[Endoscopic and morphometric analysis of the reduction of acute inflammatory process in the gastric mucosa after therapy with Regasthym Gastro].

AIM: To analyze the anti-inflammatory efficacy of Regasthym Gastro (alpha-glutamyl-tryptophan) in the treatment of patients with chronic atrophic gastritis according to endoscopic and morphometric studies. MATERIALS AND METHODS: As part of a double-blind placebo-controlled study, the results of gastroscopy and histological (morphometric) studies were retrospective analyzed in 80 patients diagnosed with chronic atrophic gastritis associated with Helicobacter pylori in exacerbation: 43 patients took Regasthym Gastro, 37 patients - placebo. The conclusions of the gastroscopy were structured in the form of a standardized scale, which included an assessment of criteria in points (from 0 to 3): thickness of folds, hyperemia, edema of the gastric mucosa, the signs of atrophy, metaplasia; the severity of the erosive process. The sum of points according to all criteria was used to assess the dynamics of the inflammatory process: positive dynamics; lack of dynamics; the pathological process is progressing. The results of the endoscopic examination were compared with morphometry data (the number of inflammation pool cells per 1 mm2 of gastric mucosa). Statistical processing of the results was carried out using the Statistica 12 application software package. RESULTS: According to the gastroscopy, before therapy, hyperemia of the gastric mucosa was present in 82.5%, edema - in 53.8%, erosion - in 17.5%, signs of metaplasia - in 12.5% of patients. After therapy with the investigated drug a statistically significant decrease in the severity of edema of the gastric mucosa (p=0.008), the total set of signs of acute inflammatory process (p=0.006), a decrease in the proportion of outcomes with negative dynamics of the inflammatory process (p=0.038) was revealed. Statistically significant (p<0.05) correlations were found between gastroscopy data of inflammation and the number of neutrophil, eosinophil granulocytes, macrophages and lymphocytes per 1 mm2. CONCLUSION: Regasthym Gastro contributes to a significant decrease in the severity of the inflammatory process according to the evaluation of the results of gastroscopy and morphometry. It is possible to recommend the inclusion of this drug in the complex therapy of chronic gastritis to increase the effectiveness and reduce the risks of progression of inflammation.

[Substantiation of the drug «Cytoflavin¼ application and cognitive-behavioral therapy in complex treatment of deforming coxarthrosis in elderly patients.]

The article presents the results of a study of the effectiveness of the addition of a standard course of conservative therapy to 104 patients of the older age group with coxarthrosis deforming the drug «Cytoflavin¼ and cognitive-behavioral therapy courses. It was found that such scheme increases the effectiveness of therapeutic interventions, which manifests itself as the improvement of the mental and physical components of quality of life by reducing pain and increasing the functionality of some of the affected hip. At the heart of positive clinical effect is a decrease in processes of inflammation and reduction of tension of regulatory processes in the organism.

[SUBSTANTIATION OF INDICATIONS FOR BIOFEEDBACK THERAPY AND CYTOFLAVIN APPLICATION IN TREATMENT OF OSTEOCHONDROSIS NEUROLOGICAL COMPLICATIONS IN ELDERLY PATIENTS].

The aim of the study was to assess the impact of cytoflavin and bioflavin therapy on the dynamics of clinical and psychophysiological status of patients with Osteochondrosis. 150 patients with osteochondrosis of a backbone were investigated. The patients were divided into two groups using method of randomization: the main group - 75 patients - and control group -75 patients. All patients received a standard treatment (non-steroidal anti-inflammatory drugs, myorelaxants, chondroprotectors, as well as physiotherapy). The main group in addition to standard treatment received biofeedback therapy and cytoflavin. The results showed that cytoflavin and biofeedback therapy significantly enhanced the positive effect of standard treatment and significantly increased the quality of life of patients. It is recommended to treat elderly patients with neurological complications of spinal osteochondrosis with Cytoflavin in combination with biofeedback therapy Before prescribing biofeedback therapy and Cytoflavin it is necessary to take into account a number of positive and negative predictors of their effectiveness in reducing severity of pain syndrome.

SURGICAL PREVENTION AND TREATMENT OF POSTOPERATIVE HYPOPARATHYROIDISM IN PATIENTS OPERATED ON THYROID GLAND.

The objective of the research was to develop and evaluate the algorithm of prevention and treatment of postoperative hypoparathyroidism (PHPT) based on determining parathyroid glands (PTG) viability and the use of antihypoxant-antioxidant therapy in the postoperative period. The research was based on the results of a comprehensive examination and treatment of 60 patients who were operated for thyroid gland diseases. The patients underwent inpatient treatment at the surgical department of Ivano-Frankivsk Central City Clinical Hospital and Ivano-Frankivsk Regional Oncology Center from 2015 to 2017. We proposed an algorithm for surgical prevention and treatment of PHPT during thyroid gland surgeries which consisted in the following. We performed a visual assessment of PTG intraoperatively and evaluated each gland from 0 to 3 points according to the degree of its viability affection. If the gland was evaluated at 0-2 points, we left it in situ, since there was a high probability of maintaining its function. If it was evaluated at 3 points, its autotransplantation was performed. Cytoflavin drug was applied in a dose of 10 ml per 200 0.9% NaCl intravenously once a day during 7 days in the postoperative period for the purpose of antihypoxant-antioxidant therapy. 2 groups of patients were formed in order to evaluate the effectiveness of the algorithm. Each group consisted of 30 people. Patients of Group I underwent surgery on thyroid gland according to generally accepted rules. Patients of Group II underwent interventions according to the above-mentioned algorithm. The use of our proposed algorithm (intraoperative assessment of PTG viability and antihypoxant-antioxidant therapy in the postoperative period) significantly reduces the frequency of permanent PHPT justifying indications to its application.

[Clinical efficacy of the immunomodulatory agent cycloferon (tablets) in viral respiratory infections: Results of a systematic review and meta-analysis]. / Klinicheskaia éffektivnost' immunomoduliatora tsikloferona (tabletki) pri virusnykh infektsiiakh organov dykhaniia: rezul'taty sistematicheskogo obzora i metaanaliza.

The authors carried out a systematic review and subsequent meta-analysis of randomized clinical trials evaluating the efficacy of the immunomodulator agent cycloferon as tablets in adults and children with viral respiratory diseases. A total estimate of its clinical efficacy was obtained in terms of compared heterogeneous groups and response variables. The data published in 16 articles were used to calculate the formal parameters of the clinical efficacy of cycloferon (increased absolute and relative benefits, odds ratio (OR); the number of patients needed to be additionally treated with cycloferon to achieve a favorable outcome or to prevent a poor outcome in one patient, etc.). High heterogeneity hampered the unequivocal interpretation of results; however, combining the compared homogeneous groups in the meta-analysis (with adjustments for fixed and random effects) increased the statistical power of the investigation. In children aged 6 to 18 years, the OR for the positive effect of the drug (no new cases after its preventive administration) was 5.3 (95% confidence interval (CI), 4.8-5.9), heterogeneity test, χ2 = 249.5; p=0.000...; I2 = 94.8% (95% CI, 92.7-96.3%). This suggested the heterogeneity of clinical trial data and extrapolated this estimate to medical practice. The use of cycloferon in adults to treat acute respiratory viral infection enhanced their chances of enduring the disease in a mild form and avoiding serious complications: the OR for positive outcomes was 9.7 (95% CI, 7.0-13.0), while the effect was more homogeneous than in children (heterogeneity test, χ2 = 7.4; p=0.061...; I2 = 59.4% (95% CI, 0-86.5). Thus, the use of cycloferon to treat and prevent acute viral respiratory infections showed a more than 5-fold increase in the probability of avoiding the disease or enduring the latter in a mild form.

[Evaluation of bio-inverse communication and Cytoflavin effects on the dynamics of the clinical and psychophysiological condition of elderly patients with osteochondrosis].

We conducted a study of 150 patients on the basis of polyclinic № 91 in St. Petersburg. The effect of Cytoflavin and bio-inverse communication therapy on the dynamics of the condition of elderly patients with osteochondrosis was evaluated. A number of positive effects from such an addition to existing therapy, potentiating the nominal effect, were revealed.

[Effect of the Cytoflavin on the distal polyneuropathy severity in patients with diabetic foot syndrome with arteries mediacalcinosis]. / Vliianie tsitoflavina na vyrazhennost' distal'noi polineiropatii u bol'nykh sindromom diabeticheskoi stopy s mediakal'tsinozom arterii.

The aim of the study was to evaluate the effectiveness of cytoflavin in the complex treatment of patients with diabetic foot syndrome. MATERIAL AND METHODS: The research is based on the results of a comprehensive survey of 140 people with diabetic foot syndrome. Depending on the treatment, all patients were divided into 2 groups. The first group (n=35) received basic therapy. The second group (n=35) in addition to basic therapy received cytoflavin 10 ml (+200 ml 0.9% NaCl) for 10 days, followed by switching to the tablet form of the drug 2 tablets twice a day for 1 month. RESULTS: Analyzing the severity of polyneuropathy after treatment, we noted a more positive dynamic in patients who in addition to standard therapy received cytoflavin.

[EFFICACY OF CYTOFLAVIN IN COMPLEX TREATMENT OF DIABETIC FOOT SYNDROME].

The study involved 97 patients with severe diabetic foot syndrome (DFS) subcompensated type 2 diabetes. All patients were available mediacalcification foot and lower leg arteries of different severity. Depending on the treatment, all patients were divided into 2 groups by stratified randomization. The І group received standard therapy, which is indicated for the DFS. A ІІ group of patients additionally received basic therapy drug Cytoflavin 10 ml 0,9% NaCl 200 ml for 10 days, followed by transfer to tablet form Cytoflavin 2 tablets 2 times per day orally for one month. We noted a positive trend of treatment of patients who, in addition to standard therapy received the drug Cytoflavin. Thus, the use of complex surgical treatment of patients with mixed form of DFS Cytoflavin reduces the severity of distal polyneuropathy, improves oxygenation of tissues and restores the enzyme activity of antioxidant system, that manifested neuroprotective, antioxidant and anti-hypoxic effects of drugs, which substantiates the indications for its use in the this pathology.

[Peculiarities of clinical and psychophysiological status of elderly patients with osteochondrosis.]

We conducted a study of 220 patients in polyclinic № 91 in St. Petersburg. It was revealed that elderly patients with osteochondrosis are characterized by a high prevalence and severity of osteochondrosis against the background of metabolic disorders in the structures of the spine. At the same time, the actual condition of the spine does not always determine the severity of the pain syndrome. The effect of osteochondrosis on the development of comorbid pathology has been clarified. The ways of correction of the clinical and psychophysiological status of elderly patients with osteochondrosis such as appointment of Cytoflavin, behavioral therapy and biofeed back therapy are suggested.

[Cytoflavin rationale for the use in treatment of patients with postsurgical hypothyroidism]. / Obosnovanie primeneniya tsitoflavina v kompleksnom lechenii bol'nykh s posleoperatsionnym gipoparatireozom.

The aim of the study was to assess the effectiveness of cytoflavin inclusion in complex treatment of patients with hypoparathyroidism occurring after thyroid surgery. To do this, an analysis of treatment of 54 patients who received surgical treatment for thyroid diseases of various etiologies. Depending on the scheme of post-operative medical therapy, the patients were divided into 2 groups: group I patients (27 persons) received basic therapy according to regulatory documents, II of the group (27 patients) in addition cytoflavin intravenous drip of 10 ml to 200 ml 0.9% NaCl for 7 days. In addition to standard clinical and laboratory examination, all patients were studied and the level of active ionized Ca2+ and PTH, oxidation products of the modified protein, lipid peroxidation and antioksidazation system dynamics - 1, 3 and 7 days after surgery. It was revealed that in the first days after the surgical treatment of patients significantly reduced the levels of ionized Ca2+ and PTH that may be regarded as signs of postoperative hypoparathyroidism, as well as the activation of the system of lipid peroxidation and antioxidant system depression. Turning cytoflavin in drug regimens improved the efficiency of the treatment, which was manifested in arresting to 7 days of monitoring signs of hypoparathyroidism, improve tissue oxygenation and restoring the balance by reducing the activity of the system of lipid peroxidation and antioxidant system strengthening.

EXPERIMENTAL ASSESSMENT OF THE SPECIFIC EFFICIENCY OF NEW METABOLIC DRUG RUNIKHOL ON MODELS OF NON-ALCOHOLIC FATTY LIVER DISEASE.

We present results of preclinical evaluation of the specific efficiency of new metabolic corrector runikhol on models of non-alcoholic fatty liver disease in laboratory rats (228 albino males of gray Wistar rats weighing 220 - 240 g). The drug based on succinic acid positively influences the key types of metabolism impaired under conditions of development of the metabolic syndrome. Results of research testify to high efficiency and good prospects of using runikhol in the treatment of metabolic syndrome accompanied by organ disorders.

[Biological Functions of Succinate (a Review of Foreign Experimental Studies)].

The published data on the modern concept of the biological role of succinate, an intermediate of the citric acid cycle are analysed in the review. Special interest to succinate is determined by investigations on the mitochondrial functions at different pathologies, discovery of the hypoxia-inducible factor HIF-1 and studies on the human genome, that resulted in detection of the G-protein coupled receptors, which selectively are bound with succinate. According to the published experimental data, besides participation in oxidative reactions, succinate is considered as a key contributor to physiological, metabolic and genetic processes.

[AGE-SPECIFIC METABOLIC THERAPY FOR ALCOHOL DEPENDENCE IN ELDERLY PATIENTS WITH REGARD TO THEIR AKMEOLOGICAL FEATURES].

Aocoholism in the elderly determines tne protracted nature or tne pathological craving for etnanol in post-abstinence syndrome period, restricts arsenal of active pharmacotherapy and updates the search for new pharmacological therapeutic strategies. The results showed that the inclusion of the drug "Remaxol" in the treatment of clinical manifestations of craving for ethanol in post-abstinence syndrome period of associated forms of alcoholism in the elderly provides better in relation to conventional therapy dynamics of reduction of somatovegetative and neurological manifestations of alcohol withdrawal syndrome, as well as the main components of craving for alcohol, will increase the efficiency of outpatient treatment at the stage of remission. The duration of remission of mental and behavioral disorders caused by alcohol use in elderly patients is, apart from pharmacotherapy, due to such social and psychological factors and akmeological features as education, leadership potential, high social activity, a high level of social intelligence and its implementation, lack of intense intrapersonal conflict, high ductility and activity.

[The structure of psychopathology associated with addictive disorders, against alcohol addiction and the possibility of its neurometabolic correction of the elderly].

The article considers the actual problem in modern medicine, the study of psychiatric symptoms associated with addictive disorders on the background of alcohol abuse in the elderly. It is shown that neurotic pathology in elderly patients with alcohol dependence is characterized by the presence of six major symptoms, reflecting the excitation processes, overcoming compensation, deficit symptoms, irritation and stabilization of the pathological state. It is proved that Cytoflavin, maintaining a certain level of excitement in the cerebral cortex, provides the optimal voltage of compensatory mechanisms in older people in overcoming their psychiatric symptoms, connected with addictive disorders.

[Citoflavin in the complex therapy of elderly patients with alcohol dependence syndrome]. / Tsitoflavin v kompleksnoi terapii bol'nykh pozhilogo vozrasta s sindromom alkogol'noi zavisimosti.

Objective. Alcoholism in the elderly age determines the protracted nature of the pathological craving for ethanol in post-abstinent period, limits the arsenal of active pharmacotherapy and updates the search for new pharmacological therapeutic strategies. Authors studied the efficacy of cytoflavin in the outpatient complex therapy of post-abstinent disorders. Material and methods. One hundred and seven patients, mean age 64.4±8.5 years, with transition (II-III) stage of alcoholism (F10.2 in CD-10) were examined. A battery of psychometric scales was administered. Results. The effect of cytoflavin on affective, somato-autonomic and neurological manifestations of alcohol withdrawal syndrome and craving for ethanol was found. Conclusion. The findings suggest that cytoflavin provides a significantly more efficient reduction of psychopathological symptoms of alcohol addiction in elderly patients.

[Results of analysis of clinical effectiveness of cytoprotectors used in therapy of widespread forms of psoriasis].

The authors report comparative analysis of the efficacy of cytoprotectors and basal therapy used to treat widespread forms of psoriasis. Combination of both modalities including remaxol and ademetionine increases the effectiveness of the treatment by 23% as appears from the decrease of PASI of 89.6% patients from 23.6 +/- 2.2 to 5.7 +/- 2.2 scores.

[The structure of psychopathology associated with addictive disorders, against alcohol addiction and the possibility of it's neurometabolic correction in the elderly].

The article presents the analysis of the structure and dynamics of psychopathology associated with addictive disorders in elderly patients with alcohol dependence. In terms of syndromic approach the structure of neurotic disease in elderly patients with a verified diagnosis of mental and behavioral disorders associated with alcohol consumption was evaluated. In the overall structure of neurotic pathology in these patients the analysis of symptoms of neurotic diseases, the research of the structure of syndromes and their dynamics were carried out, as well as the patient's attitude to the disease and to its manifestations was determined. A factor model of the pathogenesis of neurotic pathology connected with mental and behavioral disorders due to alcohol use in elderly patients was developed. The high clinical effectiveness of the drug "Cytoflavin" used in the reduction of psychiatric symptoms in patients aged from 62 to 74 years with a diagnosis of mental and behavioral disorders associated with alcohol consumption has been shown.

[Features of psychopharmacotherapeutic correction of alcohol dependence in the elderly].

The article is devoted to the actual in modern medicine problem as the study of the prevalence of alcohol dependence and its psyhofarmacological correction in the elderly. It is shown that elderly and old age as a result of reduction of the reserve capacity of the organism for clinical pathology becomes addictive specific psychopathological features that affect the course of disease and maintenance of preventive treatment. On the basis of empirical evidence the authors prove that at the border severity of alcohol withdrawal syndrome the drug "Cytoflavin" has a fairly pronounced psyhofarmacological activity for older people with alcohol dependence.

[Antihypoxants in current clinical practice].

Hypoxia is a universal process accompanying and determining the development of various pathological conditions. In the most general form hypoxia can be defined as the incompatibility between energy requirements of the cell and energy production in the system of mitochondrial oxidative phosphorylation. The energetic status of the cell can be improved by such pharmacological products as antihypoxants of 5 groups: inhibitors of fatty acid oxidation, succinate-containing and succinate-producing agents, components of the natural respiratory chain, artificial redox-systems, and macroergic compounds. This paper is focused on the mechanisms of action of these products, their major effects, and results of clinical studies. Special emphasis is laid on succinate-containing products combining properties of a balanced polyionic solution and an antihypoxant (reamberin, cytoflavin, remaxol). They are known to be effective against various pathological conditions including ischemic stroke, toxic, hypoxic and dyscirculatory encephalopathies, infectious diseases, posthypoxic lesions in the central nervous system of newborns, various intoxications), etc.

[Comparative evaluation of reamberin and mafusol on acute toxic liver damage models].

Comparative evaluation of the infusion of reamberin and mafusol has been carried out on the model of toxic liver damage caused by ammonium chloride. Reamberin contributed to more rapid normalization of indices due to an increase in the substrate reserve for energy metabolism. In a group of animals with alcohol intoxication, only the treatment with Reamberin allowed the system of antioxidant protection (reduced glutathione, thiol groups) and functional activity of the liver to be to normalized by the end of experiments on a level of the control group (intact animals).