[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.

[Behavioral psychotherapy and citoftavin in the treatment of deforming coxarthrosis in elderly patients]

The authors studied the efficiency of the expansion of the standard course of conservative therapy of deforming coxarthrosis by appointment Cytoflavin and behavioral therapy. The study was performed on 104 elderly patients. It was found that the addition of the existing 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. Positive quality extra medical appointments was the absence of significant side effects when taken orally Cytoflavin requiring discontinuation of the drug, as well as the absence of failure patients from further sessions of behavioral therapy.

[Dynamics of cognitive disorders in patients with type 2 diabetes mellitus under effect of metabolic therapy]

The aim of this study was to investigate the efficiency of metabolic therapy in correction of cognitive impairment in patients with type 2 diabetes. We undertook the analysis of results of the treatment of cognitive dysfunction in 80 patients with a diagnosis of type 2 diabetes. All patients received basic hypoglycemic therapy. 32 patients (study group) received in addition to the basal glucose lowering therapy daily intravenous infusion of 10 mlcytoflavindiluted in 200 ml of a 0.9% sodium chloride solution for 10 days, followed by 2 tablets b.i.d. for 25 days.The group of comparison consisted of 29 patients given in addition to the basal glucose-lowering therapy daily intravenous infusion of 24 ml (600 mg) thioctacid diluted in 200 mL of a 0.9% sodium chloride solution for 10 days. Thereafter, they received 1 tablet of thioctacid BV once daily for 30 days. The control group consisted of 19 patients who received basic hypoglycemic therapy without additional metabolic therapy.Inclusion of cytoflavin in the combined treatment of patients with type 2 diabetes ensured a more effective correction of cognitive impairment. There was a statistically significant improvement in optical-spatial activities (p = 0.001), attention (p = 0.001), abstract thinking (p = 0.046), and memory (p<0.001) compared to those in other groups, according to the MOS test. Positive dynamics was expressed as the improvement of the optical-spatial activities by 9,8 ± 10,3%, attention by 13,5 ± 11,8%, abstract thinking by 7,0 ± 8,9%, and memory by 23.0 ± 14 6%. The study of variations of the serum level of brain neurotrophic factor (BDNF) over time during the treatment with metabolic preparations reveal edits statistically significant increase (p = 0.002) in the patients treated with cytoflavin compared with comparison (p = 0.139) and control (p = 0.078) groups. These results suggest the influence of cytoflavin on the processes of neuroplasticity under conditions of hyperglycemia, improvement of cerebral microcirculation and cerebroprotective action of this medication.

[THE PHARMACOTHERAPEUTIC EFFICIENCY OF CYTOFLAVIN IN PATIENTS WITH DIABETIC FOOT SYNDROME: IMMEDIATE AND LONG-TERM RESULTS]

Immediate and long-term results of parenteral and oral administration of cytoflavin to patients with diabetic foot complicated by grade I and II trophic ulcers (Wagner classification) are considered with special reference to the assessment of reparative processes, normalization of the serum pro oxidant-antioxidant system, and improvement of clinical and instrumental bloodflow characteristics.

[ROLE OF SUBSTRATE ANTIHYPOXANTS IN CORRECTION OF ABNORMALITIES OF MYOELECTRICAL ACTIVITY OF GASTROINTESTINAL TRACT IN VICTIMS WITH SEVERE COMBINED TRAUMA]

The abnormalities of myoelectrical activity of gastrointestinal tract were detected in 80 victims with severe combined trauma. There were observed a decrease of total electrical activity and dyscoordination of electrical activity of sections of gastrointestinal tract. An application of substrate antihypoxants should normalize the indices of myoelectrical activity of gastrointestinal tract. This approach allowed elimination of imbalance of total power between superposed (the stomach, the duodenum) and other sections of gastrointestinal tract. This would remove dyscoordination contraction of the jejunum and the ileum.

[THE INFLUENCE OF CYTOFLAVIN AND CARDIOXIPIN ON THE PARAMETERS OF 24-HOUR ARTERIAL PRESSURE MONITORING IN PATIENTS WITH CHRONIC CEREBRAL CIRCULATION INSUFFICIENCY, ARTERIAL HYPERTENSION AND HYPERCHOLESTEROLEMIA]

This comparative study of the influence of cytoflavin and cardioxipin on the parameters of 24-hour arterial pressure monitoring in 56 patients with chronic cerebral circulation insufficiency, arterial hypertension and hypercholesterolemia included 32 women and 24 men aged 42-72 years divided into 3 groups matchedfor the stage of diseases, age, sex, severity of AH, total cholesterol level, and antihypertensive therapy. Patients of group 1 were treated without cytoflavin and cardioxipin. Those in group 2 received daily i/v droplet infusion of 10 mg/kg cardioxipin (20-30 droplets/min). Patients of group 3 were given daily i/v droplet infusion of 10 ml cytoflavin in 200 ml 0.9% sodium chloride solution for 10 days. 24-hour arterial pressure monitoring was used to estimate the influence of the two drugs on systolic and diastolic pressure, its daily rhythm, AP variability and frequency of elevation. The study showed that both therapeutic modalities improved daily AP rhythm as manifested in a significant increase of the number of patients with the dipper rhythm and a decrease in the number of systolic/diastolic non-dipper patients. Moreover cytoflavin significantly decreased the number of systolic over-dippers compared with control group.

[COGNITIVE ABNORMALITIES IN POSTOPERATIVE PERIOD OF THYROID SURGERY]

An evaluation of cognitive functions was presented in 90 patients undergoing thyroid surgery. An attention deterioration, shot-term memory impairment and degradation were revealed after operation. It was shown that reduction of manifestations of cognitive dysfunction and stabilization of the haemodynamics indices were allowed due to application of cytoflavin during operation and in early postoperative period.

[EFFECTIVENESS OF CYTOFLAVIN FOR THE CORRECTION OF COGNITIVE IMPAIRMENTS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS]

Authors studied the efficacy of cytoflavin in the correction of cognitive impairment in patients with type 2 diabetes mellitus and the drug influence on the level of brain-derived neurotrophic factor (BDNF) in blood serum. The results of treatment and examination of 60 patients with type 2 diabetes diagnosis have been analyzed. The majority (49-81.6%) of patients initially exhibited light (35-71.4%) and moderate (14-28.6%) cognitive impairments. All patients received standard treatment with oral antidiabetic drugs: metformin monotherapy (26 patients or 43.3%) and combined therapy (metformin + gliclazide, 34 patients or 56.6%). In addition, 30 patients (main group) received a complex metabolic drug cytoflavin daily intravenously (10 mL in 200 mL of 0.9% sodium chloride) for 10 days with transition to the tablet form in a dose of 2 tablets (with 0.6 succinic acid, 0.1 riboxin, 0:05 nicotinamide, 0.01 riboflavin) two times a day for 25 days. The control group (n = 30) consisted of patients who received only basic hypoglycemic therapy. The inclusion of cytoflavin in the scheme of complex treatment of patients with type 2 diabetes ensured a more effective correction of cognitive impairments as compared to the group receiving basic therapy. This is confirmed by the results of neuropsychological testing (MoCA test) and improved optical and spatial activity, attention, abstract thinking, and memory on the average by 14.2% compared to the value before treatment (p < 0.01) in patients of standard treatment group. Patients in the control group showed positive dynamics of same parameters amounted on the average to 7.9%. The study of BDNF in the blood serum showed a significant increase in this index over time in patients who have received cytoflavin (from 1475.13 + 421.26 pg/ml to 1839.44 + 494.78 pg/mL, p < 0.01) in contrast to the control group (1625.41 + 322.53 pg/mL to 1592.04 + 373.47 pg/mL) and revealed positive correlation between the MoCA test and BDNF level in the blood serum for optico-spatial activity (r = 0.589, p < 0.01), naming (animals) (r = 0.346, p < 0.01), attention (r = 0.401, p < 0.01), memory (r=0.595, p< 0.01) and total rating in the test (r = 0.708, p < 0.01). In addition, a negative correlation was revealed between the level of carbohydrate metabolism (HbA1c) and BDNF levels in the blood serum (r = -0.494, p < 0.01) in both groups.

[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.

[The assessment of the effects of cytoflavin and cardioxipin on the emotional status of rats with dyslipidemia]

OBJECTIVE

To compare the effects of cytoflavin and cardioxipin on the emotional status of rats with experimental disturbance of lipid metabolism using the uplifted cruciform labyrinth method.

MATERIAL AND METHODS

The disturbance of lipid metabolism was induced by the introduction of exogenic cholesterol-in -oil emulsion in dosage 40 mg /kg of body mass during 20 days. Pharmacological treatment was performed in the 11th day. The drugs were injected intraperitoneally during 10 days: cytoflavin in dose 1,75 ml/ kg (175 mg/kg with succinic acid), cardioxipin in dose 52,5 mg/kg.

RESULTS AND CONCLUSION

Cytoflavin and cardioxipin caused the positive changes in the parameters of emotional status of rats in conditions of experimental dyslipidemia.

[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.

[The study of the effectiveness of drug prevention mechanisms of cardiovascular aging by cytoflavin]

The aim of the research was the search of the mechanism of Cytoflavin action in patients with isolated systolic arterial hypertension (ISAH) as the aging model. The following research methods were applied: the assessment of complaints, 24-hour arterial pressure monitoring, ultrasound diagnostic, volume sphygmography, lipid profiles and coagulogram, molecular phenotyping by MALDI-TOF-TOF-MS. The combination of Cytoflavin with standard therapy of ISAH led to the most expressed return development of clinical symptoms, the restoration of the haemodynamics, structural and geometrical parameters of cardiovascular system, indicators lipid profiles and coagulogram in the comparison with patients with ISAH, who accepted standard therapy and those of the control groups. Molecular mechanisms of Cytoflavin action, including regulation of the activity of cell signaling pathways through intermolecular interactions were found. We recommend using Cytoflavin together with the standard therapy in treatment of ISAH, which provides the action of geroprotectors for cardiovascular system.

[Modern methods of energy homeostasis correction in elderly patients]

In the multicenter randomized clinical-instrumental prospective study 185 patients aged 55-75 years (mean age 68 years) with 94 men and 91 women with cerebral infarction were included. All the patients were hospitalized in the period from 6 to 24 hours from the time of the debut of clinical symptoms, 42,2% of patients scored 14 and above on NIH scale on admission. Patients were randomized into 3 groups: 1st group consisted of 64 patients treated as an antioxidant by 5% solution of ascorbic acid 2 times a day the recommended dose (20 ml/day) for 20 days; 2nd group consisted of 72 patients who received energy monitor Cytoflavin in a daily dose of 20 ml (10.0 ml/drip 2 times a day for 10 days); 3rd group consisted of 49 patients with Cytoflavin therapy extended to 20 days, moreover from 11th to 20th day the dose was 10 ml/day. Cytoflavin treatment was more efficient than ascorbic acid, which can be explained by different pharmacologic mechanisms. Treatment with Cytoflavin for 10 days resulted in a significant decrease of ischemia zone volume by 25% in average, treatment with Cytoflavin for 20 days--by 29%, which manifested in better outcomes in neurologic and functional status. Ascorbic acid demonstrated no effect on morphologic parameters. Patients having at the time of admission 18-20 points according to the NIH and treated with Cytoflavin for 20 days demonstrated significant trend towards improvement of the parameters of the neurological status.

[Efficiency of intensive care with cytoflavin in patients of advanced age in combined traumatic brain injury]

Research objective--determination of efficiency of intensive care with inclusion Cytoflavin in patients of old age in combined traumatic brain injury. A prospective controlled blind randomized study was conducted. In 1st group (21 people) the patients received a standard intensive care, in 2nd group (18 persons) Cytoflavin was included in complex intensive care. Using Cytoflavin starting from 2 days post-traumatic period (with the correction of blood circulation and respiration) had antioxidant and detoxification effects, contributed to the recovery rate of free radical and metabolic processes, reduced the degree of impairment in the structural-functional state of membranes and restored the conformational structure of membrane proteins in the earlier periods. Reduction in reactions of disadaptation led to regression of multiple organ dysfunctions, restoration the level of consciousness at an earlier date. The number of cases of severe respiratory distress syndrome decreased.

[Clinical effectiveness of cytoflavin inclusion in intensive care of patients with combined traumatic brain injury]

Autors determine the clinical effectiveness of including cytoflavin in intensive care of patients with severe combined traumatic brain injury. A prospective blind randomized controlled study was conducted on two groups involving 101 participants. In group I (58 patients), the intensive care was standard. In group II (43 patients), the intensive care included cytoflavin which was added beginning with the second day of the post-traumatic period. For this purpose, 10 ml of cytoflavin was dissolved in 200 ml of 10% aqueous solution of glucose and was administered intravenously at a speed of 140 drops (7 ml) per minute within 7 days. The use of cytoflavin in complex intensive care of severe combined traumatic brain injury within two days after injury (with the proper correction of blood circulation and respiration) reduced the number of multiple organ dysfunctions, the number is purulent-septic complications, the time of regress in multiple organ dysfunctions, and the reanimation period in intensive care department on the average by a factor of 1.4 - 1.6 (p < 0.005).

[Rationale of application of the drug Cytoflavin in complex treatment of patients with diabetic foot syndrome with mediacalcification arteries]

The study involved 60 patients with diabetic foot syndrome (DFS) with severe subcompensated diabetes type II. 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 first group received basic therapy that is indicated for DFS which included antibiotics, vessels extending drugs neuroprotective and detoxification facilities. The second group of patients in addition to basic therapy received the drug cytoflavin 10 ml 0.9% NaCl 200 ml for 10 days, followed by transfer to the tablet form cytoflavin 2 tablets 2 times a day orally for 1 month. We noted a positive trend treat patients in addition to standard therapy received the drug cytoflavin, resulting in a marked neuroprotective, antihypoxant and antioxidant effects of the drug. Thus, the use of complex surgical treatment of patients with mixed form DFS cytoflavin reduces the severity of distal polyneuropathy, improves tissue oxygenation and restores the activity of antioxidant enzymes system, manifested a marked neuroprotective, anti-hypoxic and antioxidant effects of drugs and indications to justify its use in this condition.

[Efficacy of the energy-modifier cytoflavin in the treatment of patients with hypertensive encephalopathy]

AIM

To evaluate the efficacy of cytoflavin in the treatment of patients with hypertensive encephalopathy (HE).

SUBJECTS AND METHODS

One hundred and forty patients aged 39 to 73 years, diagnosed with HE, were examined and randomized to 2 groups. A study group (n = 74) received cytoflavin in a dose of 2 tablets b.i.d. on days 1 to 25 days inclusive during standard basic therapy. A comparison group (n = 66 persons) had standard basic therapy only. A control group consisted of 30 apparently healthy individuals. The investigators studied the frequency of headache, dizziness, and other complaints and the intensity of cephalalgic syndrome, by using a visual analog scale, the quality of life by the Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36) questionnaire, that of sleep by the subjective sleep characteristics questionnaire elaborated at the Moscow City Somnological Center, the level of asthenia by a subjective asthenia rating scale (Multidimensional Fatigue Inventory (MFI-20), and autonomic status, by applying objective and subjective scales on days 1 and 25 of therapy.

RESULTS

The study has shown that cytoflavin used in the above dose for 25 days reduces the frequency and magnitude of complaints of headache, dizziness, "venous" complaints, the degree of autonomic and asthenic disorders, and impairments in the quality of sleep and life in the patients with HE at all disease stages. A stepwise discriminant analysis has indicated that the degree of cephalgic syndrome, and autonomic disorders, and worse sleep quality are the most effective points for using the energy-modifier cytoflavin.

CONCLUSION

HE treatment based on the current pathogenetic principles may have a preventive impact on the development of HE or slow down the rate of its progression.

[Cerebral dysfunction after coronary artery bypass graft surgery with cardiopulmonary bypass]

The cardiac surgery is accompanied by multifactorial alteration of the brain, which can present in different clinical types of postoperative cerebral dysfunction. A stroke was diagnosed only after coronary artery bypass graft surgery with cardiopulmonary bypass. Postoperative cognitive dysfunction (including acute cognitive dysfunction and deferred cognitive impairment) was significantly more frequent after surgery with cardiopulmonary bypass. The preoperative use of complex cytoprotective medication Cytoflavin decreased the severity of the deferred cognitive impairment. The data show the prospects of the pharmacological neuroprotection in cardiac surgery with cardiopulmonary bypass.

[Potentials for the conservative therapy in the complex treatment of varicocele in adolescents]

The article presents the results of the evaluation of the influence of varicocele on the reproductive system of adolescents from the perspective of involvement of periprostatic venous plexus and prostatovesicular complex in the pathological process. The study involved 90 adolescents 16-18 years old with left varicocele and disturbances in ejaculate parameters, of which 60 had pelvic congestion. Patients and control group received a comprehensive treatment, including preoperative trophic and flebotonic therapy, laparoscopic surgical clipping of the internal spermatic vein and post-operative rehabilitation. Patients of the study group along with this treatment received prostatotropic drug Vitaprost. According to the results of study, it was found that in patients with varicocele, attention should pay to the status of the venous outflow from the pelvic organs, which leads to the pelvic congestion and causes degenerative changes in the prostate in half of cases, which in turn negatively affects the spermogram parameters and increases the risk of subfertility. The use of prostatotropic drugs in the treatment of patients suffering from varicoceles with pelvic congestion is appropriate and pathogenetically justified, as it promotes a more rapid restoration of the structure and function of the prostate.

[Pharmacological treatment of hemorheological disorders in children with acute respiratory viral infection]

This article presents the results of monitoring in a group of children with severe forms of acute respiratory viral infection and toxic encephalopathy. Hemorheological disorder in the form of hyperviscosity syndrome has been detected in all patients with severe forms of acute respiratory viral infection. It was suggested the inclusion of cytoflavin in the complex therapy for correcting the hemorheological status. The administration of cytoflavin led to reduction of erythrocyte aggregation and general improvements in rheological indices of children with severe forms of acute respiratory viral infection and toxic encephalopathy.

[Effect of cytoflavin on some physiological values in patients with toxicohypoxic encephalopathy]

The effect of cytoflavin upon bolus intravenous administration on the state of hemodynamic values and liquid sectors of the organism was studied in patients with toxicohypoxic encephalopathy caused by heavy acute poisoning. It is established that the bolus administration of cytoflavin is less effective than dropwise intravenous injection.

[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.

[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.

[Use of metabolic drugs and psychotherapy in dental implantation in elderly patients]

The estimation of efficiency of metabolic drugs and psychotherapy in dental implantation in the elderly was carried out. On the basis of the study results an important pathogenetic significance of use of metabolic drug cytoflavin and cognitive therapy in the treatment of partially adentia at elderly patients was justified. It was proved that the optimization of the internal picture of health by means of the implementation of information and regulatory functions, and emotional reinforcement of the therapeutic process in patients receiving cytoflavin and cognitive therapy would improve the effectiveness of the treatment, to increase "survival" performance of implants and to approach to understanding the underlying mechanisms of forming health in elderly patients with partial adentia.

[The diagnostics of adaptive reactions of blood on application the stress-modulating therapy in patients with brain chronic ischemia]

The article deals with the results of analysis of electrophoretic mobility of erythrocytes and leukogram in patients with dyscirculatory encephalopathy on different stages of disease on application therapy with inclusion of stress-modulating pharmaceuticals into course of treatment. It is established that the electrophoretic mobiliy of erythrocytes makes it possible to evaluate the adaptive indicators blood in patients with dyscirculatory encephalopathy. The consideration of these indicators makes feasible the substantiation of inclusion of stress-modulating therapy into complex treatment of patients with chronic cerebrovascular inefficiency.

[Cytoflavin in the treatment of patients with chronic abacterial prostatitis and erectile dysfunction]

The problem of chronic prostatitis (CP) and erectile dysfunction (ED) involves not only their high prevalence, but also the insufficient effectiveness of their treatments. In this regard, there is need for administration the pathogenetic drugs with antihypoxic, antioxidant and neuroprotective effects and improving blood flow to the genitals. The study included 60 men with CP associated with ED, aged 22 to 60 years. Patients were randomized into 2 groups of 30 people. Patients of comparison group received baseline therapy (alpha1-adrenoblockers, non-specific anti-inflammatory drugs, digital prostate massage and vacuum phallostimulation). Antibiotics were applied on the basis of their potential effectiveness in chronic abacterial prostatitis. In addition to the above treatment, patients of main group received step-down therapy with cytoflavin (in infusion, then oral administration). Positive dynamics was noted in both groups of patients; however, according to the indicators of the severity of pain and dysuria, as well as quality of life, positive dynamics in the main group of patients was more significant. Similarly, the dynamics of objective criteria for inflammation in the prostate gland was more pronounced when using cytoflavin. After treatment, the rigid phase of erection during vacuum fallotest occurred within 2-3 min from the beginning of the procedure in 16 (53.3%) patients of main group and only in 9 (30%) patients of comparison group. During follow-up examination at 6 months after treatment, stable remission was found in 75% of patients of main group. Thus, the inclusion of cytoflavin in the scheme of complex treatment of patients with abacterial CP associated with ED is pathogenetically justified, makes it more efficient and provides good DFS.

[Pharmacological correction of hypoxia in patients with severe carbon monoxide poisoning]

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 patients' condition depends on the intensity of hypoxia due to breath deficiency because of methadone. The development of hypoxia, in its turn, causes 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 leads 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 the improvement of the acute poisonings clinics, what was 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.

[The application of combined physiotherapeutic methods for the complex treatment of patients with dyscirculatory encephalopathy]

This article reports the results of applying basic pharmacotherapy (enalapril, cytoflavin) and its combination with physical factors (transcranial electrostimulation, combined application oftranscranial electrostimulation and low-frequency magnetic therapy) in the complex treatment of patients with stage I-II dyscirculatory encephalopathy. The study has demonstrated that the combined treatment with cytoflavin, enalapril, transcranial electrostimulation and low-frequency magnetic therapy produced the most pronounced therapeutic effect (82.5%), as confirmed by positive dynamics of clinical and functional parameters.

[Immune system disorders and their correction in critically ill patients with toxic and hypoxic encephalopathy]

In this article there are materials, which were received in the process of treatment of 69 patients with azaleptin (leponeks) acute severe poisonings. The immunologic research has shown that the first phase of acute poisonings in patients with toxicohypoxic encephalopathy is accompanied by severe immune alterations. The alterations of proinflammation and antiinflammation cytokines have been investigated and its increase has not been revealed. It was shown, that the employment of citoflavin in intensive therapy of acute poisonings leads to decrease of the level of immunosupression.

[Use of cytoflavin into the complex intensive therapy of acute cerebral insufficiency caused by poisoning]

In the result of treatment of 147 patients with toxic acute brain insufficiency were revealed that the employment of citoflavin (20 ml with 400 ml 5% glucosae twice a day) in 7 days intensive therapy of acute brain insufficiency leaded to decrease of hypoxic brain damages and intensity of brain depression, what was revealed in improvement of brain bioelectric activity. Rehabilitation of central nervous system regulation function and life-support systems leaded to quick rehabilitation of respiratory part of oxygen transport. These changes in acute period leaded to quick reparation of cognitive-mnestic functions and social adaptation. The employment of citoflavin leaded to improvement of clinic of toxicohypoxic encephalopathy and to decrease of secondary lung complications (decrease of coma-period from 45,3 ± 8,2 to 27,7 ± 6,9 hours; decrease of secondary lung complications from 72,7% to 35,9%).

[Metabolic correction of the lipid-transport system in experimental diffuse purulent peritonitis]

The research was performed in 55 male chinchilla rabbits. For the first time the effect of metabolic preparations "citoflavin" and "neoton" of the protein-lipid spectrum of blood was studied in experimental diffuse purulent peritonitis. The development of diffuse purulent peritonitis caused negative changes in blood lipid-transport system which resulted in a decreased blood protein level and high density lipoproteins (HDL) and growth of triglycerides. In the HDL phospholipid spectrum the pathological changes are characterized by an increased lisophosphotide content and compensatory growth of the level of poliglycerophosphatides. A comparative analysis has shown that both preparations possess unidirectional action which is more pronounced in "citoflavin" than in "neoton".

[Correction of bioenergetic processes in small intestine during experimental widespread purulent peritonitis]

The functional activity of mitochondria of the muscular coat of small intestine (MCSI) has been studied in the normal state and under experimental widespread purulent peritonitis (WPP) conditions. The experiments have been carried out on a group of 55 male rabbits of chinchilla breed. It is established that, as a result of the WPP development, the functional activity of mitochondria in MCSI considerably decreases. The comparative analysis of the efficiency of metabolic drugs cytoflavin and neoton showed advantage of the citoflavin preparation, the administration of which allowed the indices of mitochondria in intact animals to be exceeded on the fifth day of postoperative period. The research results show expediency of a complex treatment of WPP using cytoflavin preparation for the normalization of biological oxidation processes and elimination of enteric insufficiency.

[Assessment of multimodal effect of cytoflavin in the acute brain stroke in patients with metabolic syndrome]

Sixty patients were randomized to treatment with cytoflavin (n=30) or nootropil (n=30). Patients of the main group received cytoflavin along with standard treatment for correction of hemodynamics. The treatment scheme was as follows: intravenous injections during 10 days, tablets - from 11 to 35 days. The same scheme of treatment was used in the comparison group. The total duration was 35 days. Patients were assessed with NIHSS, the Rankin scale, the Barthel index, MMSE. MRI was used to verify ischemic lesions. The therapeutic efficacy of cytoflavin was significantly higher compared to nootropil in respect to the restoration of neurological functions and self-service abilities as well as to the reduction of cognitive deficit.

[The use of cytoflavin in sports nutrition]

Sports nutrition for 35 athletes was supplemented by the metabolic preparation cytoflavin 1 month before a pre-competition training camp. Their physical status was estimated using a specialized Omega-C hardware-software complex. It was shown that cytoflavin promotes physical fitness of the athletes by improving energy supply, psychoemotional conditions, and competition form. It is recommended to use cytoflavin for the training of athletes in the pre-competition period.

[Metabolic immunocorrection treatment of experimental widespread purulent peritonitis]

The effect of citoflavin and neoton preparations on the migration activity of neutrophil granulocytes under action of mitogen-induced immunocompetent blood cells, Peyer's patches, spleen and inguinal lymph was studied on a group of 55 male chinchilla rabbits with experimental model of widespread purulent peritonitis. It is established that the regulating action of immunocompetent cells on the migration of neutrophil leukocytes under the conditions of widespread purulent peritonitis is stable and widespread process, which is observed within 5 days of the postoperative period. The use of citoflavin and neoton during the postoperative period produces correction of the activity of immunocompetent cells, changing their properties in regulation of the migratory activity of neutrophil granulocytes. The effect is characteristic of both preparations and it is observed in all investigated organs, being manifested to a greater degree in immunocompetent cells of peripheral blood and Peyer's patches. Metabolic preparation citoflavin exhibits a more pronounced immunotropic action in comparison to neoton, which contains creatine phosphate.

[Pharmacologic correction of hypoxia in patients with acute cerebral failure due to acute poisoning with carbon monoxide and combustion products]

The article deals with the materials, which have been received in the process of the examination and treatment of 48 patients with acute severe carbon monoxide and burning products poisonings on fires. It has been registered that the including of citoflavin into the complex program of the intensive therapy of acute severe carbon monoxide and burning products poisonings on fires leads to a decrease of hypoxia and manifestations of acute toxicohypoxic cerebral deficiency, which significantly improves the clinics of acute severe poisonings.

[Dynamics of the symptoms of chronic ischemia during the treatment with cytoflavin]

Sixty patients with chronic brain ischemia (discirculatory encephalopathy, I and II stages) were enrolled in the study. Patients of the first group (n=30) were treated with cytoflavin and patients of the second group (n=30) received piracetam prescribed first as injections and then in pills. The treatment duration was 35 days. Standard neurological examination and psychometric assessment of patients and dopplerography of cerebral vessels were carried out. Cytoflavin was shown to have a positive effect on the neurological status. It decreases asthenic, cephalgia and vestibulo-cerebellar syndromes as well as neurological and emotional disturbances reducing the symptoms of depression and anxiety and improving cognitive functions and memory as well as quality of life of patients. The changes were significant compared to those in the group of patients treated with piracetam.

[Neuroimmune aspects of the pathogenesis and nitric oxide negative effects modifying the pathogenetic treatment of tick-borne infections]

Patients with different forms of infections transmitted by Ixodidae ticks: meningeal and focal forms of tick-borne encephalitis, neuroborreliosis and mixed-infection (tick-borne encephalitis + Ixodidae tick borreliosis) were examined. CD-typing of lymphocytes in the cerebral spinal fluid (CSF), measuring blood and CSF cytokine content as well as blood nitric oxide (NO) metabolites were used to identify main pathogenetic mechanisms of the immune inflammation development in the central nervous system in tick-borne encephalitis associated with the hyperproduction of NO metabolites in the blood and CSF, inflammatory cytokine reaction and apoptosis. The antioxidant cytoflavin is suggested as a drug for pathogenetic treatment of neuroinfections with modifying effect of NO. The significantly rapid reduction (p<0.05) of general brain, focal brain and neuropsychological disorders as well as the decrease (p<0.05) in the endogenous hyperproduction of NO metabolites were found in patients (n=35) who received cytoflavin compared to those (n=35) who did not receive this drug. The authors recommend to use the drug in dose 10.0 ml once a day intravenously in drops during 7 − 10 days.

[Using cytoflavin for prophylaxis and treatment of cognitive amnestic disorders in patients with heavy toxicohypoxic damage of brain]

Results of the therapy of patients with toxicohypoxic encephalopathy diagnosis upon heavy poisoning by psychotropic substances are presented. It is established that administration of the antihypoxant cytoflavin provides for a substantial decrease in the extent of metabolic disorders related to the development of heavy hypoxia. The use of cytoflavin significantly decreases the degree of encephalopathy and favors faster and better recovery of the mnestic and other cognitive functions in patients upon heavy toxicohypoxic brain damage caused by acute poisoning.

[Efficacy of cytoflavin in patients with hypertonic encephalopathy and constitutional venous insufficiency]

We examined 60 patients with constitutional venous insufficiency, suffering from hypertensive encephalopathy of I and II stages, mean age 43,4± 6,3 years. Patients of the main group (n=30) received Cytoflavin (2 tablets twice a day) and standard therapy (acetylsalicylic acid and antihypertensive drugs). Thirty patients of the parallel group received only standard therapy. At the 25th day of the study, there were the decrease in the number of complaints, including specific "venous complaints", the reduction of cephalalgia syndrome, asthenic and autonomic disorders; the improvement of quality of life and better cerebral hemodynamics on all structural and functional levels.

[The immune activity of cytoflavine in the treatment of the diffuse septic peritonitis]

Influence of citoflavin 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 citoflavin at patients with widespread purulent peritonitis renders corrective action on immunocompetent cells, changing their properties of regulation of migratory activity of neutrophil granulocytes. It is revealed that such action of citoflavin is connected with function restoration of mononuclear cells to inhibit migration of neutrophil leukocytes and with restoration of stimulation of migration of neutrophil leukocytes under the influence of the LPS-activated monocytes to the values received in norm. The revealed effects at use of citoflavin are most expressed by the 5th day of the postoperative period.

[Correction of nonspecific damages in acute poisoning of substance from the group of opiate drug in patients in critical condition]

The obtained materials were received in the process of examination and treatment of 134 patients in the early phase of severe acute poisoning with the development of opiate toxicohypoxic encephalopathy using a corrector of tissue metabolism Cytoflavinum. Positive clinical results were achieved: reduction of length of stay of patients in a comatose state, reduction of incidence of pulmonary complications and mortality. The results of immunological studies have established immunomodulatory effects of cytoflavinum in patients with severe acute poisoning opiates. These biochemical studies have shown that the effects cytoflavinum realized largely due to its ability correct the effects of tissue hypoxia.

[Current approaches to cerebroprotective treatment of premature newborns in reanimation and intensive care departments]

This work was conducted in the frames of a multicenter clinical trial. The aim was to study efficacy of cytoflavin (infusion solution) in the prevention and treatment of posthypoxic CNS lesions in premature newborns. The study included 120 premature newborns (gestation period 28-36 weeks) who was born in severe distress and needed the intensive therapy after primary reanimation measures. Cytoflavin was prescribed in the first 2-4 h after the delivery to 61 newborns. The control group included 59 newborns who did not receive the drug. To assess treatment efficacy, the determination of some plasma neurospecific proteins (GFAP, NSE, MBP) was carried out along with standard clinical/instrumental and laboratory monitoring. The results revealed the marked cerebroprotective effect of cytoflavin. The significantly higher rate of normalization of KOC, pO2, PCO2 and elimination of lactate acidosis that led to the reduction of severity and frequency of ischemic and hemorrhagic CNS lesions as well as lower levels of plasma neurospecific proteins were seen in the main group compared to the control one.

[Correction of central nervous system energy processes in children with the minimal cerebral dysfunction]

Clinical-neurophysiological investigation of the efficiency of complex metabolic neuroprotector Cytoflavin in monotherapy was performed in 64 children of 4-8 years old with the minimal cerebral dysfunction. During the treatment other preparations were not used. Neurologic status, neurophysiological inspection, neuropsychophysiological and speech testing were performed before and after the course of treatment. Efficiency of Cytoflavin was established in children with the minimal cerebral dysfunction of preschool and early school age. By increasing a cerebral blood flow, improving parameters EEG and decreasing intracranial pressure, the drug had positive influence on the psycho-emotional and cognitive spheres, decreased asthenia syndrome, improving social adaptation of the children. Side-effects of Cytoflavin administration were not observed.

[Experience of cytoflavin administration for treating acute carbon monoxide poisoning]

Results of an analysis of the efficiency of using cytoflavin, a drug possessing cytoprotective and antihypoxemic properties, in a group of 215 patients with a diagnosis of acute carbon monoxide poisoning in 2004-2010 are compared to analogous data for 215 patients with same diagnosis treated in 1999-2004 without cytoflavin administration. It is established that timely application of cytoflavin (against the standard treatment of CO poisoning) favored lower expressiveness of post-hypoxemic encephalopathythatis characteristic of the given pathology.

[Clinical-encephalographic evaluation of preterm children treated with cytoflavin during the first year of life]

An aim of the study was the clinical and neurophysiological evaluation of the effect of cytoflavin and reanimation measures on the rate of nervous and mental development of preterm newborns with cerebral ischemia, II--III stage, during the first year of life. One hundred and twenty children with gestational age 28--36 weeks and body mass 1060-3150 g were studied. In the main group (n=61), the complex treatment included cytoflavin in dosage 2 ml/kg/day, intravenously during 5 days. The control group (n=59) received basic treatment without cytoflavin. The follow-up till the age of 1 year comprised the global assessment of state and neurological status using quantitative measurements of muscle postural tone on the INFANIB scale, psychomotor development (BSID-II) and assessment of CNS functional state by analyzing computed EEG signals during physiological sleep. The results obtained demonstrated the fast normalization of all studied measures of development of children treated with cytoflavin compared to those of the control group.

[Cardiotropic activity of synthetic peptide CH3CO-Lys-Lys-Arg-Arg-NH2 (protectin)]

Peptide CH3CO-Lys-Lys-Arg-Arg-NH2 (protectin) was synthesized and its activity was studied on the model of experimental myocardial infarction in rats in comparison to the reference antihypoxant drug riboxin. Intranasal injections ofprotectin at doses within 2-20 microg/kg once a day by course of 7 days produced a pronounced anti-ischemic action, improved coronary circulation of the blood, increases contractile activity of myocardium, reduced intensity of lipid peroxidation, and improved antioxidant protection. In some respects (improved coronary circulation of the blood, increased antioxidant protection), protectin was more effective than riboxin.

[Prevention of cognitive dysfunction in patients operated on thyroid gland]

The cognitive functions assessment in 68 patients operated on thyroid gland is presented. It is elicited that attention decrease, short-term memory upset, depressed work-capacity develop after intervention. It is shown that cytoflavin use within the intervention and early postoperative period permit to decrease cognitive dysfunction signs.

[Methods for the prevention and treatment of toxico-hypoxic encephalopathy in patients with acute severe poisoning]

The study included 147 patients with toxico-hypoxic encephalopathy resulting from acute poisoning. It was shown that intensive therapy with cytoflavin (20 ml in 400 ml of 5% glucose solution twice daily for 7 days) reduced severity of hypoxic brain lesions and suppression of CNS as apparent from the improvement of its bioelectric activity. The recovery of CNS regulatory action on the life-sustaining systems of the body promoted normalization of the respiratory component of oxygen transport. The improvement of the patients' conditions in the acute phase contributed to accelerated recovery of cognitive-amnestic functions and social adaptation. Cytoflavin therapy improved the clinical picture of toxico-hypoxic encephalopathy due to the reduction in the duration of the comatose state from 45.3 +/- 8.2 to 27.7 +/- 6.9 hr and the decrease in the frequency of secondary pulmonary complications from 72.7 to 35.9%.