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 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.

[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.

[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.

[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.

[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.

[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.

[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.

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.

[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.

Matrix tablets based on a carrageenan with the modified-release of sodium riboflavin 5'-phosphate.

The focus of this work was to produce modified-release monolithic matrix tablets containing sodium riboflavin 5'-phosphate (vitamin B2) as active pharmaceutical ingredient (API). Riboflavin 5'-phosphate is absorbed from the upper gastrointestinal tract by a specific transport mechanism. The aim of this work was the development of modified-release tablets from which most or the entire API can dissolve within 5 h. The dissolution was started in medium pH 1.2 (gastric juice) and finished in medium pH 4.5. The matrix former was iota-carrageenan combined with microcrystalline cellulose (MCC) and lactose in different ratios. Factorial design was used in this work so as to study the effects of the MCC/lactose ratio on the parameters of the tablets, and especially on the dissolution process. The dissolution data were subjected to statistical analysis, and the release profiles were fitted with different models. It was found that the MCC/lactose ratio influenced the quality of the tablets to a high degree. The Korsmeyer-Peppas model proved to characterize the total dissolution profile best, but fitting of the separate sections was also possible with a linear model.

[Investigation of the antioxidant activity and cardioprotective effect of reamberin and cytoflavin in newborn rats exposed to chronic hemic hypoxia].

The authors analyzed the antioxidant activity of reamberin and cytoflavin and evaluated their cardioprotective effect, by investigating lipid peroxidation and oxidative modification of plasma proteins, as well as the ultrastructure of newborn rat cardiomyocytes under chronic hemic hypoxia induced by sodium nitrite. Reamberin and cytoflavin can reduce the manifestations of mitochondrial dysfunction and the degree of cardiomyocyte damage in the neonatal rats due to the antioxidant and membrane-protective properties of the drugs. Succinic acid in combination with the metabolic components of the drugs significantly inhibits lipid peroxidation, by improving the structure of membranes and the mitochondrial function of cardiomyocytes.

[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.

[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.

[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.

[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.

[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.