[TREATMENT OF THROMBOTIC COMPLICATIONS IN THE INJURED PERSONS IN POLYTRAUMA].

Comparative results of treatment of thrombotic complications in the injured persons with combined trauma of trunk in two groups were adduced. The scheme of prophylax3 is and treatment of thrombotic complications was proposed; application of this scheme have permitted to reduce their rate in 5 times, from 54.5 to 11.2%.

[Peyronie's disease: comparative results of conservative treatment].

Long-term clinical experience with conservative treatment of Peyronie's disease has demonstrated that clinical efficacy of this therapy comprises maily anesthesia while erectile problems are not solved. Introduction of the drugs into the fibrous plaque is not adequate and hard to perform. Some drugs affect only some components of pathogenesis. For stabilization of the process it is recommended to use transdermal electrophoresis or phonophoresis. The search for new effective drugs and methods continues.

Efficacy of hypolipidemic treatment in inhibition of experimental atherosclerosis: the effect of nicotinic acid and related compounds.

The hypolipidemic and antiatherogenic effects of different nicotinic acid derivatives were studied. Five rabbit groups maintained on an atherogenic diet were given simultaneously various nicotinic acid derivatives (50 mg/kg body weight/day): nicotinic acid, Xantinol-nicotinate, beta-pyridylcarbinol or Pirozadil (bis-3,4,5-trimethoxybenzoate, 2,6-pyridindiyldimethylene). All 4 compounds showed a clear hypocholesterolemic and antiatherogenic effect, as measured by serum cholesterol, and by planimetric evaluation of the aortic lesions in terms of percent surface area affected in the aortas and coronary lumen. The simultaneously observed elevation of the HDL/LDL cholesterol ratio of the aortic tissue possibly indicates an antiatherogenic effect of these changes.

Decrease in LDL and increase in HDL concentrations in type II hyperlipoproteinaemic patients on low-dose combination therapy of cholestyramine and Complamin.

A low-dose combination of Complamin retard (1 g t.i.d.) and cholestyramine (4 g b.i.d.) was compared with each agent alone in 2 serial open trials without dietary restriction using type IIa and IIb hyperlipoproteinaemic patients. Complamin alone produced decreases in LDL and VLDL cholesterol concentrations (up to 20%) whereas cholestyramine alone produced only a modest reduction in LDL (up to 15%). The combination produced marked, progressive reductions in total cholesterol (up to 35%) and LDL (up to 40%); reductions in VLDL (up to 45%), total triglyceride (up to 60%) and free fatty acids (up to 60%) were found only in type IIb patients. The average increase in HDL-cholesterol from the 2 studies for combination therapy was 35%. No side-effects were reported or measured and compliance was excellent. The results demonstrate the potential of a method of achieving beneficial actions on lipoprotein levels with a well-tolerated therapy.

Serum profile of non-esterified fatty acids (NEFA) in patients with hyperlipoproteinemia under xantinol--nicotinate (XN) medication.

The effect of 50 mg/kg body weight Xantinol-nicotinate (XN) on serum lipids and on non-esterified fatty acids (NEFA) was tested in 94 out-patients with hyperlipoproteinemia Types IIa, IIb, IV and V. The lipids were measured before treatment, during a 3-week period of drug administration and 10 days after rejection. In each group of hyperlipoproteinemic patients the lipid lowering effect of XN was accompanied by a constant fall in serum NEFA levels. The time dependent course of NEFA showed that the higher the initial level, the longer the time span required to achieve the lowest values. In the context of the partially conflicting data on the hypolipidemic action of nicotinic acid and its derivatives, it is suggested that the constant decrease in NEFA induced by XN treatment might contribute significantly to the lipid lowering effect of this drug.

Xanthinol nicotinate in the management of leg ulcers associated with haemoglobinopathies.

The therapeutic role of xanthinol nicotinate, with its potent action on the peripheral circulation, in promoting healing of leg ulcers when added to conservative measures of ulcer treatment in adult beta-thalassaemia major and sickle cell thalassaemia, was evaluated in a double-blind crossover trial in 16 patients suffering from multiple leg ulcers. Conservative measures of ulcer treatment were leg raising in horizontal position for 14 hours, bed-rest, local antiseptic dressings and antibiotics. Xanthinol nicotinate or placebo was administered in a daily dose of 8 tablets (2400 mg) for 10 weeks. Comparison of the treatment results of conservative measures plus xanthinol nicotinate and those of conservative measures plus placebo revealed a statistically significant higher rate of complete ulcer healing during xanthinol nicotinate therapy (p less than 0.01). Apart from a low incidence of generalized itching and flushing at the start of the trial, xanthinol nicotinate was well tolerated in the prescribed dose.

Role of xanthinol nicotinate in the revival of monkeys subjected to acute haemorrhagic shock.

The therapeutic potential of xanthinol nicotinate in the revival of anaesthetised monkeys subjected to acute blood loss was investigated. The arterial pressure was lowered to 40 +/- 5 mmHg by rapid arterial bleeding and was maintained at this level for 2 h. Shed blood was then returned through infusion, to the animals. Animals alive at the end of 72 h observation period were considered as survivors. The test drug was infused 1/2 h prior to and 1/2 h, 1 h, 1 1/2 h and 2 h after the onset of oligaemic hypotension. The animals which received normal saline instead of test drug were treated as control. The physiological and biochemical parameters recorded prior to and after the onset of oligaemic hypotension were heart rate, pulse pressure, electrocardiogram, electroencephalogram (EEG), lactic acid, creatine phosphokinase, urea and glucose. The results showed tachycardia, narrowing of pulse pressure, depression of ST segment with occasional T inversion, slowing of EEG with increase in amplitude, rise in blood lactic acid, creatine phosphokinase, urea and glucose. The magnitude of these responses were proportional to the duration and severity of shock. These changes were markedly attenuated in the drug treated group. Enhancement of survival was observed in drug treated groups as compared to control. It was 10 per cent in control as against 60, 86, 71, 57 and 50 per cent in the groups which received the test drug 1/2 h prior to and 1/2 h, 1 h, 1 1/2 h and 2 h after the onset of oligaemic hypotension. It is concluded that the beneficial effect of the drug in the revival of monkeys subjected to acute haemorrhagic shock may be due to better maintenance of tissue perfusion.

Treatment of intermittent claudication with antiplatelet agents.

In a double-blind study, 296 patients with intermittent claudication (Fontaine stage II) were treated with 250 mg ticlopidine twice daily, 500 mg aspirin every third day plus 75 mg dipyridamole three times daily, or 300 mg xanthinol nicotinate three times daily for 6 months. Ticlopidine and aspirin/dipyridamole, but not xanthinol nicotinate, improved platelet aggregation, reduced beta-thromboglobulin, platelet factor IV and fibrinopeptide A concentrations, and increased antithrombin III concentrations and red blood cell filterability. No changes in lipid profiles, platelet count or fibrinogen were recorded following any treatment. The doppler systolic blood pressure ratio was improved in patients treated with ticlopidine or aspirin/dipyridamole, but not with xanthinol nicotinate. It is concluded that antiplatelet treatment is useful for the treatment of limb arteriopathy.

Pentoxifylline in strokes: a clinical study.

The results of a comparative clinical study with pentoxifylline -- a new vasoactive compound -- and xanthinol nicotinate in fifty-eight patients suffering from cerebral thrombosis with hemiplegia or monoplegia, are presented. Pentoxifylline appeared to be more effective in reducing motor deficit and was significantly better in improving the patients' intelligence and memory score. Recovery from speech deficit was equally well seen with both drugs.

[Raynaud's phenomenon: diagnostic and therapeutic aspects]. / Il fenomeno di Raynaud: aspetti diagnostico-terapeutici.

The Authors report their experience concerning 120 patients with Raynaud's Disease (50 pats.) or Syndrome (70 pats.). All patients were studied before and after treatment, by clinical, thermometric, oscillographic and photoplethysmographic observation and by the Doppler examination, in order to evaluate the functional and organic component of the disease. Surgical treatment was reserved to 45 patients with secondary or primitive Raynaud's phenomenon refractory to medical therapy. The treatment of choice was thoracic sympathectomy. The result was excellent in 64% of cases, fair in 26%, and nil in 8%. 75 patients were treated with various drugs for a period of 6 months or 1 year. In 54% of cases the result was excellent, fair in 29%, and nil in 16%. The Authors conclude that diagnosis of Raynaud's Syndrome is above all clinical, that a leading part is played by photoplethysmography and the Doppler examination, and that medical therapy is indicated in the first instance, since it is capable of preventing the rise of those distal trophic disorders that constitute one of the main indications of surgical treatment.

[Effect of complamin on the systemic and cerebral hemodynamics of atherosclerosis patients with chronic cerebral vascular disorders]. / Vliianie komplamina na sistemnuiu i tserebral'nuiu gemodinamiku u bol'nykh aterosklerozom s khronicheskim narusheniem mozgovogo krovoobrashcheniia.

Thirty-eight atherosclerotic patients with chronic disorders of the cerebral circulation (CDCC) received 300 mg of complamin by intravenous drip. The clinical signs of vasodilation were noted at 5-15 min after the initiation of infusion whereas following it the findings observed included a significant reduction in the kinetic parameters of the myocardium and globular blood volume, an elevation in the peripheral vascular resistance and tone of the cerebral hemisphere vessels, a decrease in the pulse vascular resistance and tone of the cerebral hemisphere vessels, a decrease in the pulse blood-filling of the left carotid bed and deterioration of intracerebral venous congestion. Complamin is recommended for use to improve the rheological properties of the blood and microcirculation in patients with CDCC with elevated or normal myocardial contractility. Its application should be avoided in patients with low cardiac output and heart failure, in cases of labile arterial pressure and vascular dystonia with marked pulse variations in the cerebral vessels and also when the blood return to the cerebral veins is impeded.

[Effect of complamin on the levels of ACTH, cortisol and lipids in the blood of elderly patients with ischemic heart disease]. / Vliianie komplamina na soderzhanie AKTG, kortizola i lipidov v krovi bol'nykh ishemicheskoi bolezn'iu serdtsa starshikh vozrastnykh grupp.

Blood ACTH, cortisol and lipid levels, as well as complamin effects thereon, were studied in 116 elderly and old coronary patients. Changes of lipid metabolism were not identical in coronary patients of different age. They were particularly unfavorable in old age. ACTH and cortisol levels and the ACTH/cortisol ratio change with age, and the highest hypercortisolemia is found in old age. Complamin regulates lipid metabolism and blood ACTH and cortisol in coronary patients of advanced age. The ACTH/cortisol ratio is however unaffected by treatment and remains stable in all age groups.

[Effect of a series of vasoactive drugs on the compensatory adaptive processes of the brain during acute experimental cerebral venous stasis]. / Vliianie riada vazoaktivnykh preparatov na kompensatorno-prisposobitel'nye protsessy v golovnom mozge pri ostroi tserebral'nom venoznom zastoe v éksperimente.

In 120 rats with acute intracranial venous congestion the authors investigated the influence of some vasoactive drugs on compensatory-adaptive processes in the brain. They studied reactions of the nerve cells, pericellular and perivascular edema, and vessels to the administration of cavinton, trental, xanthinol nicotinate, troxevasin, and euphyllin. It has been demonstrated that vasoactive drugs have a varying influence on the compensatory processes in the brain. Thus, cavinton and trental significantly improve the venous outflow from the cranial cavity, sharply reduce cerebral edema, and stimulate reparative processes. Xanthinol nicotinate deteriorates compensatory-adaptive reactions, troxevasin exerts a favourable effect at an early stage, euphyllin acts in a biphasic mode.

[Value of complamin and seduxen in the correction of hemodynamic disorders of epileptic children and adolescents]. / Znachenie komplamina i seduksena v korrektsii gemodinamicheskikh narushenii u detei i podrsotkov, bol'nykh épilepsiei.

Children and adolescents with an unfavourable course of epilepsy received a multiple modality treatment including complamin (xantinolnicotinate). Thirty of the 36 patients showed positive response which was twice as much as in patients receiving only anticonvulsive drugs. The study of the cerebral hemodynamics with the help of regional cerebral blood flow determination by means of intravenous administration of 133Xe and REG showed a tendency to normalization of the vascular supply to the brain. In 66 of the 87 epileptic patients studied the employment of diazepam improved the microcirculation of the cerebral tissue and the venous outflow from the cranial cavity which allows the recommendation of diazepam as a vasoactive agent.

[Evaluation of the efficacy of xavin treatment of ischemic heart disease]. / Otsenka éffektivnosti lecheniia bol'nykh ishemicheskoi bolezn'iu serdtsa ksavinom.

The results of ksavin treatment of 90 patients suffering from ischemic heart disease are discussed. Ksavin was given in a daily dose of 450-1,200 mg for 3 weeks. The clinical efficacy of the treatment was correlated with the risk factors and the indices of the ECG, centra hemodynamics and spiroergometry. The effect was good in 55% of the patients and satisfactory in 30%. No effect was produced in 15% of the patients. The best results were observed in younger patients with disease of short duration and no concomitant arterial hypertension. A favourable effect of ksavin on lipid metabolism and blood coagulation was noted. The study showed ksavin to be an effective measure in the treatment of ischemic heart disease.

[Effect of xanthinol niacinate on the autoimmunity and capillary permeability in patients with stable stenocardia]. / Vliianie ksantinol-nikotinata na sostoianie autoimmuniteta i pronitsaemost' kapilliarov u bol'nykh so stabil'noi stenokardiei.

A three-month antianginal therapy with long-acting nitrates and xanthinol nicotinate given in various daily doses have shown that there is a positive clinical effect, a reduction in the level of immune complexes and IgG in most patients, which is followed by a decrease in capillary permeability and dienic conjugate levels both in erythrocytes and plasma.

[The efficacy of using antiaggregants in chronic glomerulonephritis with grade-I chronic kidney failure]. / Efektivnist' vykorystannia antyahrehantiv pry khronichnomu hlomerulonefryti z I stupenem khronichnoï nyrkovoï nedostatnosti.

Both short-term and long-term effectiveness of xantinole nicotinate as well as trentale and combinations thereof with dipyridamole has been demonstrated in patients with chronic glomerulonephritis presenting with grade 1 chronic renal insufficiency, which fact can be accounted for by their vasoactive and antiaggregant actions. Particular regimens have been developed to treat the medical condition in question with the above drug preparations, comparative evaluation was done of their effects on the clinical course of the illness as well as on the effective renal plasma flow, concentration of nitrogenous remainder in blood and urine, concentration of medium size molecules in blood. It is advisable that antiaggregants be administered long term (from several months to several years).

[Disorders of organic hemodynamics of the liver and their correction in suppurative cholangitis]. / Narusheniia organnoi gemodinamiki pecheni i ikh korrektsiia pri gnoinom kholangite.

The blood flow in the portal vein and hepatic artery was studied by means of ultrasonic Doppler flow measurement to investigate organic and regional hemodynamics of the liver in purulent cholangitis. The blood flow in the portal vein was found to be significantly diminished in patients with acute cholangitis and hepatic failure. Hepatic microcirculation was studied on a experimental model of obstructive jaundice and obstructive purulent cholangitis in rats by polarographic measurement of hydrogen clearance. Considerable reduction of the volume rate of the local blood flow was noted, and the degree of the reduction was related to the severity and duration of the disease. Decompression of the biliary tract by external drainage improved the local blood flow rate which, however, diminished again in prolonged external drainage. The use of pharmacological agents for correction of microcirculation in decompression of the biliary tract led to total and rapid correction of the volume rate of the local blood flow.

[The dynamic changes in the regional volumetric cerebral blood flow and local vascular reactivity in acute craniocerebral trauma in animals with alloxan diabetes]. / Dinamika izmenenii regionarnogo ob''emnogo mozgovogo krovotoka i mestnoi sosudistoi reaktivnosti pri ostroi cherepno-mozgovoi travme u zhivotnykh s alloksanovym diabetom.

The authors studied the condition of regional volumetric cerebral blood flow and local vascular reactivity in experimental mild and moderate craniocerebral trauma in 31 animals with alloxan diabetes and in 29 animals with isolated brain injury. It is shown that alloxan diabetes aggravates cerebral vascular disorders occurring in injury to the skull and brain. Vasoactive agents Cavinton and xantinol nicotinate promote regression of the changed cerebral blood flow.

[Occlusion rheoplethysmography]. / Universal'naia okkliuzionnaia reopletizmografiia.

The investigation of the peripheral circulation by using the all-purpose occlusion rheoplethysmography enables the reaction of rising the venous tone in response to the action exerted by the tissue ischemia products to be quantitatively estimated along with a one-time determination of the arterial and venous hemodynamics of the crus at rest and in reactive hyperemia. The blood flow volume-velocity rates determined by means of the proposed method are of a considerable diagnostic value for characterization of the peripheral hemodynamics in patients with cardio-vascular pathology, in performing pharmacological tests and in medication with drugs displaying vasoactive properties.