[Neuroprotective effect of cytoflavin in the treatment of premature newborns with hypoxic-ischemic encephalopathy]. / Neiroprotektivnoe deistvie Tsitoflavina pri lechenii nedonoshennykh novorozhdennykh s gipoksicheski-ishemicheskoi entsefalopatiei.

OBJECTIVE: Evaluation of the effectiveness of Cytoflavin as a neuroprotective therapy for neurological complications in premature newborns with hypoxic-ischemic encephalopathy. MATERIAL AND METHODS: 56 premature newborns with low body weight were examined. Newborn children, depending on the therapy, were divided into 2 groups: Group I - 32 premature newborns with hypoxic-ischemic encephalopathy; received basic therapy and Cytoflavin; Group II - 24 premature newborns with hypoxic-ischemic encephalopathy; received only basic therapy. Moreover, the state of neurospecific enolase (NSE) and blood lactate were studied. RESULTS: Patients of the first group who received cytoflavin, on days 5-6 after treatment there was a decrease in the severity of cerebral ischemia. Also, decreased levels of NSE and blood lactate. CONCLUSION: The revealed neuroprotective effect of cytoflavin in the treatment of premature newborns with hypoxic-ischemic encephalopathy, good tolerability of the drug and its compatibility with other drugs used in the standard treatment of perinatal lesions of the nervous system, which makes it possible to recommend Cytoflavin for the treatment of neurometabolic disorders in children in the first months of life in complex therapy perinatal lesions of the nervous system of premature newborns.

Early predictive blood markers of hemorrhagic stroke - influence of cytoflavin therapy.

Examination of the patterns of free-radical processes (FRP) and changes of the early screening markers to predict the course of hemorrhagic stroke (HS) and applied pathophysiologically based therapy can be of great practical importance. This study aimed to determine early changes in the parameters of oxidative stress and routine biochemistry blood tests in patients with HS and to assess their relationship with clinical outcome. The effects of early applied cytoflavin were also investigated. The prospective study included 151 patients with HS. Forty-eight percent of patients in the standard conservative therapy were given cytoflavin antioxidant energy therapy from the first day of hospitalization. The neurological status, neuroimaging, biochemical blood tests and FRP were assessed on days 1, 5, 10, and 20 of hospitalization. In patients with HS, an imbalance of all stages of FRP was detected proportionately to the severity of HS. The malondialdehyde concentration above 5.3 µmol/L, the number of leukocytes above 15 800, glucose above 11.9 mmol/L, lactate dehydrogenase above 574 IU/L, and lactate above 2.5 mmol/L, detected on the first day, predetermined a high risk of death. Additional cytoflavin treatment allowed stabilizing the clinical laboratory picture of HS, improved the treatment results, and reduced hospital mortality rate.

[Violations of higher mental functions and their correction in patients undergoing video laparoscopic cholecystectomy under conditions of inhalation anesthesia with sevoflurane]. / Narusheniya vysshikh psikhicheskikh funktsii i ikh korrektsiya u bol'nykh, perenesshikh videolaparoskopicheskuyu kholetsistektomiyu v usloviyakh ingalyatsionnoi anestezii sevofluranom.

OBJECTIVE: To substantiate the advisability of using cytoflavin to correct postoperative cognitive dysfunction (POCD) in patients undergoing video laparoscopic cholecystectomy (VLCE) under conditions of inhalation anesthesia with sevoflurane. MATERIAL AND METHODS: The data of two representative groups of patients (n=60) who underwent video-laparoscopic cholecystectomy under the conditions of inhalation anesthesia with sevoflurane were analyzed. At the stages of the perioperative period, in order to monitor the state of higher mental functions, neuropsychological testing was performed: anxiety and depression scales (HADS), the Montreal scale of cognitive dysfunction (MoCA), and frontal dysfunction batteries (FAB). Patients of the first group (n=19) were not corrected for POKD. For the correction of cognitive impairment, patients of the second group (n=41) were treated with Cytoflavin according to the 20 ml regimen per 250 ml of 0.9% sodium chloride solution intravenously once before the operation, then within 4 days of the postoperative period. RESULTS: Neuropsychological testing in group I patients revealed the development of moderate POCD. The inclusion of Cytoflavin in the treatment regimen in the II group of patients contributed to an improvement in the state of HMF, accompanied by a decrease in the level of anxiety and depression. CONCLUSION: The inclusion of Cytoflavin in treatment regimens helps prevent the development of POKD and is accompanied by an improvement in the state of higher mental functions, which is manifested by a decrease in the level of anxiety and depression, favorably affecting the emotional background of patients.

[The efficacy of metabolic treatment in the early recovery period of patients with ischemic stroke]. / Éffektivnost' metabolicheskoi korrektsii v rannem vosstanovitel'nom periode u patsientov s ishemicheskim insul'tom.

AIM: To evaluate the efficacy of including cytoflavin in rehabilitation measures in the early recovery period of patients with ischemic stroke. MATERIAL AND METHODS: Results of rehabilitation measures of 100 patients (50 women and 50 men, aged 18 to 85 years) in the early recovery period of ischemic stroke were analyzed. Psychological testing included NIHSS, MMSE, Rankin scale, Rivermead mobility index, exercise tolerance test. Depending on the rehabilitation scheme, patients were divided into the main group (n=50), who received a verticalization course and cytoflavin (intravenously, drip 20.0 ml in 250.0 ml 5% glucose for 14 days). The control group (n=50) included patients who received standard treatment. RESULTS AND CONCLUSION: Inclusion of cytoflavin in the rehabilitation scheme for patients with ischemic stroke increased the effectiveness of treatment, which was manifested by a decrease in the severity of neurological disorders assessed with NIHSS by 17.6% in the main group versus 10.8% in the control group (p<0.05) and recovery of cognitive functions assessed with MMSE by 5.8% versus 1.6%, respectively (p<0.05). In addition, there was a positive dynamics in the restoration of blood pressure (by 37.1% in the main group versus 30.6% in the control group (p<0.05)).

[The intraoperative prophylaxis of local ischemical brain damage in neurosurgical patients with cerebral aneurysm]. / Intraoperatsionnaia profilaktika lokal'nogo ishemicheskogo povrezhdeniia golovnogo mozga u neirokhirurgicheskikh patsientov s tserebral'noi anevrizmoi.

AIM: To study the effectiveness of intraoperative administration of Cytoflavine for the prevention of ischemic brain injury during cerebral aneurysm (CA) clipping with temporary occlusion of the leading artery under general anesthesia. MATERIAL AND METHODS: The prospective cohort single-center study included 40 patients with CA ( the main group - 27 patients with intraoperative administration of cytoflavine; the comparison group -13 patients without use of cytoflavine), who underwent aneurism clipping with temporary occlusion of the afferent artery. We assesed the intraoperative state of the brain, the time of awakening and extubation of patients after surgery, neurological deficit and local ischemic changes in the area of surgery according to the CT of the brain in the early postoperative period, resuscitation bed-day and the relationship of these indicators with the duration of temporary occlusion of the afferent artery in the selected groups of patients. RESULTS: In intergroup comparison, patients of the main group treated with intraoperative cytoflavin showed a reduction in the time of awakening (p=0.013) and the time of extubation (p=0.01) both with temporary occlusion of the afferent artery and in patients without temporary occlusion (p<0.05). The duration of resuscitation bed-day decreased in the main group of patients receiving intraoperatively cytoflavine (p=0.01), as well as in patients in the comparison group without temporary occlusion (p<0.05). CONCLUSION: Temporary occlusion of the afferent artery with short intervals of vessel occlusion in combination with intraoperative intravenous administration of cytoflavine expands the tolerability to artery occlusion in patients operated in the 'cold' period, reduces the possibility of neurological deficit, reduces the recovery period and resuscitation bed-day after surgical clipping CA.

[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.

[Prevention of cognitive dysfunction in elderly cancer patients operated on the pelvic organs in conditions of multimodal anesthesia]. / Profilaktika kognitivnoi disfunktsii u pozhilykh onkologicheskikh bol'nykh, operirovannykh na organakh malogo taza v usloviiakh mul'timodal'noi anestezii.

The aim of the study was to evaluate the impact of various variants of multimodal anesthesia on the cognitive functions of elderly patients after surgical interventions on pelvic organs, the development of preventive measures for POCD. MATERIAL AND METHODS: A study was conducted in 76 elderly patients aged 62 to 84 years with an increased risk of developing POCD. Of these, 46 women and 30 men. Patients were divided into two groups, depending on the type of anesthesia. The 1st group consisted of 37 patients who had low-flow anesthesia with sevoflurane combined with epidural analgesia. 2nd - 39 patients who had anticipated multimodal analgesia on the basis of systemic administration of lidocaine, sulphate magnesia, verapamil. In each group, patients are divided into subgroups - the main (O) and control (K). In the main subgroups anesthetics were supplemented with 20 ml. Cytoflavin, administered 20-25 minutes before the end of surgery and on the 1-3 days of the perioperative period. Cognitive functions were assessed by standardized scales: Mini Mental State Examination (MMSE), Montreal Cognitive Evaluation Scale (MoCA), Frontal Assessment Batteries (FAB). The level of anxiety and depression was determined by the hospital scale of anxiety and depression (HADS). RESULTS: At oncological patients of advanced age in 52.5% of cases there is a moderate degree of cognitive impairment. In the perioperative period, in the study groups, when using different variants of multimodal anesthesia, there is an equivalent transient decrease in cognitive functions by 12.5 and 12.8%. The use of cytoflavin can reduce the manifestation of POCD from 1-day perioperative period, improve the cognitive status of patients. CONCLUSION: In cancer patients of advanced age, cognitive impairment is observed, aggravated after surgical treatment, regardless of the variant of multimodal anesthesia. Protection by Cytoflavin allows to restore the cognitive functions of elderly cancer patients, reduce the manifestations of POCD.

[Investigation of markers for myocardial remodeling during experimental hypobaric hypoxia in the correction with cytoflavin]. / Issledovanie markerov remodelirovaniia miokarda pri éksperimental'noi gipobaricheskoi gipoksii na fone korrektsii preparatom tsitoflavin.

The limited possibilities of determining myocardial morphological changes in the clinic make it necessary to investigate the effects of intermittent hypobaric hypoxia in an experiment setting. OBJECTIVE: To reveal the peculiarities of changes in the markers of myocardial remodeling in experimental hypobaric hypoxia. MATERIAL AND METHODS: The investigation was conducted on 26 mature male Wistar rats weighing 220-310 g, which were divided into 3 groups: 1) 6 intact animals; 2) 10 rats that were exposed to 30-day simulated hypobaric hypoxia without correction; 3) 10 rats that were given once-daily intraperitoneal injections of cytoflavin solution at a rate of 0.5 ml/100 g of body weight for 30 days before immersion in a hypobaric chamber. RESULTS: The early stages of myocardial remodeling in hypobaric hypoxia were found to be characterized by structural re-systematization of the components of the normal ventricular wall, which was manifested by cardiomyocyte hypertrophy and ischemia; circulatory disorders; fibroblast proliferation that dramatically enhances the extracellular expression of protein matrix, which can lead to the formation of fibrous tissue and irreversible myocardial dysfunction. Elevated matrix metalloproteinase levels are evidence for collagen degradation and cardiac remodeling. In the authors' opinion, the cyto- and angioprotective effects of cytoflavin in rats treated with the latter used in combination therapy are associated with the composition of the drug, the active components of which have mutually potentiating effects, are inducers of the major metabolic pathways in the cells and are also activators of key energy-generating processes. CONCLUSION: Identification of the molecular mechanisms of myocardial remodeling is of great practical importance. This enables remodeling markers to be considered as a potential therapeutic target in the treatment of hypoxia-induced myocardial injury.

[Intraoperative cerebroprotection in total intravenous anesthesia in children of school age]. / Intraoperatsionnaia tserebroprotektsiia pri total'noi vnutrivennoi anestezii u detei shkol'nogo vozrasta.

AIM: To improve the quality of anesthesia in school-age children by using intraoperative metabolic-mediated cerebroprotection to reduce the incidence of cognitive impairment after total intravenous anesthesia based on propofol. MATERIAL AND METHODS: A randomized, prospective, longitudinal clinical study was conducted, involving 60 school-age children operated under total intravenous anesthesia on the basis of propofol. Children were randomized into two equal groups. Patients of the 1st group did not receive intraoperative metabolic-mediated cerebroprotection, patients of the 2nd group were treated with cytoflavin. For Z-assessment of changes in cognitive potential, neuropsychological testing of 30 children of the same age who were not subjected to surgical intervention was performed. RESULTS AND CONCLUSION: On the 1st day of the postoperative period, 13.79% of patients of the 1st group had postoperative cognitive dysfunction (POCD), on the 7th day, POCD was observed in 26.67% of children. In the 2nd group, POCD was detected in 6.67% and 3.33% of patients on the 1st and 7th day, respectively (p=0,009). The results confirm the efficacy of cytoflavin in intraoperative prevention of POCD in school-age children.

[Dynamics of indicators of the functional state of the central nervous system in Navy operators treated with cytoflavin after a long working cycle]. / Dinamika pokazatelei funktsional'nogo sostoianiia tsentral'noi nervnoi sistemy u operatorov Voenno-morskogo flota posle dlitel'nogo rabochego tsikla na fone priema tsitoflavina.

AIM: To evaluate the efficacy of cytoflavin in the correction of functional state and working ability of Navy operators after a long working cycle. MATERIAL AND METHODS: Results of the examination of 25 Navy operators, aged from 27 to 42 years, were analyzed at baseline and after treatment with cytoflavin. The Rusalov questionnaire for Individuality Formal Dynamic Properties and EEG were used to evaluate the state of participants. RESULTS AND CONCLUSION: The results demonstrate the ability of cytoflavin to exert the positive effect on the energetic component of the functional state of Navy operators after a long working cycle, increasing the psychomotor activity and optimizing the spontaneous electrical activity of the brain. The activation of energetic potential, physical activity and emotional reactions by cytoflavin is correlated with the growth of the central nervous system reserves in Navy operators treated after a long working cycle.

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

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

Delivery of Riboflavin-5'-Monophosphate Into the Cornea: Can Liposomes Provide Any Enhancement Effects?

Keratoconus is a progressive condition caused by the thinning of the cornea, which eventually deforms the front surface of the eye into a cone shape leading to ghosting, multiple images, glare, and several other vision problems. Currently, keratoconus is treated with UV-induced riboflavin (Rb)-mediated collagen cross-linking, which requires a physical removal of the corneal epithelium under topical anesthesia. This study reports the penetration of Rb and its more water-soluble form, riboflavin-5'-monophosphate (RbP), into the bovine cornea ex vivo. Using ex vivo bovine corneal tissues and 0.8 mg/mL drug solutions in phosphate buffer, it was established that RbP penetration into the cornea within 3 h of diffusion experiment was greater (17.3 ± 0.8 µg) compared with Rb (10.4 ± 4.2 µg). In the cornea, RbP was found to convert to Rb, which is mediated with enzymes present in this tissue. Several formulations including the conventional and propylene glycol-containing liposomes with encapsulated RbP have been developed, and their effect on the drug penetration into the bovine cornea was evaluated. Encapsulation of RbP into the liposomes did not provide any statistically significant improvement in the penetration of RbP into the cornea.

[Meta-analytic assessment of parenteral cytoflavin effectiveness in different neurologic disorders]. / Metaanaliticheskaia otsenka klinicheskoi éffektivnosti tsitoflavina pri nevrologicheskikh zabolevaniiakh.

AIM: To carry out an integral quantitative assessment of the clinical efficacy of parenteral use of cytoflavin in treatment of patients with CNS disorders based on the systemic selection of published controlled clinical trials and their meta-analysis. MATERIAL AND METHODS: Twenty-one high evidence-based studies on the efficacy of parenteral use of cytoflavin in different CNS disorders (4314 patients) have been analyzed. Comparisons with basic treatment groups were undertaken to clarify the drug clinical effects adjusted for heterogeneity and variability of response parameters. RESULTS AND CONCLUSION: An analysis of formalized efficacy indicators (increase in the absolute and relative value, odds ratio (OR) etc.) has demonstrated the advantages of cytoflavin. Group combination has increased the statistical power of the meta-analysis. Two models with fixed (Mantel-Haenszel amendment) and random effects were used. All the estimation protocols in different clinical groups of patients with neurologic diseases provided similar results and confirmed the stability of calculated values irrespective of heterogeneity of data arrays. OR of positive outcomes in neuropathologies treated with cytoflavin was 3,02 with χ2 heterogeneity 427,3 and p = 0,000…, I2= 85,7% (82%; 88%).

[Study cytoflavin dose-dependent effect in the treatment of acute ischemic stroke]. / Izuchenie dozozavisimogo effekta tsitoflavina v terapii ostrogo perioda ishemicheskogo insul'ta.

AIM: To compare the efficacy of cytoflavin in doses of 10 and 20 ml/day in the complex pharmacological therapy of patients with acute ischemic stroke. MATERIAL AND METHODS: Eighty-six patients, aged from 43 to 85 years, were examined. Patient's status was assessed using the NIHSS, the Rankin scale, the Barthel index and the Rivermead mobility index. Patients were stratified into 3 groups: patients of group 1 received standard treatment, patients of group 2 received cytoflavin in dose of 10 ml/day in addition to standard treatment and patients of group 3 were treated with cytoflavin in dose of 20 ml/day in addition to standard treatment. RESULTS AND CONCLUSION: Cytoflavin in doses of 10 and 20 ml/day significantly promotes the regression of neurological deficit, improves day-to-day activity, and therefore, improves functional independence in daily life. The dose-dependent effect of the drug was shown. The use of cytoflavin in dose of 20 ml/day resulted in the more rapid regress of neurological symptoms during inpatient treatment and higher indices of daily activities and functional independence of patients that was important for the further rehabilitation.

Targeted delivery of glucocorticoids to macrophages in a mouse model of multiple sclerosis using inorganic-organic hybrid nanoparticles.

Glucocorticoids (GC) are widely used to treat acute relapses in multiple sclerosis (MS) patients, but their application is accompanied by side effects due to their broad spectrum of action. Here, we report on the therapeutic option to apply GC via inorganic-organic hybrid nanoparticles (IOH-NP) with the composition [ZrO]2+[(BMP)0.9(FMN)0.1]2- (designated BMP-NP with BMP: betamethasone phosphate; FMN: flavinmononucleotide). We found that these BMP-NP have an increased cell type-specificity compared to free GC while retaining full therapeutic efficacy in a mouse model of MS. BMP-NP were preferentially taken up by phagocytic cells and modulated macrophages in vivo more efficiently than T cells. When GC were applied in the form of BMP-NP, treatment of neuroinflammatory disease in mice exclusively depended on the control of macrophage function whereas effects on T cells and brain endothelial cells were dispensable for therapeutic efficacy. Importantly, BMP-NP were not only active in mice but also showed strong activity towards monocytes isolated from healthy human volunteers. We conclude that application of GC via IOH-NP has the potential to improve MS therapy in the future.

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

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

[Effect of cytoflavin on the clinical and autonomic-psychological manifestations of hypertensive disease].

AIM: To evaluate the impact of incorporating cytoflavin in a treatment regimen for patients with different stages of hypertensive disease (HD). SUBJECTS AND METHODS: The results of treatment were analyzed in 140 patients with HD (53 with Stage I, 50 with Stage II, and 37 with Stage III). According to the treatment regimen, the patients were divided into 2 groups. A study group (n=74) received combination treatment involving antihypertensive therapy and cytoflavin intravenously dropwisely in a single dose of 200 ml of 5% glucose solution for 10 days, then 2 tablets twice daily for 60 days, with a total cycle time being 70 days. A comparison group (n=66) had antihypertensive therapy only. Thirty apparently healthy individuals (a control group) were examined to have reference values. All the patients were examined using conventional clinical and laboratory studies. The patients' complaints and neurological status were assessed using respective questionnaires over time - before and after treatment. RESULTS: The incorporation of cytoflavin in a treatment regimen was ascertained to reduce the degree of anxiety, depressive, dissomnic, and cognitive disorders, improves quality of life in patients with Stage I HD, and lowers the degree of asthenic and autonomic disorders in all disease stages. CONCLUSION: The found efficacy and safety of the drug may recommend its incorporation in combination therapy regimens for Stages I-III HD.

[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.

[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.