[Gastroesophageal variceal bleeding in cirrhotic patients: the possibilities of effective hemostasis]. / Varikoznye pishchevodno-zheludochnye krovotecheniia pri tsirroze pecheni: vozmozhnosti éffektivnogo gemostaza.

AIM: To improve the results of treatment of gastroesophageal variceal bleeding (GEVB) in cirrhotic patients with thrombocytopenia. MATERIAL AND METHODS: A total experience of the clinic includes 338 GEVB patients, endoscopic variceal ligation (EVL) and transjugular intrahepatic portosystemic shunt (TIPS) were performed in 162 and 157 cases respectively. Nevertheless, just the efficacy of initial pharmacological hemostatic therapy was analyzed. RESULTS: Administration of serotonin adipinate 30-50 mg/day during 3-5 days in addition to standard initial therapy allowed us to achieve permanent hemostasis during initial treatment if EVL was impossible. Serotonin adipinate induces thrombocytes' adhesion and improves fibrin clot strength. This therapy markedly decreases mortality (33.3% vs 46.7%), incidence of recurrent bleeding (46.4% vs 60.0%). Also it contributes successful hemostasis with endoscopic ligation and effective portal decompression by TIPS procedure.

[EFFICIENCY OF SEROTONIN ADIPINATE IN INTESTINAL DYSFUNCTION IN PATIENTS AFTER COLORECTAL OPERATIONS].

We performed a retrospective analysis of case histories of acute colonic obstruction due to colon cancer A total of 291 patients were divided on two groups: 1--a control group (patients presenting risk of developing intestinal dysfunction with 'basic' therapy, n = 123); 2--the comparison group (n = 57) represented patients who were taken to optimize the post-operative period with the inclusion in the scheme of the basic treatment of serotonin adipinate. The use of serotonin adipinatein treatment of intestinal dysfunction allows fully restore bowel motility to 3rd day.

[Regional anesthesia and timely treatment for neuropathy in patients with pyonecrotic forms of the diabetic foot].

Regional anesthesia was studied for its impact on the functional status of a peripheral nerve in 20 patients with purulent diseases of the lower extremities in the presence of diabetes mellitus. The impact of conservative therapy on the peripheral nerve was also studied in these patients. There was no negative impact of regional methods of anesthesia on the function of the nerve, its improvement due to treatment with alpha-lipoic acid and serotonin adipinate.

[A revised classification of hypoxic conditions]. / Utochnenie klassifikatsii gipoksicheskikh sostoianii.

The precised classification of circulatory hypoxia described in the paper is principally different from those published earlier by that it discriminates between hypoxia preconditioned by impaired cardiac-muscle constriction, on the one hand, and hypoxia due to malfunctions of smooth muscles (SM), on the other hand. The genesis of SM malfunctions is predetermined by impaired interactions of serotonin with SM serotonin receptors. The clinical use of serotonin adipinat reduces the local organic and total-tissue hypoxia in different pathologies and provides for better treatment results. The mentioned precised classification can be used to gain more data on the tissue-hypoxia pathogenesis and to schedule the clinical-and-experimental research on the purpose-oriented basis.

[The treatment of critical lower limb ischemia using serotonin]. / Lechenie kriticheskoi ishemii nizhnikh konechnostei s ispol'zovaniem serotonina.

This paper describes the first experience with conservative treatment of 30 men suffering from critical lower limb ischemia using serotonin as an agent which may return endogenous vasomotility to normal and eliminate tissue hypoxia. Good and satisfactory results were obtained in 76% of patients (43 and 33% respectively). Deterioration followed by amputation was marked in 7% of patients. The removal or considerable abatement of rest pains was recorded in 86% (53 and 33% respectively) of cases. Amputation was performed in 10% of patients. It is recommended that serotonin adipinate should be included into multiraodality therapy of atherosclerotic critical lower limb ischemia. The use of the treatment method suggested will allow to improve the treatment results, to reduce the number and level of amputations, and to minimize the percentage of disability.

[Prophylaxis and treatment of serotonin insufficiency in surgical patients]. / Profilaktika i lechenie serotoninovoi nedostatochnosti u khirurgicheskikh bol'nykh.

The authors demonstrate that appearance in blood of chemical substances (ligands) capable to bind with serotonin receptors of smooth muscles (SM) leads to serotonin insufficiency. Intravenous injection of serotonin adipinat corrects serotonin insufficiency (biochemical stage) which leads to restoration of disordered function of SM (pharmacological stage). Normal function of SM eliminates functional intestinal obstruction (from the first hours after surgery), vascular insufficiency, tissues hypoxia (clinical stage) in surgical patients with different diseases. Serotonin adipinat was used in more than 900 surgical patients. It is concluded that this drug is a necessary component of prophylaxis and treatment of functional intestinal obstruction, vascular insufficiency, local and regional tissues hypoxia.

[Serotonin and serotonin receptors in the genesis of stress and adaptation]. / Serotonin i ego retseptory v geneze stressa i adaptatsii.

The paper presents a current concept of the genesis of stress and adaptation with regard to new data on serotonin and its receptors. There is evidence that stress is transient hypoxia that results from dysfunction of smooth muscles (SM) in the microcirculatory bed (a pharmacological stage) with partial or complete dysfunction of the organ or system where dysfunction has occurred (a clinical stage). Impaired interaction of serotonin with GM serotonin receptors, which occurs with excess serotonin receptor ligands due to various stress factors, underlie the pharmacological and clinical manifestations of stress. The occurrence of transient hypoxia is followed by the activation of antistress (adaptive) processes in the organism with thrombocytic release of serotonin. In endogenous hyperserotoninemia, microcirculation improves, a hypoxic area ceases, and/or damaged and necrotic tissues localize. With this, endogenous serotonin-induced recovery of different organs is the essence of an adaptive process. Clinical and experimental evidence suggesting that exogenous serotonin administration just simulates an elevation in the concentration of endogenous serotonin as a material substrate of the human adaptive system.

[Ultrastructural changes in gastroduodenal mucosal cells in patients with perforating ulcer and effect of serotonin adipinate on their postoperative rehabilitation]. / Ul'trastrukturnye izmeneniia kletok slizistoi obolochki zheludka i dvenadtsatiperstnoi kishki u bol'nykh s perforativnoi iazvoi i vliianie serotina adipinata na dinamiku ikh reabilitatsii v posleoperatsionnom periode.

Consideration is given in the paper to the state of the mucosal cell ultrastructure in the gastroduodenal zone in patients with perforating ulcer. Apparent inflammatory-degenerative type ultrastructural alterations have been found to be precent in the gastric and duodenal mucous coat in the zone of perforating ulcer. The above alterations are noted to persist by day 10 in these postsurgical patients having been administered conventional treatments. The use of serotonin adipinate promotes earlier restoration of the ultrastructural picture in the mucous coat of the gastroduodenal zone.

[The effect of serotonin on the healing of an experimental stomach ulcer following vagotomy]. / Vplyv serotoninu na zahoiuvannia eksperymental'noï vyrazky shlunka za umov vahotomiï.

On the model of gastric ulcer induced by stress with subsequent trunk vagotomy in rats it is shown that exogenic serotonin induces increased concentrations of serotonin in the gastric tissues, among them in the region of ulcer's defect, decreased amounts of histamine and increased serotonin-histamine indexes, and also promotes calming down of inflammatory phenomena and optimization of reparative processes in the region of ulcer.

[The concept of the clinical use of serotonin adipinate in treating surgical patients]. / Kontseptsiia klinicheskogo primeneniia serotonina adipinata pri lechenii khirurgicheskikh bol'nykh.

The influence of serotonin adipinate on the mechanisms of development of tissue hypoxia, disturbances of the microcirculatory bed and smooth muscles before, during and after operative interventions was studied in experiments and clinical practice. The syndrome of serotonin insufficiency is described including smooth muscle insufficiency which can be abolished by serotonin adipinate administered at the early postoperative period irrespective of the cause of surgery, age and sex of the patient. Good results were obtained in treatment of patients after operations on the liver, pancrease, heart, in patients with the diabetic foot and in other diseases. No complications or lethal outcomes resulting from using serotonin adipinate were noted.

[Use of serotonin adipinate in combined therapy of hemodynamic disorders in acute poisoning by psychopharmacological preparations]. / Primenenie serotonina adipinata v kompleksnoi terapii narushenii gemodinamiki pri ostrykh otravleniiakh psikhofarmakologicheskimi preparatami.

Serotonin adipinate in a dose of 40-60 mg was injected by drip infusion to 30 patients with acute poisoning by psychotropic drugs for correcting circulatory disorders. The drug corrected hemodynamic disorders in the lesser and greater circulation by increasing the stroke volume and normalizing total peripheral vascular resistance and central blood volume.

[Use of serotonin for treatment of patients with diabetic angiopathies]. / Primenenie serotonina dlia lecheniia bol'nykh s diabeticheskimi angiopatiiami.

In 26 patients (female 11, males--15) with diabetic angiopathy (necrosis of the foot or toes) local measurement of pO2 by transcutaneous mode was carried out before and during introduction of serotonine adipinate. Simultaneously with evaluation of pO2 in 14 patients electromyography (EMG) was made. Serotonine adipinate was introduced intravenously with a speed of 5.0-10.0 mg per hour. In this group mean age of the patients made up 57.4 years, mean values of initial pO2 25.6 mm Hg, and mean indices of pO2 at the moment of serotonine treatment 38.5 mm Hg. Average increase of pO2 during serotonine infusion was registered as 50.4% in comparison with mean initial data. In all 14 patients, who underwent simultaneous measurement of pO2 and registration of EMG, reinforcement of electrical activity of smooth muscles (SM) of various intensity and increase in tissue pO2 were detected. Improvement of microcirculation (increase of transcutaneous pO2, reinforcement of electrical activity of SM as a result of serotonine introduction) evidences that functional and morphological changes of serotonine receptors of SM are involead in genesis of diabetic angiopathy. The data obtained showed that in diabetes mellitus, besides insulin deficiency, insufficiency of such an endogenous factor as serotonine duclops. Thus, serotonin should be used for prophylaxis and treatment of diabetic angiopathies.

[Use of serotonin adipinate in acute oral poisoning]. / Primenenie serotonina-adipinata pri ostrykh peroral'nykh otravleniiakh.

Ninety-five patients with acute poisonings with psychotropic agents, barbiturates, amitriptyline, leponex, cholinolytics, and organophosphorus insecticides were treated by gastro-enteroadsorption making use of activated coal. In order to enhance propulsive function of the gastrointestinal tract, serotonin adipinate was repeatedly administered in a dose of 5 to 20 mg. Evacuation of the enteroadsorbent in the rectum was enhanced fivefold in comparison with a control group of similar patients administered traditional drugs (proserine, pituitrin, cerucal). As a result of such therapy, the toxicogenic phase of poisoning was shortened and mortality in the observed group reduced twofold in patients poisoned with psychotropic agents, 5.4 times in those with barbiturate poisoning, and 3.5 times in those with organophosphorus poisoning.

[Curative activity of spiramycin adipate by parenteral route in experimental septicemia in mice. Comparison with orally administered basic spiramycin]. / Activité curative de l'adipate de spiramycine utilisé par voie parentérale dans la septicémie expérimentale de la souris. Comparaison avec la spiramycine base administrée par voie orale.

Experimental septicemia was induced in mice by intraperitoneal injection of 10 to 100 lethal doses of Staphylococcus aureus and Streptococcus pneumoniae. Animals were treated by a mixture of adipic acid and spiramycin (subcutaneous route) or by spiramycin base (oral route), 1 and 6 hours after infection. To determine the effective dose 50% that achieves survival of half the mice after 7 days, each drug was used in 6 dosages (mg/kg) and each dosage was given to 12 mice. In 21 independent experiments, ED50S of spiramycin adipate by the subcutaneous route were found to be 5 to 50 times lower than those of spiramycin base per os. These results are consistent with the high serum peak concentrations of spiramycin adipate observed following subcutaneous administration.

Evaluación comparativa entre ácido kaínic, santonina y adipato de piperazina solos y asociados como antihelmínticos: terapétuica y tolerancia / Comparative evaluation between kainic acid, santonine and piperazine adipate alone and combined as antihelminthes: therapeutics and tolerance

Se estudió a la población escolar de una zona endémica para geohelmintiasis mediante estudios coproparasitoscópicos, utilizando el método de flotación. Se seleccionaron con 200 pacientes que presentaban parasitosis por Ascaris lumbricoides, Trichuris trichiura y uncinaria. En un estudio posterior se valoraron por el método de frotis fecal de Kato Katz, además de realizar tres estudios por el método de raspado anal con cinta de celulosa engomada. Los pacientes se dividieron en cinco grupos y se les administró en una sola dosis: grupo 1, santonina a concentración de 66.6 mg/10 ml; grupo 2, adipato de piperazina a concentración de 1333.2 mg/10 ml, grupo 3, ácido Kaínico a concentración de 6.6 mg/10 ml; grupo 4, combinación de santonina 33.3 mg/10 ml, piperazina 666.6 mg/10 ml y ácido Kaínico 3.3 mg/10 ml, y grupo 5, adipato de piperazina a concentración de 2666.4 mg/10ml. Posterior al tratamiento se practicaron nuevamente los exámenes mencionados a manera de control. Los resultados demostraron que la combinación de ácido Kaínico, piperazina y santonina es mejor en el control de la helmintiasis que los fármacos utilizados en forma independiente

[Blood mineral (Ca, Mg, Na K, Pa) levels and aspartate aminotransferase, leucine aminopeptidase, creatine phosphokinase and alkaline phosphatase activity and blood glucose levels in cattle with hypomagnesemia prior to and following infusion of a 500 ml solution containing 60 g of Mg adipate and 60 g of Ca gluconate]. / Untrsuchungen über den Gehalt an Mineralstoffen (Ca, Mg, Na, K, Pa) und über die Aktivität der Aspartataminotransferase, der Leuzinaminopeptidase, der Kreatinphosphokinase und der Alkalischen Phosphatase im Blutserum sowie über den Gehalt an Glukose im Blutplasma von Rindern mit Hypomagnesämie vor und nach Infusion einer Lösung mit je 60 g Mg-Adipat und Ca-Glu-konat in 500 ml.

The levels of various compounds in blood serum and blood plasma were tested in 14 heads of cattle with hypomagnesiaemia (x = 0.76 +/- 0.29 mg/100 ml), prior to and following infusion of 500 ml of a calcium-magnesium solution (containing 60 g of magnesium adipate and 60 g of calcium gluconate). Concomitant hypocalcaemia (6.1 mg/100 ml) was recordable only from one animal. Most of the potassium as well as all Pa and protein values in blood serum were physiologically normal, while sodium ws somewhat reduced. The glucose level in blood plasma was increased in the animal with concomitant hypocalcaemia and in one animal with poor recovery potential. The drops in magnesium and calcium levels in blood serum, following infusion, in cattle with hypomagnesiaemia was very similar to that in clinically intact cattle. Aspartate-aminotransferase and creatinine-phosphokinase activities of the serum were increased in all cattle, but leucine-aminopeptidase activity in only some of them. The activity of alkaline phosphatase of the blood serum was physiologically normal.