[Bioregulatory drug Newrexan in the treatment of anxiety and dissomnia. Resolution of the Council of Experts (June 8, 2023)]. / Bioregulyatsionnyi preparat N'yureksan v lechenii trevozhnosti i dissomnii. Rezolyutsiya Soveta ekspertov (8 iyunya 2023 g.).

Bioregulatory drug Newrexan in the treatment of anxiety and dissomnia. Resolution of the Council of Experts.

Predictors of atrial fibrillation in patients with ischemic stroke of undetermined etiology.

Aim    To identify a complex of predictors and to create a mathematical model for prognosis of atrial fibrillation (AF) in patients with ischemic stroke of undetermined etiology. Material and methods    The study included 981 patients with ischemic stroke. Effects of the following factors were evaluated: gender, a history of stroke, a history of thromboembolism, presence of diabetes mellitus, grade of arterial hypertension, functional class (FC) of chronic heart failure (CHF), age, data of blood biochemistry, and data of coagulogram. The prognostic model was constructed using the binary logistic regression. The value of area under the ROC curve for the proposed prognostic model was calculated.Results    The main predictors of AF in patients with ischemic stroke of undetermined etiology were CHF FC, a history of stroke, age, gender, values of cholesterol and prothrombin index, which were included into the final prognostic model. The sensitivity of the developed model was 83.5 % and the specificity was 85.5 %. The area under the ROC curve corresponding to the interrelation between the prognosis of AF and the regression function value was 0.921±0.012 with 95 % confidence interval: 0.898-0.944.Conclusion    According to the results of the study, the probability of AF in patients with ischemic stroke increased with CHF progression, recurrent stroke, older age, female gender, and reduced prothrombin index and cholesterol level.

[Possibilities of improving the effectiveness of therapy in patients with chronic cerebral ischemia against the background of COVID-19]. / Vozmozhnosti povysheniya effektivnosti terapii patsientov s khronicheskoi ishemiei golovnogo mozga na fone COVID-19.

OBJECTIVE: To study the possibility of improving the efficacy of treatment with mexidol in COVID-19 patients with chronic cerebral ischemia (CCI). MATERIAL AND METHODS: Three hundred and four patients with CCI and COVID-19 were observed, group 1 (n=152) consisted of patients receiving basic therapy and mexidol, group 2 (n=152) received only basic therapy. Mexidol was administered intravenously for 14 days, 500 mg (10 ml) per 400 ml of saline solution, then Mexidol FORTE 250 was administered in a dose of 250 mg 3 times a day for 2 months. The state of cognitive functions (MoCA scale), sleep (Spiegel questionnaire), asthenia (MFI-20 scale), and quality of life (SIP questionnaire) were evaluated. Examinations were performed before treatment, 30 and 75 days after start of treatment. RESULTS: In group 1, there was a more complete and earlier recovery of the state of cognitive functions (an increase in indicators on the MoCA scale, p<0.01), a regression of asthenia (p<0.05), and normalization of sleep (p<0.01). By the end of the study, there were significantly more patients in group 1 with complete or significant recovery of all quality of life indicators. CONCLUSION: Long-term sequential therapy with mexidol provides a more complete recovery of impaired functions in patients with CCI and COVID-19.

[Treatment of a neglect syndrome in movement rehabilitation of stroke patients]. / Osobennosti korrektsii sindroma neglekta pri osushchestvlenii dvigatel'noi reabilitatsii patsientov s polusharnym insul'tom.

AIM: To increase the efficiency and improvement of rehabilitation in patients with a neglect syndrome after stroke. MATERIAL AND METHODS: The results of treatment of 750 stroke patients, 396 women and 354 men, aged from 30 to 82 years, average age 63.4 years, were analyzed. An influence of cortexin on removal of the neglect syndrome, functional rehabilitation, increase in daily life activities and quality of life was studied. All patients were divided into two matched-controlled groups, receiving and not receiving cortexin. The functional rehabilitation was followed up using Barthel, Lindmark, Scandinavian and Merton and Sutton scales, MMSE and MoCA scales for assessment of cognitive functions, Sickness Impact Profile for quality of life. Moreover, the efficacy was evaluated by absence of signs of neglect syndrome. RESULTS: The combined rehabilitation with the use of cortexin helps to remove the neglect syndrome and improve the functional rehabilitation of stroke patients. CONCLUSION: Use of cortexin during rehabilitation in stroke patients with a neglect syndrome is justified and expedient for the increase of its efficiency that permits to recommend this drug for wide use in clinical practice.

[Theoretical and practical principles of neurorehabilitation in post-stroke patients]. / Teoreticheskie i prakticheskie printsipy neiroreabilitatsii patsientov, perenesshikh insul't.

This article is devoted to the basic principles of organization and carrying out the rehabilitation of patients with severe neurological diseases. Theoretical and practical aspects and prerequisites of effective rehabilitation are considered. An analysis of neurological dysfunctions due to focal brain's damages is important for the general organization of rehabilitation and for carrying out different methods of rehabilitation. Characteristics of multidisciplinary management of patients with severe neurological diseases are considered. Advantages and risks of early rehabilitation, and characteristics of passive verticalization are discussed.

[Dose-dependent effects of cortexin in chronic cerebral ischemia (results of a multicenter randomized controlled study)]. / Dozozavisimoe deistvie korteksina pri khronicheskoi ishemii mozga (rezul'taty mnogotsentrovogo randomizirovannogo kontroliruemogo issledovaniia).

AIM: To study an effect of cortexin on neurological symptoms and oxidative stress as part of the ischemic cascade in chronic cerebral ischemia (CCI), I-II stages. MATERIAL AND METHODS: The multicenter randomized controlled study included 189 patients with CCI, 42 (22.2%) men and 147 (77.8%) women, mean age 64.3±0.5 years. Patients were randomized into three groups. Group 1 received intramuscular injection of 20 mg of cortexin, group 2 received 10 mg of cortexin; group 3 received basic treatment only. The duration of treatment was 10 days, the treatment course was repeated after 6 months. The patients were examined at baseline and during treatment (in total 5 times). Along with clinical and neurological examinations, some scales and tests ('Fedin Outpatient scale of chronic brain ischemia', MFI-20, Spiegel sleep scale, the Zung self-rating depression scale, Spielberger's inventory, the clock-drawing test, the 5-word test) were used. The severity of oxidation stress was assessed by the content of reduced SH-groups and total superoxide dismutase activity. RESULTS AND CONCLUSION: A dose-dependent effect of cortexin on the severity of neurological disorders, asthenia, sleep disturbance was shown. Antidepressant and anxiolytic effects were insignificant and were determined after repeated courses of the drug. The laboratory data confirmed the antioxidant effect regardless of the dose of cortexin. The safety and good tolerability of the drug were shown.

[Rehabilitation of stroke patients]. / Reabilitatsiya patsientov posle insul'ta.

The present article is devoted to the problems of the organization and carrying out of rehabilitation in post stroke patients. The features of stroke patient's management with the help of multidisciplinary team are discussed. Main principles and rules of physical, psychotherapeutic and medication rehabilitation are reviewed.

[Therapeutic possibilities of improvement of cognitive functions, psychoemotional condition and a quality of life in post-stroke patients].

OBJECTIVE: To study an influence of cytoflavin on normalization of cognitive functions, psychoemotional condition and a quality of life in stroke patients. MATERIAL AND METHODS: It was analysed the results of treatment of 1450 stroke patients. The cognitive functions was followed up using MMSE and MoCA scales, psychoemotional condition--Beck Depression Questionnaire and Wakefield Depression Scale, Hamilton Scale of Anxiety, quality of life--Sickness Impact Profile. RESULTS AND CONCLUSION: The results of the study revealed that the use of cytoflavin was well founded in the treatment of stroke patients for improvement of cognitive functions, psychoemotional condition and the quality of life.

[The possibilities of increase of efficacy of rehabilitation of stroke patients with neglect syndrome].

OBJECTIVE: To evaluate different treatment schemes for post stroke patients with neglect syndrome (NS). MATERIAL AND METHODS: We studied management rules for patients with NS and the effect of ceraxon (citicoline) on the functional rehabilitation and removal of the neglect syndrome. We analyzed treatment results of 120 stroke patients. The functional rehabilitation was followed up using Barthel, Lindmark and Merton and Sutton scales, cognitive functions were assessed with the MMSE scale and the battery of frontal dysfunction, psychoemotional condition with the Beck Depression Questionnaire. Moreover, treatment efficacy has been evaluated by the absence of NS signs. RESULTS AND CONCLUSION: Maintenance of management rules and use of ceraxon improved the functional rehabilitation of stroke patients with NS.

[Treatment of cognitive and psychoemotional disorders in poststroke patients].

OBJECTIVE: To evaluate the efficacy of the drug sermion (nicergoline) in poststroke patients with cognitive and psychoemotional disorders. MATERIAL AND METHODS: The study included 880 patients, including 440 patients with depression and 440 with cognitive impairment, mean age of patients was 69,6 years. The restoration of cognitive functions was followed up using MMSE scales, psychoemotional condition was assessed with the Beck Depression Questionnaire and the Wakefield Depression Scale. RESULTS AND CONCLUSION: The efficacy of sermion has been demonstrated. Application of this drug in the rehabilitation of stroke patients significantly contributes to the improvement of cognitive functions and normalization of mental and emotional state of patients.

[Evaluation of efficacy and safety of mydocalm in the early rehabilitation of stroke].

An effect of mydocalm on muscle tone and functional rehabilitation in 1700 stroke patients (mean age 63,4 years) has been studied. Patients have been divided into two standardized groups: the basic group (850 persons who received mydocalm) and control one (850 persons who didn't receive mydocalm). The muscle tone was followed up using the Ashworth Scale, pain syndrome was assessed with the Huskisson visual analog scale and a multidimensional verbal-color pain test. The functional rehabilitation was evaluated using Barthel, Lindmark, Scandinavian and Merton & Sutton scales. Psychoemotional condition was assessed with the Beck Depression Questionnaire and the Wakefield Depression Scale, quality of life was measured by the Sickness Impact Profile. The results of the study have revealed that the use of mydocalm result in the improvement of muscle tone, decrease of pain syndrome, increase of functional rehabilitation and improvement of psychoemotional condition and the quality of life of post stroke patients. The findings of the study have demonstrated the good tolerability of mydocalm. Adverse events in the mydocalm group have been identified more rarely than in the control group.