekotorye osobennosti énergoobespecheniia organizma pri sakharnom diabete.

In the blood of patients (104) with diabetes mellitus of various severity some energy metabolic indices (lactate, pyruvate, nonesterified fatty acids, and in some patients also glycogen and glycogenolytic activity of the blood), tissue oxygen tension and immunoreactive insulin were studied simultaneously. The glycogen content, a and b phosphorylase activity were determined in the liver and the skeletal muscles, and lactate, glycogen, and pyruvate in the blood of animals with experimentally induced diabetes mellitus (alloxan and immune diabetes). Changes in the energy metabolism were revealed in all forms of diabetes mellitus: in hyperinsulinism accompanying early forms of diabetes mellitus there was activation of anaerobic processes and tissue hyperoxygenation, and at the late stages of the disease a tendency to tissue hypoxia. Experimental diabetes was accompanied by glycogen reduction in the skeletal muscles together with the growth of b phosphorylase activity. This could be due to the reduction of glucose-6-phosphate in the muscles and to a disturbed activity of the other systems regulating glycogen metabolism.