[THE USE OF "REAMBERIN" AS BIOLOGICAL RESPONSE MODIFIER TO INCREASE THE NATURAL KILLER CELLS' CYTOTOXICITY IN PATIENTS WITH LUNG TUBERCULOSIS]

The effect of the drug "Reamberin" cytotoxic activity of natural killer cells (EC) in an experimental model in the blood samples of patients with pulmonary tuberculosis and healthy donors. Simulation acute systemic inflammation by adding to the culture medium of BCG. After 48 hours, selection was performed mononuclear peripheral blood by gradient centrifugation tests set cytotoxic tumor cell line K-562. Revealed the stimulating effect of the drug "Reamberin" cytotoxic activity of natural killer cells. Metabolic Correction has had a positive impact on the energy metabolism of blood natural killer cells, to increase their survial and cytotoxicity.

Safety and efficacy of sonographically guided high-intensity focused ultrasound for symptomatic uterine fibroids: preliminary study of a modified protocol

OBJECTIVES

We aimed to assess the safety and efficacy of sonographically guided high-intensity focused ultrasound for treating patients with symptomatic uterine fibroids using a modified protocol.

METHODS

This work was part of an ongoing prospective phase 1 study. Twenty patients with 22 symptomatic fibroids were treated with sonographically guided high-intensity focused ultrasound under no anesthesia. The modified protocol consisted of repeated and shortened (<25 minutes) treatment sessions of high-input acoustic intensity (1000-1500 W/cm(2)) and intensified sonication pulses (1500-2000) at each spot. The primary end points were periprocedural complications. The secondary end points were symptomatic improvement and radiologic evidence of treatment responses, including the degree of fibroid infarction and volume shrinkage 3 months after treatment. Symptomatic improvement was assessed by a pain score, a pictorial chart menstrual score, the Urogenital Distress Inventory short form, and the Incontinence Impact Questionnaire short form. The degree of fibroid infarction was assessed by the nonperfused ratio on contrast-enhanced magnetic resonance imaging, defined as the ratio of the nonperfused fibroid volume to the total fibroid volume.

RESULTS

Nineteen patients tolerated the treatment well, with no major adverse events. One patient who received treatment for a fibroid located within 6 cm from the skin had third-degree skin burns at 2 sites of 1 cm in diameter. Fibroid-related abdominal pain, pictorial chart, Urogenital Distress Inventory, and Incontinence Impact Questionnaire scores were significantly improved (P < .05). The median nonperfused ratio at 3 months was 20% (95% confidence interval, 5%-32.5%). Median volume shrinkage at 3 months was 17.2% (95% confidence interval, 4.3%-26.6%).

CONCLUSIONS

Sonographically guided high-intensity focused ultrasound using a modified protocol may be safe and effective for symptomatic uterine fibroids in selected patients to avoid skin burns.

[The morphofunctional state of the liver and the possibilities of pharmacotherapy for its disease in small bowel obstruction]

OBJECTIVE

To study the results of liver morphological studies in 40 Vietnamese pot belly pigs with simulated small bowel obstruction.

MATERIALS AND METHODS

Liver morphofunctional changes in acute strangulation ileus were investigated in an experiment on 40 Vietnamese pot belly pigs weighing 15-20 kg. Five animals were used as a control.

RESULTS

In simulated acute ileus, the found morphofunctional changes in hepatocytes were characterized by toxic dystrophy of the organ with the signs of secondary hepatitis.

CONCLUSION

During the experiment, the course of the disease and surgical restoration of small bowel patency have been found to be accompanied by significant histological and ultrafine structural disorders of the liver, which is a rationale for intensive antihypoxant, antioxidant, and hepatoprotective therapy in the pre- and postoperative periods.

[Correction of early liver dysfunction in patients with acute small bowel obstruction]

Conducted a comprehensive examination and surgical treatment for acute obstruction of the small intestine (SI). It is established that, both before and after surgery to restore patency of SI is a significant violation of the functional state of the liver. This became the basis for the appointment of antioxidant therapy in the complex standard treatment. Using the solution reamberin promotes effective correction protein syntesis function disorders of the liver, reduces the severity of inflammation and stagnation in the hepatocytes, the severity of endogenous intoxication and the incidence of postoperative complications.

[SODIUM SUCCINATE AS METHOD OF INTENSIVE CARE OPTIMIZATION OF NEWBORNS' MULTIORGAN FAILURE SYNDROM]

With the aim of ascertainment of pathogenesis of newborns' multiorgan failure syndrom it was made a research of lactat, pyruvate, urea containing and succinatedehydrogenase activity of newborns venous blood with sequences to perinatal infection and perinatal asphyxia. Was set the reliable increase of concentration of lactat, pyruvate and their ratio, that demonstrates the presence of cellular energy deficit. There was direct correlation communication between concentrations of pyruvate and urea. In the application of sodium succinate to reduce the content of lactic and pyruvic acids, their ratio, increase the activity of succinatedehydrogenase, which is evidence of improved mitochondrial energy production, as well as reduces the frequency of gastrointestinal insufficiency implementation.

[Metabolic and organ protective properties of various infusion solutions and the choice of starting therapy in the pre-admission stage of acetic acid poisoning]

MATERIALS AND METHODS

We conducted an open prospective study in 60 patients (30 men and 30 women) with acetic acid poisoning. A randomization was performed on the groups, taking into account the tactics of infusion therapy: group I--15 patients who did not receive an infusion therapy at a pre-admission stage; group II--15 patients who received the infiusion therapy with solution of sodium chloride 0.9%; group III--15 patients who received the infusion therapy with modified gelatin (Gelofusinwn), group IV-15 patients who received the infusion therapy with reamberinum.

RESULTS

We found that the most favorable results were noted in patients of group IV in the early posttraumatic period.

[INFLUENCE OF REAMBERIN® AND CYCLOFERON® ON CONCETRATION OF "AVERAGE MOLECULES" IN SERUM OF PATIENTS WITH RECCURENT DEPRESSIVE DISORDERS IN OUTPATIENT OBSERVATION]

The influence Reamberin® and Cycloferon® concentration "average molecules" in the serum of patients with the recurrent depressive disorders (RDD) was investigated. It was set that the use of these drugs helps to normalize the concentration of "average molecules". which indicates that the elimination of the syndrome of "metabolic" intoxication. Based on the data, we can consider it appropriate inclusion Reamberin® and Cycloferon® in the therapeutic treatment of patients with RDR.

Use of oral gadobenate dimeglumine to visualise the oesophagus during magnetic resonance angiography in patients with atrial fibrillation prior to catheter ablation

BACKGROUND

Atrio-oesophageal fistula was first reported as a fatal complication of surgical endocardial and percutaneous endocardial radiofrequency ablation for atrial fibrillation, with an incidence after catheter ablation between 0.03% and 0.5%. Magnetic resonance angiography (MRA) was usually performed to obtain pre-procedural 3D images, used to merging into an electro-anatomical map, guiding step-by-step ablation strategy of AF. Our aim was to find an easy, safe and cost-effective way to enhance the oesophagus during MRA.

METHODS

In 105 consecutive patients, a right-left phase encoding, free breathing, 3D T1 MRA sequence was performed in the axial plane, >24 hours before catheter ablation, using an intravenous injection of gadobenate dimeglumine contrast medium. The oesophagus was enhanced using an oral gel solution of 0.7 mL gadobenate dimeglumine contrast medium mixed with approximately 40 mg thickened water gel, which was swallowed by the patients on the scanning table, immediately before the MRA sequence acquisition.

RESULTS

The visualisation of the oesophagus was obtained in 104/105 patients and images were successfully merged, as left atrium and pulmonary veins, into an electro-anatomical map, during percutaneous endocardial radiofrequency ablation. All patients tolerated the study protocol and no immediate or late complication was observed with the oral contrast agent administration. The free-breathing MRA sequence used in our protocol took 7 seconds longer than MRA breath-hold conventional sequence.

CONCLUSION

Oesophagus visualization with oral gadobenate dimeglumine is feasible for integration of oesophagus anatomy images into the electro-anatomical map during AF ablation, without undesirable side effects and without significantly increasing cost or examination time.

Mixed antimony(V) complexes with different sugars to modulate the oral bioavailability of pentavalent antimonial drugs

Previous studies have shown that the association of the drug meglumine antimoniate (MA) with β-cyclodextrin can improve its bioavailability by the oral route. In this work, ribose and maltose were investigated for their ability to form mixed or association complexes with MA, release MA and modulate the serum levels of Sb after oral administration in mice. Analysis of the MA/ribose composition by high performance liquid chromatography coupled to mass spectrometry (LCMS-IT-TOF) revealed the presence of mixed meglumine-Sb-ribose and Sb-ribose complexes. Analysis of the MA/maltose composition suggested the formation of MA-maltose association compounds. Circular dichroism characterization of these compositions following dilution in water at 37 °C suggested a partial and slow dissociation of the association compounds. When the MA/ribose composition was administered orally and compared to MA, the serum concentration of Sb was significantly lower after 1 h and greater after 3 h. On the other hand, the MA/maltose composition showed similar serum Sb concentration after 1 h and higher level of Sb after 3 h, when compared to MA. In conclusion, the present study has demonstrated the formation of mixed or association complexes of MA with sugars, such as maltose and ribose, which promoted sustained serum level of Sb after oral administration.

Meglumine exerts protective effects against features of metabolic syndrome and type II diabetes

Metabolic syndrome, diabetes and diabetes complications pose a growing medical challenge worldwide, accentuating the need of safe and effective strategies for their clinical management. Here we present preclinical evidence that the sorbitol derivative meglumine (N-methyl-D-glucamine) can safely protect against several features of metabolic syndrome and diabetes, as well as elicit enhancement in muscle stamina. Meglumine is a compound routinely used as an approved excipient to improve drug absorption that has not been ascribed any direct biological effects in vivo. Normal mice (SV129) administered 18 mM meglumine orally for six weeks did not display any gastrointestinal or other observable adverse effects, but had a marked effect on enhancing muscle stamina and at longer times in limiting weight gain. In the established KK.Cg-Ay/J model of non-insulin dependent diabetes, oral administration of meglumine significantly improved glycemic control and significantly lowered levels of plasma and liver triglycerides. Compared to untreated control animals, meglumine reduced apparent diabetic nephropathy. Sorbitol can improve blood glucose uptake by liver and muscle in a manner associated with upregulation of the AMPK-related enzyme SNARK, but with undesirable gastrointestinal side effects not seen with meglumine. In murine myoblasts, we found that meglumine increased steady-state SNARK levels in a dose-dependent manner more potently than sorbitol. Taken together, these findings provide support for the clinical evaluation of meglumine as a low-cost, safe supplement offering the potential to improve muscle function, limit metabolic syndrome and reduce diabetic complications.

[Gerontological trends of contemporary forms of alcohol dependence. Approaches to full compensation and rehabilitation]

Quality of life has already been investigated in elderly patients with alcohol dependence. Indicators were deteriorated with long-term experience of alcohol and somatic diseases. Practice of Reamberin, Cytoflavin, Cycloferon has improved quality of life and physical status of elderly patients.

[Induction of type 1, 2 and 3 interferons by acridone acetates]

The induction profile of endogenous interferons of three types under the action of meglumine acridone acetate and sodium acridone acetate, as well as the characteristics of the kinetics of their accumulation and circulation in the blood of experimental animals are described. Meglumine acridone acetate provided balance in induction, production and circulation of the interferons in the blood vs. sodium aeridone acetate under the same conditions. The optimal dose of meglumine acridone acetate (2.0-3.5 mg/mouse) with effective, consecutive and overlapping induction-production of the interferons ensured their prolonged (for 72 hours) circulation in the blood after a single administration.

[Capabilities of pharmacological correction with Reamberin the cerebrovascular disorders with ENT diseases of the elderly patients]

Endointoxication's syndrome and manifestations of immune deficiency observed among elderly patients with acute exacerbations of ENT diseases and concomitant cerebrovascular pathology. Reamberin in pathogenetic therapy arrests manifestations of intoxication and optimizes immunobiological homeostasis.

[The use of succinate-containing preparations in combine therapy of diffuse toxic goiter]

We studied dynamics of hormonal status, lipid peroxidation, protein oxidative modification, enzymatic activity of the antioxidative system in the patients with newly diagnosed diffuse toxic goiter (Graves' disease). It was shown that the use of succinate-containing antioxidant reamnberin accelerates normalization of hormonal status and free radical oxidation; it reduces the duration of hospitalization.

[Reamberin optimizes drug therapy in children with acute Epstein-Barr viral infection]

The efficacy of a 1.5% reamberin solution possessing detoxicating, antihypoxant, antioxidant, and membrane-protective properties, used as a component of the complex infusion therapy in children with acute Epstein-Barr virus infection, has been estimated. The dynamics of the inflammatory process in children treated by the drug complex including reamberin is characterized by rapid relief of general symptoms, improvement of state, and reduction in length of the febrile period of disease as compared to patients treated with glucose-saline solutions and basic therapy. The administration of reamberin in children contributed to the early elimination of metabolic shifts by the period of convalescence, as evidenced by improvement in some laboratory parameters, including protein-synthesis function of the liver.

Cutaneous leishmaniasis "chiclero's ulcer" in subtropical Ecuador

An 18-year-old female presented with a severe ulcerative lesion on her right ear of 6 weeks duration. Her right ear was edematous and erythematous with a large, painless ulcerative lesion covering a third of the pinna and satellite papular lesions on the posterior. She was diagnosed with chiclero's ulcer. A skin smear stained with Diff-quik showed abundant Leishmania parasites. Chiclero's ulcer is a rare clinical presentation and is typically severe and difficult to treat. Physicians in Ecuador recommend administering prolonged intramuscular Glucantime. Side effects are common and can be severe resulting in low patient compliance. Because of preferences of the patient and the large volume needed for her weight, we recommended topical treatment with a lotion of Glucantime mixed half and half with white Merthiolate. After applying this lotion to the lesion 3 to 4 times a day for 6 weeks, the lesion healed.

Generic sodium stibogluconate is as safe and effective as branded meglumine antimoniate, for the treatment of tegumentary leishmaniasis in Isiboro Secure Park, Bolivia

Human cutaneous leishmaniasis (CL) and mucous leishmaniasis (ML) are highly endemic in Isiboro Secure Park, which lies in the Bolivian department of Cochabamba--an area where branded meglumine antimoniate (Glucantime) is expensive and poorly distributed. The safety and efficacy of generic sodium stibogluconate (SSG), from Albert David Ltd, was therefore explored, in CL and ML cases from the park, who were treated with 20 mg/kg.day for 20 and 30 days, respectively. A questionnaire recording adverse effects was completed by a physician in each treatment centre. Efficacy of treatment was assessed at the end of treatment and at follow-ups 1 month and 3, 6 and 12 months later. Overall, 146 patients completed treatment with SSG in 2003-2004. No fatalities or severe adverse effects were reported but mild to moderate adverse effects were noted in 41 (28%) of the patients. The incidence of adverse effects was significantly higher among the cases of ML than among the cases of CL. Of the 86 patients with CL who completed 6 months of follow-up, 81 (94.2%) were considered to have been clinically cured; a comparable cohort of 69 CL cases who had been treated with Glucantime in 2001-2002 showed a similar frequency of clinical cure (90%). Generic SSG was shown to be safe and efficacious for the treatment of tegumentary leishmaniasis in Bolivia. Being several times cheaper than Glucantime, it could contribute to improving the access of CL and ML patients to treatment, not only in Bolivia but also in other countries of Latin America.

Dressings combined with injection of meglumine antimoniate in the treatment of cutaneous leishmaniasis: a randomized controlled clinical trial

BACKGROUND

Cutaneous leishmaniasis (CL) is a neglected infectious disease and a major health problem in several developing countries. Despite some reasonable explanation for their potential benefits, there is only trace evidence regarding the role of dressings in the treatment of CL.

METHODS

This randomized, assessor-blind, controlled, clinical trial was conducted in an endemic area for CL caused by Leishmania major in Iran to assess the efficacy of administration of weekly intralesional meglumine antimoniate (i.l.MA) either alone or combined with application of a silver or a non-silver polyester dressing on their lesions for 6 weeks. After screening of 241 patients with CL lesions, 83 eligible patients with 158 lesions were randomly allocated in three arms of the study. Eligibility criteria included parasitologically confirmed CL, age of 12 to 60 years; willingness to participate, duration of lesion<3 months, number of lesions<5, largest ulcer diameter<5 cm. Pregnant or lactating women were excluded. The primary outcome was absolute risk reduction (ARR) based on the proportion of complete healing, which was defined as more than 75% reduction in the size of the lesion compared with baseline in each group at the termination of treatment and 1 month later.

FINDINGS

ARR (95% Confidence Interval [CI]) in i.l.MA versus i.l.MA+non-silver dressing groups was 5.98% (-7.07% to 20.25%), between i.l.MA versus i.l.MA+silver dressing groups was -0.23% (-13.53% to 14.82%), and between i.l.MA+non-silver dressing versus i.l.MA+silver dressing groups was -6.21%(-18.28% to 6.52%) after 6 weeks of treatment. ARR (95% CI) in i.l.MA versus i.l.MA+non-silver dressing groups was -2.22% (-22.12% to 18.10%), between i.l.MA versus i.l.MA+silver dressing groups was 3.64% (-15.36% to 22.82%), and between i.l.MA+non-silver dressing versus i.l.MA+silver dressing groups was 5.86% (-12.86% to 24.31%) 1 month later.

CONCLUSION

It could not be demonstrated that the efficacy of i.l.MA was improved by either dressing.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials (IRCT.ir) IRCT138707201166N2.

[Estimation of clinical-pathogenetic efficiency of reamberin and cycloferon application in patients with the severe form of acute tonsillitis]

Efficiency of reamberin and cycloferon application combination at the patients with the heavy form of acute tonsillitis was investigated. It is set that cycloferon and reamberin application in the complex of treatment of the patients with this pathology is instrumental in normalization of the general state and feel of patients, liquidation of both commontoxic syndrome and local inflammatory displays in pharynx, and also normalization of the studied biochemical and immunological indexes. Application of cycloferon and reamberin provides the decline of "average molecules" and malon dialdehyde level to norm, that testifies about liquidation endogenous "metabolic" intoxication syndrome, and also instrumental in normalization of phagocytes activity of monocytes indexes, that describe normalize operating of the indicated preparation on the macrophage phagocytes system.

Dynamic and static magnetic resonance angiography of the supra-aortic vessels at 3.0 T: intraindividual comparison of gadobutrol, gadobenate dimeglumine, and gadoterate meglumine at equimolar dose

PURPOSE

The purpose of this study was the intraindividual comparison of a 1.0 M and two 0.5 M gadolinium-based contrast agents (GBCA) using equimolar dosing in dynamic and static magnetic resonance angiography (MRA) of the supra-aortic vessels.

MATERIALS AND METHODS

In this institutional review board-approved study, a total of 20 healthy volunteers (mean ± SD age, 29 ± 6 years) underwent 3 consecutive supra-aortic MRA examinations on a 3.0 T magnetic resonance system. The order of GBCA (Gadobutrol, Gadobenate dimeglumine, and Gadoterate meglumine) was randomized with a minimum interval of 48 hours between the examinations. Before each examination and 45 minutes after each examination, circulatory parameters were recorded. Total GBCA dose per MRA examination was 0.1 mmol/kg with a 0.03 mmol/kg and 0.07 mmol/kg split for dynamic and static MRA, respectively, injected at a rate of 2 mL/s. Two blinded readers qualitatively assessed static MRA data sets independently using pairwise rankings (superior, inferior, and equal). In addition, quantitative analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) evaluation as well as vessel sharpness analysis of static MRA using an in-house-developed semiautomated tool. Dynamic MRA was evaluated for maximal SNR. Statistical analysis was performed using the Cohen κ, the Wilcoxon rank sum tests, and mixed effects models.

RESULTS

No significant differences of hemodynamic parameters were observed. In static MRA, Gadobutrol was rated superior to Gadoterate meglumine (P < 0.05) and equal to Gadobenate dimeglumine (P = 0.06) with good to excellent reader agreement (κ, 0.66-0.83). In static MRA, SNR was significantly higher using 1.0 M Gadobutrol as compared with either 0.5 M agent (P < 0.05 and P < 0.05) and CNR was significantly higher as compared with Gadoterate meglumine (P < 0.05), whereas CNR values of Gadobutrol data sets were not significantly different as compared with Gadobenate dimeglumine (P = 0.13). Differences in CNR between Gadobenate dimeglumine and Gadoterate meglumine were not significant (P = 0.78). Differences in vessel sharpness between the different GBCAs were also not significant (P > 0.05). Maximal SNR in dynamic MRA using Gadobutrol was significantly higher than both comparators at the level of the proximal and distal internal carotid artery (P < 0.05 and P < 0.05; P < 0.05 and P < 0.05).

CONCLUSIONS

At equimolar doses, 1.0 M Gadobutrol demonstrates higher SNR/CNR than do Gadobenate dimeglumine and Gadoterate meglumine, with superior image quality as compared with Gadoterate meglumine for dynamic and static carotid MRA. Despite the shortened bolus with Gadobutrol, no blurring of vessel edges was observed.

Shoulder sonography after intraarticular fluid injection for evaluation of anterior labral tears: comparison with conventional sonography

PURPOSE

To compare shoulder sonography (US) after intraarticular fluid injection ("arthrosonography") with conventional shoulder US for diagnosing anterior labral tears.

METHODS

Thirty consecutive patients who were to undergo shoulder MR arthrography were enrolled after written informed consent was obtained. A radiologist performed conventional US, using a 2- to 5-MHz convex transducer on the subject whose arm was externally rotated, then abducted perpendicular to the trunk, and rotated internally and externally. After intraarticular injection of diluted gadolinium contrast for MR arthrography, arthrosonography was performed in the same manner as in the conventional method. Two other radiologists compared the two US methods in the diagnosis of anterior labral tears using a five-point scale. Receiver operating characteristic (ROC) curves and weighted kappa values were calculated.

RESULTS

Fourteen patients proven to have anterior labral tears by arthroscopy constituted the disease group, and 16 patients, including the 4 patients who were negative on arthroscopy, constituted the normal group. The areas under the ROC curve of arthrosonography (mean, 0.977) were larger than those of conventional US (mean, 0.858). The kappa values for assessing the interobserver agreement of the two modalities were 0.40 and 0.82, respectively.

CONCLUSIONS

Arthrosonography of the shoulder is more accurate and reliable than conventional US for diagnosing anterior labral tear.

[Effect of 3-oxypyridine and succinic acid derivatives on clinical manifestations of inflammatory diseases of the uterus and its appendages]

Two-week-long, prospective, placebo-controlled, single-blind randomized study of the effects of intravenous emoxipin (150 mg daily), reamberin (400 ml daily) and mexidol (300 mg daily) infusion on the dynamics of clinical symptoms of non-complicated recrudescence of inflammatory diseases of the uterus and its appendages (IDUA) in comparison to the standard therapy was performed. It was established that emoxipin, reamberin and mexidol administration appreciably improved the clinical state dynamics of women with recrudescence of IDUA. The effect was associated with more pronounced decrease in severity of genital and abdominal symptoms versus standard therapy results.

[Antioxidant properties of remaxol, reamberin, and ademetionine in patients with drug-induced liver injury on the background of antituberculous therapy]

The antioxidant properties of remaxol, reamberin and ademetionine have been studied in comparison to 5 % glucose solution in a group of 120 patients with drug-induced liver injury. It is established that the inclusion of this drugs in the composition of complex therapy contributed to restoration of the antioxidant potential of the cells, which was manifested by increased activity of glutathione peroxidase and superoxide dismutase and integral indices of antioxidant protection (total antioxidant capacity and total antioxidant status) with a relative stabilization of the level of glutathione-S-transferase. Maximum pharmacotherapeutic effect with respect to all of the studiea indices has been achieved by the use of remaxol.

[Acute respiratory viral infection in children: clinical pattern, hemorheology disorders, methods of therapy]

Clinical and laboratory indices of intoxication and hemorheology disorders that arise during acute viral infection in children have been studied. It is established for the first time that reamberine is capable of reducing the plasma and blood viscosity and can be used in the program of infusion therapy of high blood viscosity syndrome in children with acute respiratory viral infections. One of the positive mechanisms of reamberin clinical performance is its positive impact on microcirculation and hemorheology. Thus, reamberin can be considered as a means of pathogenetic therapy in acute period of infectious toxicosis during acute respiratory viral infections in children.

[Reamberin in tuberculosis chemotherapy and its effect on liver function]

The use of reamberin for prophylaxis of side effects was estimated in 257 patients with tuberculosis of the respiratory organs under the chemotherapy. The reference group involved 241 patients treated with the chemotherapeutics alone. Reamberin in the treatment of the patients, including subjects with multidrug resistant Mycobacterium tuberculosis, promoted a 2-fold decrease in the frequency of the intoxication syndrome during the first month of the treatment. Adverse reactions (toxic, allergic) to the antituberculosis chemotherapeuties were 2.4 times less frequent in the patients additionally treated with reamberin. Positive effect of reamberin on the activity of AIAT and AsAT was observed, the effect being higher, when the pathogen was susceptible to the drugs.

The CCKB antagonist CI988 reduces food intake in fasted rats via a dopamine mediated pathway

Studies have shown a reduction of food intake following peripheral and brain injection of CCK. However, it remains to be established whether endogenous central CCK is involved in the regulation of food intake. We investigated the role of central CCK in the regulation of food intake by pharmacological manipulation of the CCK(B) (CCK(2)) receptor system. Intracerebroventricularly (ICV) cannulated male Sprague Dawley rats were fasted for 24h and received an ICV injection of the CCK(B) receptor antagonist CI988 at a dose of 10 nmol or 49 nmol or vehicle. Another group received two consecutive ICV injections consisting of the corticotropin-releasing factor (CRF) receptor-1 (CRF(1)) antagonist, CP376395 (3 nmol) or the CRF(2) receptor antagonist, K41498 (2 nmol) alone, or followed by CI988 (49 nmol). Lastly, another group of rats received an intraperitoneal (IP) injection of the dopamine antagonist, flupentixol (~197 and ~493nmol/kg) alone, or followed by CI988 (49 nmol, ICV). Cumulative food intake was assessed for 11h. Vehicle injected rats showed a robust feeding response. CI988 at 49 nmol reduced food intake by 30% starting at 2h post injection. CP376395 and K41498 had no effect on food intake. Flupentixol injected IP at a dose of 197 and 493 nmol/kg alone did not modulate food intake whereas the higher dose blocked the CI988-induced reduction of feeding. During the dark phase, CI988 had no effect on food intake in unfasted rats. In summary, CCK(B) signaling is involved in the regulation of food intake after a fast likely by downstream dopamine signaling.

[Clinical efficacy of reamberin in drug-addicts with hepatic lesions]

Infusion of 1.5% reamberin solution was shown to be a safe tool for combined therapy of severe viral hepatitis in drug addicts with signs of polyorganic lesions. Reamberin had detoxicating, antioxidative, hepato- and nephroprotective effects associated with clinical improvement, reduced hospital stay and normalized biochemical characteristics. Moreover, it increased the serum antioxidative potential and non-specific resistance of the patients.

[The study of dynamics of clinical and molecular phenotypes in the generalized form of myasthenia with optimized and combined treatment]

The aim of the study was the research of clinical and molecular phenotypes in the generalized form of myasthenia with optimized treantment, which includes the application of basic mode of the treatment and meglumine sodium succinate, and also the combined mode of the treatment, which includes the mode of the treatment and meglumine sodium succinate and ozonotherapy. The most epressed improvement of indicators of the clinical and neurologic status (the eliminaton of motoring breakdown, eye movement disrders, the weaknesses of mimic, respiratory and chewing muscles, bulbar syndrome, the doubling in eye and ptosis, pharyngeal violations and increase in volume of movement of eyes) was observed in the group of patients receiving the combined therapy. The reduction of the epressiveness of the defeat of the neuromotor device and the decrement of the amplitude of the various degree of M-answer in patients with myasthenla is revealed in the application of the combined therapy in the comparison with the application of the basic and optimized therapy. For the first time we have investigaed the dynamics of the intensity of the expression of specfic peptides and proteins in blood serum in patients with the application of basic therapy, reamberin and ozonotherapy, which have allowed to open the new mechanisms of the efficiency ofthe combined therapy of the disease.

[Efficiency of succinic acid infusion solutions in minor surgery]

A group of 66 patients with purulent-septic surgical pathology on the background of type 2 diabetes mellitus (in the compensation phase) and atherosclerosis of vessels in lower extremities (in the decompensation phase) have been studied. The status of all patients has been determined by the syndrome of systemic inflammation reaction (rated 12.4 +/- 2.2 on the APACHE II scale). Group I (n = 30) included 19 men aged 53.7 +/-7.7 and 11 women aged 54.4 +/- 9.1, which were administered reamberin (single daily dose of 500 ml for three days after operation). Group II (n = 36) included 24 men aged 56.1 +/- 9.2 and 12 women aged 51.9 +/- 8.8 with analogous pathology and general status, which received infusion therapy without reamberin. It is established that the administration of reamberin in patients with purulent-septic surgical pathology on the background of type 2 diabetes mellitus and atherosclerosis of vessels in lower extremities is patho-. genetically justified and allows the reperfusion syndrome upon various operations to be prevented and the critical state in post-operation regime to be eliminated.

[Pharmacological prophylaxis of reperfusion syndrome in patients with severe polytrauma accompanied by shock]

A comparative assessment of buffer activity of reamberin and polyoxyfumaren was made. Their influence on systemic consumption of oxygen, content of lactate in blood, parameters of central hemodynamics were followed. The research includes 44 victims (aged 25-70 years) with severe shockogenic injuries. Reamberin was included in composition of fluid therapy of I group (n=30)and polyoxyfumaren was used in 11 group (n=14). Parameters of acid-base balance of arterial blood, VO2, VCO,, contents of lactate in mixed venous blood, parameters of central hemodynamics were measured in monitor regimen before the infusion. It was proved, that the intravenous infusion of reamberin and polyoxyfumaren accompanied by reliable rise of minute consumption of oxygen (27 and 18% respectively). The drugs decrease the lactate level in blood, reliably increase buffer capacity of blood, correct the metabolic acidosis. Both antihy-poxanthines allow the increase of minute volume of circulation: reamberin on 15%, polyoxyfumaren on 34,9%. The volemic effect of polyoxyfumaren resulted in the increase of circular plasma volume after finishing the infusion on 49,5%, in the case of reamberin - on 16%.

[Comparative efficacy of clinical use of reamberin, remaxol and ademethionine in patients with tuberculosis of the respiratory organs and liver drug-injury]

The efficacy ofreamberin, remaxol, S-adenosyl-L-methionine (ademethionine) and 5% glucose solution was estimated in the treatment of patients with tuberculosis of the respiratory organs and drug hepatotoxicity signs confirmed by higher activity of liver indicative enzymes and nitrogen oxide levels. Remaxol showed a pronounced positive effect on the cytolytic syndrome signs, evident from lower activity of alanine aminotransferase and aspartate aminotransferase. At the same time ademethionine was superior to remaxol in the effect on the cholestatic signs and inferior in the effect on the cytolytic signs. By the effect on the activity of alanine aminotransferase and aspartate aminotransferase, reamberin was inferior to remaxol and superior to ademe-thionine, its effect on the cholestasis markers level vs. the other drugs being superior only to that of 5% glucose solution. As compared to reamberin, ademethionine and 5% glucose solution, remaxol promoted higher integral indices of the host antioxidant protection (total antioxidant capacity and total antioxidant status), that partially explained the drug pronounced hepatoprotective effect.

[Effect of 3-oxypyridine and succinic acid derivatives on endometrial leucocyte infiltration and lipid peroxidation in recrudescence of inflammatory diseases of the uterus and its appendages]

The effect of domestic 3-oxypyridine and succinic acid derivatives (emoxipin, reamberin and mexidol) included in the complex treatment of recrudescence of inflammatory diseases of the uterus and its appendages, as manifested in endometrial leucocyte infiltration (ELI) compared to lipid peroxidation products concentration in blood serum, was assessed in a short-term, prospective placebo-controlled single-blind randomized trial. It has been found that two-week infusions of emoxipin (single dose, 150 mg), reamberin (single dose, 400 ml), and mexidol (single dose, 300 mg) favor a decrease in ELI and influence ambiguously on lipid peroxidation - antioxidant (LPA) system condition in blood serum of patients. It has been found that 3-oxypyridine derivative (emoxipin) decreases the intensity of ELI, but does not affect LPA system condition. Succinic acid derivative (reamberin) is inferior to emoxipin in the degree of decreasing ELI, but reduces the concentration of the antioxidant protein ceruloplasmin. Mexidol, being 3-oxipyridine and succinic acid derivative simultaneously, exceeds reamberin in decreasing ELI, increases concentration of blood antioxidant components (alpha-tocopherol and ceruloplasmin), and decreases the level of primary isopropanol-soluble products of lipid peroxidation.

[Efficacy of reamberin for the treatment of acute intestinal infections caused by opportunistic bacteria]

Reamberin was shown to improve the efficacy of the treatment of acute intestinal infections caused by opportunistic bacteria. Its introduction into combined therapy accelerated normalization of the patients' general conditions, improved their well-being, eliminated syndrome of infectious toxicosis, diarrheic and abdominal pain syndromes, decreased duration of postinfectious asthenia, had beneficial effect on biochemical and immune parameters. Reamberin reduced the level of medium-sized molecules and malonic dialdehyde to the upper normal value which suggests elimination of endogenous "metabolic" intoxication syndrome, normalization of the level of circulating immune complexes and their fractional composition. The study showed that introduction of reamberin in combined therapy of acute intestinal infections is pathogenetically justified.

[The immunoregulating action of reamberine and its use in the treatment of duffuse peritonitis]

Influence of reamberin on dynamics of functional condition of mitogen-induced immunocompetent blood cells at patients with widespread purulent peritonitis is studied. It is established that investigated immunocompetent cells have regulating effect on migration of neutrophil leukocytes at widespread purulent peritonitis during all postoperative period. PHA-activated mononuclear cells don't cause inhibition of migration of neutrophil granulocytes, observed in norm. At the same time the LPS-activated monocytes lead to migration strengthening of neutrophil granulocytes, in comparison with the data received in norm. Usage of reamberin at patients with widespread purulent peritonitis renders corrective action on immunocompetent cells, changing their properties of regulation of migratory activity of neutrophil granulocytes. The revealed effects at use of reamberin most expressed by the 7-10th days of the postoperative period.

[Correction of metabolic hypoxia in patients with severe burn injury and septic toxemia]

The clinical efficacy of the preparation reamberin in correction of metabolic hypoxia in patients with severe thermal burn injury under septicotoxemia was studied. It was established high efficacy of the preparation in the correction of the antioxidant defense system, its considerable antitoxic activity. Established role of reamberin in maintaining the functioning of the humoral detoxication systems, and antimicrobial resistance in patients with severe thermal injury.

[Effect of succinate-containing medications on hepatic structural changes in acute experimental cholecystitis]

Histological and electron microscopic changes in the hepatic structure were studied in animals with acute experimental cholecystitis. The administration of the succinate-containing drugs reamberin and mexidole decreased the magnitude of morphological changes in the liver tissue. Morphometric examination revealed that reamberin versus mexidole showed a high efficacy in reducing the area of hepatocytic necrosis.

The protein binding substance ibuprofen does not affect the T1 time or partition coefficient in contrast-enhanced cardiovascular magnetic resonance

BACKGROUND

Contrast enhanced cardiovascular magnetic resonance (CMR) with T1 mapping enables quantification of diffuse myocardial fibrosis. Various factors, however, can interfere with T1 measurements. The purpose of the current study was to assess the effect of co-medication with a typical protein binding drug (ibuprofen) on T1 values in vitro and in vivo.

METHODS

50 vials were prepared with different concentrations of gadobenate dimeglumine, ibuprofen and human serum albumin in physiologic NaCl solution and imaged at 1.5T with a spin echo sequence at multiple TRs to measure T1 values and calculate relaxivities. 10 volunteers (5 men; 31 ± 6.3 years) were imaged at 1.5T. T1 values for myocardium and blood pool were determined for various time points after administration of 0.15 mmol/kg gadobenate dimeglumine using a modified look-locker inversion-recovery sequence before and after administration of ibuprofen over 24 hours. The partition coefficient was calculated as ΔR1myocardium/ΔR1blood, where R1=1/T1.

RESULTS

In vitro no significant correlation was found between relaxivity and ibuprofen concentration, neither in absence (r=-0.15, p=0.40) nor in presence of albumin (r=-0.32, p=0.30). In vivo there was no significant difference in post contrast T1 times of myocardium and blood, respectively and also in the partition coefficient between exam 1 and 2 (p>0.05). There was good agreement of the T1 times of myocardium and blood and the partition coefficient, respectively between exam 1 and 2.

CONCLUSIONS

Contrast enhanced T1 mapping is unaffected by co-medication with the protein binding substance ibuprofen and has an excellent reproducibility.

Injection of gadolinium contrast through pediatric central venous catheters: a safety study

BACKGROUND

Catheter rupture during CT angiography has prompted policies prohibiting the use of electronic injectors with peripherally inserted central venous catheters (PICCs) not only for CT but also for MRI. Consequently, many institutions mandate hand injection for MR angiography, limiting precision of infusion rates and durations of delivery.

OBJECTIVE

To determine whether electronic injection of gadolinium-based contrast media through a range of small-caliber, single-lumen PICCs would be safe without risk of catheter rupture over the range of clinical protocols and determine whether programmed flow rates and volumes were realized when using PICCs for contrast delivery.

MATERIALS AND METHODS

Experiments were performed and recorded using the Medrad Spectris Solaris EP MR Injection System. PICC sizes, contrast media and flow rates were based on common institutional protocols.

RESULTS

No catheters were damaged during any experiments. Mean difference between programmed and delivered volume was 0.07 ± 0.10 mL for all experiments. Reduced flow rates and prolonged injection durations were observed when the injector's pressure-limiting algorithm was triggered, only in protocols outside the clinical range.

CONCLUSION

PICCs commonly used in children can withstand in vitro power injection of gadolinium-based contrast media at protocols significantly above clinical levels.

Meglumine antimonate treatment enhances phagocytosis and TNF-α production by monocytes in human cutaneous leishmaniasis

This work evaluated phagocytic function, hydrogen peroxide (H(2)O(2)), TNF-α and IL-10 production by monocytes and serum INF-γ levels in New World human cutaneous leishmaniasis and the influence of meglumine antimonate treatment on these immune functions. The phagocytic capacity of monocytes in untreated Leishmania-infected individuals was significantly (2.5 times) lower than that of healthy controls, and antimonial treatment increased the phagocytosis by monocytes by about five times at the end of therapy. The leishmaniasis patients showed 3.9 times higher H(2)O(2) production than controls and treatment with meglumine antimonate did not influence the production of H(2)O(2), which remained enhanced until the end of treatment. Individuals with leishmaniasis showed 6.3 times lower TNF-α production than healthy individuals and meglumine antimonate treatment caused a significant increment (11.9 times) in its production. INF-γ serum levels were higher in Leishmania-infected individuals than healthy controls, and the production of IL-10 by monocytes was not influenced by infection or antimonial treatment. Enhancement of monocyte functions by the antimonial treatment suggests that the immunomodulatory effects of the drug may also play a part in the way meglumine antimonate acts against the parasite in human leishmaniasis, by directly increasing phagocytosis and TNF-α production.

Tongue nodules in canine leishmaniosis--a case report

BACKGROUND

Canine leishmaniosis (CanL) caused by Leishmania infantum is an endemic zoonosis in southern European countries. Infected dogs can present rare or atypical forms of the disease and diagnosis can be challenging. The present report describes a case of tongue nodules in a 3-year-old neutered female Labrador Retriever dog with leishmaniosis.

FINDINGS

A fine needle aspiration of the lingual nodules revealed amastigote forms of Leishmania inside macrophages. Differential diagnosis ruled out neoplasia, calcinosis circumscripta, solar glossitis, vasculitis, amyloidosis, eosinophilic granulomas, chemical and electrical burns, uremic glossitis and autoimmune diseases. Combined therapy with antimoniate meglumine and allopurinol for 30 days resulted in the normalization of hematological and biochemical parameters. Two months after diagnosis and the beginning of treatment, a mild inflammatory infiltrate was observed by histopathology, but an anti-Leishmania immunofluorescence antibody test (IFAT) was negative as well as a PCR on both tongue lesions and a bone marrow aspirate. Seven months after diagnosis, the dog's general condition appeared good, there were no tongue lesions and a new IFAT was negative. Fifteen months after diagnosis this clinically favourable outcome continued.

CONCLUSIONS

The dog could have suffered a relapsing episode of CanL, but a new systemic or local infection cannot be excluded. Regular clinical re-evaluation should be maintained, as a future relapse can potentially occur. In conclusion, CanL should be considered in the differential diagnosis of nodular glossitis in dogs.

In vivo chronic myocardial infarction characterization by spin locked cardiovascular magnetic resonance

BACKGROUND

Late gadolinium enhanced (LGE) cardiovascular magnetic resonance (CMR) is frequently used to evaluate myocardial viability, estimate total infarct size and transmurality, but is not always straightforward is and contraindicated in patients with renal failure because of the risk of nephrogenic systemic fibrosis. T2- and T1-weighted CMR alone is however relatively insensitive to chronic myocardial infarction (MI) in the absence of a contrast agent. The objective of this manuscript is to explore T1ρ-weighted rotating frame CMR techniques for infarct characterization without contrast agents. We hypothesize that T1ρ CMR accurately measures infarct size in chronic MI on account of a large change in T1ρ relaxation time between scar and myocardium.

METHODS

7Yorkshire swine underwent CMR at 8 weeks post-surgical induction of apical or posterolateral myocardial infarction. Late gadolinium enhanced and T1ρ CMR were performed at high resolution to visualize MI. T1ρ-weighted imaging was performed with a B₁  = 500 Hz spin lock pulse on a 3 T clinical MR scanner. Following sacrifice, the heart was excised and infarct size was calculated by optical planimetry. Infarct size was calculated for all three methods (LGE, T1ρ and planimetry) and statistical analysis was performed. T1ρ relaxation time maps were computed from multiple T1ρ-weighted images at varying spin lock duration.

RESULTS

Mean infarct contrast-to-noise ratio (CNR) in LGE and T1ρ CMR was 2.8 ± 0.1 and 2.7 ± 0.1. The variation in signal intensity of tissues was found to be, in order of decreasing signal intensity, LV blood, fat and edema, infarct and healthy myocardium. Infarct size measured by T1ρ CMR (21.1% ± 1.4%) was not significantly different from LGE CMR (22.2% ± 1.5%) or planimetry (21.1% ± 2.7%; p < 0.05).T1ρ relaxation times were T1ρinfarct = 91.7 ms in the infarct and T1ρremote = 47.2 ms in the remote myocardium.

CONCLUSIONS

T1ρ-weighted imaging using long spin locking pulses enables high discrimination between infarct and myocardium. T1ρ CMR may be useful to visualizing MI without the need for exogenous contrast agents for a wide range of clinical cardiac applications such as to distinguish edema and scar tissue and tissue characterization of myocarditis and ventricular fibrosis.

Thermotherapy. An alternative for the treatment of American cutaneous leishmaniasis

BACKGROUND

Pentavalent antimonials (Sb5) and miltefosine are the first-line drugs for treating cutaneous leishmaniasis in Colombia; however, toxicity and treatment duration negatively impact compliance and cost, justifying an active search for better therapeutic options. We compared the efficacy and safety of thermotherapy and meglumine antimoniate for the treatment of cutaneous leishmaniasis in Colombia.

METHOD

An open randomized Phase III clinical trial was performed in five military health centres. located in northwestern, central and southern Colombia. Volunteers with parasitological positive diagnosis (Giemsa-stained smears) of cutaneous leishmaniasis were included. A single thermotherapy session involving the application of 50°C at the center and active edge of each lesion. Meglumine antimoniate was administered intramuscularly at a dose of 20 mg Sb5/kg weight/day for 20 days.

RESULTS

Both groups were comparable. The efficacy of thermotherapy was 64% (86/134 patients) by protocol and 58% (86/149) by intention-to-treat. For the meglumine antimoniate group, efficacy by protocol was 85% (103/121 patients) and 72% (103/143) by intention-to-treat, The efficacy between the treatments was statistically significant (p 0.01 and < 0.001) for analysis by intention to treat and by protocol, respectively. There was no difference between the therapeutic response with either treatment regardless of the Leishmania species responsible for infection. The side effects of meglumine antimoniate included myalgia, arthralgia, headache and fever. Regarding thermotherapy, the only side effect was pain at the lesion area four days after the initiation of treatment.

CONCLUSION

Although the efficacy rate of meglumine antimoniate was greater than that of thermotherapy for the treatment of cutaneous leishmaniasis, the side effects were also greater. Those factors, added to the increased costs, the treatment adherence problems and the progressive lack of therapeutic response, make us consider thermotherapy as a first line treatment for cutaneous leishmaniasis.

[Efficiency of cycloferon and reamberin combination at the treatment of the patients with chronic sepsis]

The cytokine profile of blood (CPB) at the patients with chronic sepsis (CS) streptococcus or mixed (by a streptococcus and to staphylococcus etiology) was studied. To beginning of the treatment at intensifying of CS at the patients was detected the substantial increase of maintenance of proinflammatory (IL - 1β, IL - 2, IL - 6, TNF -α) cytokines (CК) in the blood serum at the moderate increase of antiinflammatory CK (IL-4). Thus, indexes, characterizing correlation pro- and antiinflammatory CК was rate, that testified to predominating of proinflammatory potencies of blood. Application in the complex treatment of the patients with CS combination of modern detoxic preparation reamberin and immunoactive preparation cycloferon promotes normalizations of CK maintenance in the blood and betweennesss by them. In a clinical plan the use of the reamberin and cycloferon combination provided acceleration of CS intensifying liquidation. Finding allow to consider pathogenetic reasonable and clinically perspective application of this preparations combination in treatment of the patients with CS.

[Neuroprotective effects of succinate-containing antihypoxante reamberine in treatment of patients with toxicohypoxic brain injury]

As a result of survey in process of treatment of 60 patients with severe acute poisoning complicated by the toxic-hypoxic brain edema, found that inclusion of reamberin (antihypoxant containing succinate) in basic therapy leads to increase levels of the antioxidant defense system, decrease lipid peroxidation and reduce NR2A titers of autoantibodies. Reduction of degree of toxic-hypoxic encephalopathy promotes improving the clinical course, manifested shortened duration of coma and hospital bad days.

[Using of reamberin for correction of free radicals disturbances in patients with acute severe methadone poisonings]

The article deals with the materials, which have been received in the process of the examination and treatment of 44 patients with acute severe methadone poisonings. It has been revealed, that gravity of these patient's condition depends on intensity of hypoxia due to breath deficiency because of the methadone. The development of hypoxia, in its turn, cause violations of antiradical protection system and intensification of processes of peroxide lipid oxidation. It has been registered that the including of reamberin into the complex program of the intensive therapy of acute severe methadone poisonings lead to a more rapid restoration of antiradical protection system and to a decrease of activity of processes of peroxide lipid oxidation. The correction of hypoxia and free-radical violations led to improvement of the acute poisonings clinic, what had been characterized by a decrease of coma-period duration, duration of treatment with artificial lung ventilation, a decrease of secondary lung complications and a decrease of lethality.