[Results of a multicenter observational program to evaluate the effectiveness of complex therapy of patients with chronic cerebrovascular pathology with cognitive impairment with Cortexin and Neuromexol (CORNELia study)]. / Rezul'taty mnogotsentrovoi nablyudatel'noi programmy otsenki effektivnosti kompleksnoi terapii patsientov s khronicheskoi tserebrovaskulyarnoi patologiei s kognitivnymi narusheniyami preparatami Korteksin i Neiromeksol (issledovanie KORNElii).

OBJECTIVE: To evaluate the effectiveness of complex therapy with Cortexin and Neuromexol in patients with chronic cerebral ischemia (CCI) and cognitive impairment (CI). MATERIAL AND METHODS: We examined 801 patients with CCI on the background of arterial hypertension and atherosclerosis with confirmed CI: 329 (41.1%) men and 472 (58.9%) women aged 30 to 80 years (mean age 64±10 years), who were examined. Cortexin and Neuromexol. Examination - Mini-Mental State Examination (MMSE) scale, hour-long drawing test (HDT) and severity of depressive states (Brief Geriatric Depression Scale, Mini Geriatric Depression Scal, MGDS). In 30 patients receiving Cortexin and Neuromexol (main group, MG) and 30 patients in the comparison group (CG), biomarkers of ischemic brain damage (NSE, antibodies to NR2, VEGFA) were determined. The examination was carried out before the start of treatment and after 30 days. RESULTS: During therapy with Cortexin and Neuromexol, characteristic signs of a decrease in the severity of CI were noted (p<0.05). A positive correlation was revealed between the performance indicators of the MMSE and TFC tests, both before and after treatment (r=0.5 and r=0.6, respectively; p<0.05). A positive effect of therapy on the emotional background of patients was noted, in particular, a decrease in the severity of depressive symptoms on the MGDS scale. During therapy, a 2-fold decrease in the NSE level (p<0.05) was detected in the MG, which indicates a decrease in the structural and functional parameters of biomembrane neurons in the brain. The concentration of antibodies to NR2 decreased compared to the baseline level in both groups (p<0.05), and VEGFA decreased only in the MG (p<0.05). CONCLUSION: The results of the study allow us to recommend the complex prescription of Cortexin 10 mg/day for 10 days and Neuromexol tablets 125 mg (375-750 mg/day) for 30 days for chronic CVD. Complex therapy with Cortexin and Neuromexol is effective and safe in patients with CCI and CI.

[Evaluation of the effectiveness of the drug Cytoflavin in patients with dyscirculatory encephalopathy who have undergone a new coronavirus infection]. / Otsenka effektivnosti preparata Tsitoflavin u patsientov s distsirkulyatornoi entsefalopatiei, perenesshikh novuyu koronavirusnuyu infektsiyu.

OBJECTIVE: To evaluate the effectiveness of the Cytoflavin in patients with dyscirculatory encephalopathy (DE) who had a new coronavirus infection. MATERIAL AND METHODS: 82 patients were examined: 16 (19.5%) men and 66 (80.5%) women aged 58 to 80 years, mean age 69±6 years and 70±6 years, respectively. All patients had moderate vascular cognitive impairment (less than 26 points according to the MoCA test), a history of COVID-19 in the period from 3 to 12 months before the start of the study. Patients before COVID-19 were registered with a neurologist with chronic cerebrovascular diseases with non-demented cognitive impairment of vascular origin. Patients of the main group (MG) received the Cytoflavin from the 1st to the 25th day of observation, inclusive, 2 tablets 2 times a day against the background of standard basic therapy. Patients in the comparison group received only standard basic therapy. RESULTS: It was found that during therapy with Cytoflavin, patients noted a positive trend in the form of a decrease in the symptoms of cognitive impairment, improved orientation and working memory, concentration of attention and counting. Also, patients in MG noted a decrease in fatigue and depressive disorders, an increase in motivation and a positive attitude, the emergence of interest in life, an improvement in the emotional background of mood, an increase in physical activity and working capacity. Comparing the mechanisms of development of vascular dysfunction, a pathogenetic commonality between DE and the development of consequences in the form of cognitive impairment caused by COVID-19 was noted. CONCLUSION: Cytoflavin therapy at a dosage of 2 tablets 2 times a day for 25 days can be recommended as part of complex therapy for patients with DE and a COVID-19.

[Treatment of attention deficit hyperactivity disorder in children: results of a multicenter, randomized, double-blind, placebo-controlled clinical trial]. / Terapiya sindroma defitsita vnimaniya s giperaktivnost'yu u detei: rezul'taty mnogotsentrovogo randomizirovannogo dvoinogo slepogo platsebo-kontroliruemogo klinicheskogo issledovaniya.

OBJECTIVE: Evaluation of the efficacy and safety of the new drug Prospekta in the treatment of attention deficit hyperactivity disorder (ADHD) in patients aged 7-12 years. MATERIAL AND METHODS: A multicenter (35 clinical centres) double-blind, placebo-controlled, randomized, parallel-group clinical trial enrolled 363 patients. The mean age was 9.3±1.7 years. Children of both sexes aged between 7 and 12 years with a diagnosis of ADHD confirmed by DSM-V diagnostic criteria were included in the study. Patients with a total score of 22 or more on the Attention Deficit Hyperactivity Disorder-Rating Scale-V (ADHD-RS-V) were included in the study. After randomisation, patients in group 1 received Prospekta, 1 tablet twice daily; patients in group 2 received placebo according to the study drug regimen. The primary efficacy criterion was the proportion of patients with a 25% or greater reduction in the overall ADHD-RS-V scale score after 8 weeks of treatment. As additional criteria for efficacy assessment were assessed: change of ADHD-RS-V total score from baseline after 8 weeks of treatment; Clinical Global Impression Efficacy Index (CGI-EI) score after 8 weeks of treatment; side effects. RESULTS: The proportion of patients with a 25% or more reduction in the ADHD-RS-V scale score after 8 weeks of treatment was 55.9% in the Prospekta group, and 43.3% in the placebo group (p=0.0199). There was a reduction of ADHD symptoms in the Prospekta group as a mean ADHD-RS-V score decreased by 10.2±7.7 (in the placebo group by 8.1±7.9); the difference between the mean ADHD-RS-V score reduction during Prospekta and placebo treatment was 2.09±7.81 (p=0.0096). Mean CGI-EI scores calculated on the basis of physician scores were different in the Prospekta group compared to the placebo group at 6.9±3.2 versus 8.0±3.1 (p=0.0012), indicating greater clinical efficacy of the study drug. The frequency of adverse events (AEs) did not differ significantly between the groups. There were a total of 66 AEs in 46 patients, including 31 AEs in 23 (13.2%) Prospekta group participants and 35 AEs in 23 (12.2%) placebo group participants (p=0.87). No cases of serious AEs were reported during the study. Prospekta is compatible with drugs used in pediatric practice. Prospekta did not cause an exciting effect and did not adversely affect the sleep of patients. CONCLUSION: The drug Prospekta is an effective and safe treatment for ADHD in patients 7-12 years old.

Viral Safety Issues in the Production and Manufacturing of Human Immunoglobulin Preparations from Equine Plasma/Serum.

The current Russian and foreign pharmacopoeias either do not provide any information about existing types of viral diseases in horses or do not present it in full. Data of modern domestic and foreign literature was used to prepare the most complete list of viruses that cause equine diseases including 36 infectious agents, 25 of which are pathogenic for humans, 13 of the 25 of which are widespread throughout Russia. Information is provided on the magnitudes of the disease incubation periods (which are most often within one month), the external clinical signs of these diseases (which can also be asymptomatic), and the maximum possible concentrations of viruses in the blood of horses with these diseases (which can reach 8 log conventional units/mL of blood). This information is offered for use in critical production stages of heterologous immunoglobulin drugs for medical use to assure viral safety.

Ensuring Viral Safety of Equine Immunoglobulins during Production.

Equine blood plasma/serum and intermediates must be monitored for the presence of live viruses pathogenic in humans during production of equine immunoglobulins. Information concerning low-cost and simple methods for the detection of live horse viruses pathogenic and non-pathogenic to humans was gained using data of modern domestic and foreign literature. These methods are based on cultivation of these viruses on sensitive biosystems. The presented information can be used to set up blood plasma/serum control of horses at different stages of immunoglobulin production, i.e., when taking blood from horses during their quarantine period, when collecting blood from immunized horses, and before bottling the medicinal intermediate in the primary package.

[Results of a multicentre double-blind randomised placebo-controlled clinical trial evaluating the efficacy and safety of Mexidol in the treatment of Attention Deficit Hyperactivity Disorder in Children (MEGA)]. / Rezul'taty mnogotsentrovogo dvoinogo slepogo randomizirovannogo platsebo-kontroliruemogo klinicheskogo issledovaniya po otsenke effektivnosti i bezopasnosti preparata Meksidol v lechenii sindroma defitsita vnimaniya s giperaktivnost'yu u detei (MEGA).

OBJECTIVES: To evaluate the efficacy and safety of two dosing regimens of Mexidol film-coated tablets, 125 mg («RPC «PHARMASOFT¼ LLC Russia), compared with placebo in children with attention deficit hyperactivity disorder (ADHD) aged 6 to 12 years. MATERIAL AND METHODS: A multicenter randomized, double-blind, placebo-controlled study in 3 parallel groups was conducted in 14 clinical centres of the Russian Federation to assess efficacy and safety of Mexidol film-coated tablets, 125 mg («RPC «PHARMASOFT¼ LLC Russia) in the treatment of attention deficit hyperactivity disorder (ADHD) in children 6-12 years old with different dosing regimens. The study involved 333 boys and girls aged 6 to 12 years with a confirmed diagnosis of ADHD established in accordance with ICD-10 and DSM-5 criteria. After screening (up to 14 days) the patients were randomised into 3 treatment groups in a 1:1:1: Mexidol 125 mg 2 times daily, Mexidol 125 mg daily+placebo and the placebo group. The duration of treatment in all groups was 42 days. 332 children completed the study. ADHD and comorbid disorders assessment scales were used. RESULTS: There were statistically significant changes in the sum of the total scores on the SNAP-IV inattention and hyperactivity/impulsivity subscales after 6 weeks of therapy in all three study groups (p<0.05). There were statistically significant differences between the Mexidol 125 mg and placebo groups and between the Mexidol 125 mg 2 times daily and placebo groups (for the PP population: p=0.000308 and p=0.000024, respectively; for the FAS population: p=0.000198 and p=0.000024, respectively), indicating that Mexidol therapy is superior to placebo. Statistically significant differences (p<0.05) were also obtained for most of the secondary efficacy criteria (average change in SNAP-IV inattention subscale score, average change in SNAP-IV hyperactivity/impulsivity subscale score, average change in SNAP-IV subscale score - Conners index, average change in ADHD-RS-IV score, change in CGI-ADHD-S scores, change in CGI-I score - the Clinical Global Impressions Scale - Improvement) when comparing Mexidol therapy with placebo. The results of statistical analysis of the incidence of adverse events, laboratory values, physical examination show no significant differences between the compared groups in the main safety parameters. CONCLUSIONS: The regimen of Mexidol, 125 mg film-coated tablets twice daily has been shown to be superior to the regimen of Mexidol, 125 mg film-coated tablets once daily and placebo. The safety profiles of the studied dosing regimens of Mexidol and placebo were comparable.

[Evaluation of the efficacy and safety of application of the drug cortexin in the complex rehabilitation of verticalization in patients with ischemic stroke in the acute period]. / Otsenka éffektivnosti i bezopasnosti primeneniia lekarstvennogo preparata Korteksin v komplekse reabilitatsionnykh meropriiatii po vertikalizatsii u patsientov s ishemicheskim insul'tom v ostrom periode.

AIM: To evaluate the efficacy and safety of cortexin in the complex of rehabilitation measures for verticalization in patients with ischemic stroke in the acute period. MATERIAL AND METHODS: The study included 90 patients with hemispheric ischemic stroke. Patients of the first group (n=30) received cortexin in a dose of 20 mg per day intramuscularly for 10 days, along with basic therapy during early verticalization. Patients of the second group (n=30) received basic therapy during early verticalization and patients of the third group (n=30) received only basic therapy without verticalization. To assess the severity of condition, NIHSS, modified Rankin scale, the Barthel index, the Rivermead mobility index, MMSE, MOCA were used. To study cardiovascular function in patients, the segmental part of the autonomic nervous system was studied: a test with isometric load, a Valsalva test, a test based on the change in heart rate with slow deep breathing. All studies were conducted before and 10-14 days after treatment. RESULTS AND CONCLUSION: The most complete regression of neurological deficits and manifestations of cardiac autonomic neuropathy during the acute period of ischemic stroke was observed in the group of patients treated with cortexin (20 mg per day for 10 days), along with basic therapy and early verticalization, compared to the groups, which received basic therapy with early verticalization or basic therapy without verticalization.

[A multicenter observation study of the efficacy of cortexin and recognan (citicoline) in the treatment of cognitive impairments in chronic cerebrovascular pathology]. / Mnogotsentrovaia nabliudatel'naia programma po otsenke éffektivnosti kompleksnoi terapii preparatami korteksin i rekognan (tsitikolin) kognitivnykh narushenii u patsientov s khronicheskoi tserebrovaskuliarnoi patologiei.

AIM: To make a critical assessment of the therapeutic effect of complex therapy with cortexin and recognan (citicoline) for cognitive impairments in patients with chronic cerebrovascular pathology. MATERIAL AND METHODS: Presented is an analysis of results of the multicenter observation program to assess the efficacy of cortexin and recognan (citicoline) in the treatment of cognitive impairments in patients with chronic cerebrovascular pathology. Three hundred and nine patients with chronic cerebrovascular pathology, including 134 (43.4%) men and 175 (56.6%) women, aged from 30 to 80, average age 63.4±9.4 years, with confirmed cognitive deficit were examined. The diagnosis was established on the basis of complaints, case reports, the results of CT/MRI studies, as well as assessments of the neurological status and cognitive functions. Cognitive impairments were confirmed by the number of points on the Mini-mental state examination (MMSE) and the Clock drawing test. The assessment of depression was made with the Mini Geriatric Depression Scale (MGDS). All patients received cortexin and recognan (citicoline) ('Geropharm', Russia) at doses 10 mg/day for 10 days and 1000 mg/day for 1 month, respectively. RESULTS AND CONCLUSION: Complex therapy with cortexin and recognan (citicoline) showed high efficacy in the treatment of vascular cognitive disorders. The results of the study allow us to recommend the complex administration of cortexin and recognan (citicoline) ('Geropharm', Russia) in doses of 10 mg/day for 10 days and 1000 mg/day for 1 month, respectively, for chronic cerebrovascular pathology.

[Efficacy of Korteksin in acute period of hemispheric ischemic stroke]. / Éffektivnost' korteksina v ostrom periode polusharnogo ishemicheskogo insul'ta.

AIM: To study the efficacy and prolonged effect of repeated treatment with low-doses of the neuroprotection drug cortexin (30 mg, (10+10+10, morning, noon, day), daily) in patients in the acute period of hemispheric ischemic stroke. MATERIAL AND METHODS: One hundred and twenty-two patients with hemispheric ischemic stroke were studied. Patients of the first group (n=30) received cortexin in a dose of 20 mg (10+10) intramuscularly along with basic therapy, patients of the second group (n=30) received two courses of cortexin in the same dose for 10 days each with a break of 10 days in-between, patients of the third group (n=30) received only basic therapy, patients of the fourth group (n=32) received cortexin in a dose of 30 mg (10+10+10), two courses for 10 days each with a break of 10 days in-between. NIHSS, modified Rankin scale, Barthel index, Rivermead mobility index, MMSE, MOCA-test were used to evaluate the severity of the condition. RESULTS AND CONCLUSION: The most complete regression of neurological deficit during the acute period of ischemic stroke was observed in the fourth group of patients (30 mg (10+10+10) of cortexin, two courses) compared to the 1-3 groups.

[The influence of non-invasive electrical stimulation of the spinal cord on the locomotor function of patients presenting with movement disorders of central genesis]. / Vliianie neinvazivnoi élektricheskoi stimuliatsii spinnogo mozga na lokomotornye funktsii patsientov s dvigatel'nymi narusheniiami tsentral'nogo geneza.

AIM: The objective of the present study was to evaluate the influence of non-invasive (transcutaneous) electrical spinal cord stimulation on the locomotor function of the patients suffering from movement disorders. PATIENTS AND METHODS: The study involved 10 patients of both sexes at the age from 32 to 70 years (including 40% of men and 60% of women) presenting with the compromised locomotor function of varying severity associated with the disturbances of cerebral blood circulation caused either by an injury to the brain and spinal cord or by stroke. The transcutaneous electrical spinal cord stimulation was applied using different frequency regimes with the placement of the electrodes in the projection onto the region of TXI-TXII vertebrae. The active factors were bipolar electrical stimuli 0.5 ms in duration; the current strength was chosen for each patient on an individual basis taking into consideration its threshold level. Electromyograms and evoked motor responses of selected muscles, viz. m. rectus femoris, m.biceps femoris, m. tibialis anterior, and m.gastrocnemius were recorded with the use of the 'Neuro-MVP-8 eight-channel electromyography' ('Neurosoft', Russia). RESULTS: The data obtained give evidence that the stimulation of the spinal cord with a frequency of 1 Hz induces reflectory responses with monosynaptic and polysynaptic components in the muscles of the lower extremities, with the thresholds of these responses being significantly higher in the patients presenting with serious neurological problems. Stimulation with the frequencies of 5 and 30 Hz caused in the patients with paresis the involuntary movement of the legs the characteristics of which were similar to those of the locomotor movements. CONCLUSION: It has been demonstrated that the application of transcutaneous electrical spinal cord stimulation leads to increased excitability of the lumbar spinal neural structures of the patients. The study has shown the possibility of regulation of the locomotor functions in the patients presenting with movement disorders of central genesis by means of non-invasive electrical stimulation of the spinal cord.

[The efficacy of recognan in the early stage of ischemic stroke]. / Éffektivnost' preparata rekognan u patsientov v ostrom periode ishemicheskogo insul'ta.

AIM: To assess the efficacy and safety of recognan in patients with acute ischemic stroke (IS). MATERIAL AND METHODS: Seventy-nine patients, aged from 30 to 80 years, were examined in the early stage of IS. All patients received recognan (citicoline) in dose of 1000 mg/daily during 15 days. The recovery of cognitive functions (MMSE), level of consciousness (Glasgow Coma Scale), severity of focal neurological deficit (NIHSS) and functional recovery (Rankin scale, Barthel index, Rivermead Mobility Index) were assessed. RESULTS AND CONCLUSION: A decrease of cognitive impairment, improvement of memory, regression of neurological symptoms and increase in the motor activity were observed. Recognan used in dose of 1000 mg/daily during 15 days in the complex treatment of patients with IS promotes the recovery of cognitive function, reduces neurological symptoms and improves the recovery of motor activity.

[Possibilities of cavinton therapy regimen for infusions and cavinton comforte in acute and early recovery periods after ischemic stroke]. / Terapiia preparatami kavinton dlia infuzii i kavinton komforte v ostrom i rannem vosstanovitel'nom periodakh ishemicheskogo insul'ta.

AIM: To study the efficacy of a current regimen of treatment with cavinton for infusions and cavinton comforte in patients with ischemic stroke in acute and early recovery periods and to evaluate an impact of treatment on erythrocyte deformity using atomic power microscopy. MATERIAL AND METHODS: One hundred and sixty-four patients with hemispheric ischemic stroke, aged from 30 to 79 years, were randomized into main (n=100) and control (n=64) groups. Patients of the main group received complex treatment (basic therapy and cavinton R for drop infusions (10 intravenously during 10 days) followed by cavinton R comforte in dose 10 mg, 1 tablet 3 times a day during 90 days). Patients of the control group received basic therapy only. NIHSS, the Rankin scale, the Barthel index, MMSE, MоCA, the Rivermead scale, Beck depression scale, HADS were used to measure the severity of patient's state. To study the erythrocyte membrane by estimating Young's modulus, dry preparations were made with the following scanning of erythrocytes using atomic power microscopy. RESULTS: Positive changes on all scales were observed in both groups. Higher scores on NIHSS, Rankin, Barthel, MоCA, MMSE, Rivermead mobility index were found in the main group compared to the controls. There were no differences in scores on the Beck depression scale and HADS. A decrease in Young's modulus was found in the main group while in the control group this index remained unchanged. CONCLUSION: More rapid and complete regression of neurological deficit, better recovery of self-care function, cognitive function and social activity, an increase in erythrocyte membrane elasticity were found in the main group compared to the control one. These results indicate the efficacy of cavinton R and cavinton R comforte in the regimen used in complex treatment in acute and early recovery periods after ischemic stroke.

[Multicenter observational program for evaluation of the effectiveness of the recognan (citicoline) in the correction of cognitive impairment in patients with chronic cerebrovascular pathology]. / Mnogotsentrovaia nabliudatel'naia programma po otsenke éffektivnosti preparata rekognan (tsitikolin) v korrektsii kognitivnykh narushenii u patsientov s khronicheskoi tserebrovaskuliarnoi patologiei.

AIM: To study the efficacy and safety of recognan (citicoline) in the treatment of cognitive and depressive disorders in chronic cerebrovascular pathology (chronic brain ischemia) developed in patients with arterial hypertension and/or atherosclerosis. MATERIAL AND METHODS: Seven hundred and thirty-six patients with cerebrovascular pathology, cognitive impairment and mild dementia were examined. The sample included 279 (37.9%) men and 457 (62.1%) women aged from 35 to 80 years (mean age 64.5±8.7 years). The drug recognan ('Gerofarm', Russia) was administered in the dose of 1000 mg daily during 30 days. Recovery of cognitive functions was assessed with MSSE, correction of visual/spatial coordination with CDT, depression severity with MGDS. RESULTS: The improvement of cognitive function, memory and visual/spatial coordination, decrease in depression severity were observed during the treatment. CONCLUSION: Recognan reduced cognitive dysfunction and disturbances of visual/spatial coordinationas well as had a positive effect on the emotional sphere decreasing the level of depression.

[The influence of Cytoflavin therapy on the cerebral hemodynamics in patients with various stages of hypertensive disease]. / Vliianie terapii preparatom tsitoflavin na sostoianie tserebral'noi gemodinamiki pri razlichnykh stadiiakh gipertonicheskoi bolezni.

AIM: To study an influence of cytoflavin therapy on the cerebral hemodynamics in patients with various stages of hypertensive disease (HD). MATERIAL AND METHODS: One hundred and forty patients with HD, I-III stages, were randomized into 2 groups: patients of group 1 received complex treatment (antihypertensive therapy and cytoflavin), patients of group 2 were treated with antihypertensive therapy. The control group consisted of 30 healthy people. The changes in cerebral hemodynamics using the algorithm of the complex ultrasound study of cerebral vascular system were assessed. RESULTS: Disturbances of hemodynamics at all structural/functional levels of cerebral vascular system were found in all HD stages. There were a decrease in the blood flow through the common carotid, inner carotid, spinal and middle cerebral arteries, reactivity of veins of Rosenthal, blood flow through veins of Rosenthal and inner jugular veins and an increase of blood flow through spinal veins. The hemodynamic study showed that in group 1 there was the increase of blood flow through common carotid, inner carotid, middle cerebral arteries in stage I and through spinal arteries in stage I-II of HD; improvement of the reactivity of veins of Rosenthal, restoration of blood flow parameters through the veins of Rosenthal and inner jugular veins to control values, the decrease in blood flow velocity through the spinal veins in all HD stages. CONCLUSION: HD is accompanied by the damage of all structural/functional levels of cerebral vascular system. The use of cytoflavin in the complex therapy of HD exerts a positive influence on the cerebral hemodynamics reducing the severity of arterial insufficiency in the initial stages of disease, improving microcirculation and venous hemodynamics in all HD stages.

[Cognitive impairment in patients poluchennym ischemic stroke in the acute and early recovery periods in the process of neuroprotection low-dose drug cortexin]. / Dinamika kognitivnykh narushenii u bol'nykh s polusharnym ishemicheskim insul'tom v ostrom i rannem vosstanovitel'nom periodakh na fone nizkodoznoi neiroprotektsii preparatom korteksin.

AIM: To study the effect of repeated low-dose course of neuroprotection by drug cortexin on cognitive impairment in the acute and early recovery periods of hemispheric ischemic stroke. MATERIAL AND METHODS: The study involved 90 patients with poluchennym ischemic stroke. Patients of the first group received cortexin 20 mg (10+10) intramuscularly on the background of basic therapy, patients of the second group (n=30) received cortexin 20 mg (10+10) two courses for 10 days each with a break in between of 10 days, the patients of the third group - only basic therapy. For the objectification of cognitive impairment used a scale MMSE, a test of 5 words, the battery of frontal dysfunction, clock drawing test, MOCA test. RESULTS: It was noted more rapid and complete regression of cognitive disorders in patients of the 1st and 2nd groups, in comparison with patients of the 3rd group. However, the best effect of the therapy was observed still in the group of patients treated with the double rate of the drug cortexin.

[Efficacy of cortexin in acute and recovery periodes of hemispheric ischemic stroke]. / Effektivnost' korteksina v ostrom i vosstanovitel'nom periodakh polusharnogo ishemicheskogo insul'ta.

AIM: To study the effectiveness and sustained effects of early appointment of a repeated course of low-dose drug cortexin neuroprotection in patients in acute and recovery period of hemispheric ischemic stroke. MATERIAL AND METHODS: The study included 90 patients with hemispheric ischemic stroke. Patients of the first group received 20 mg cortexin (10+10) intramuscularly on basic therapy, the patients of the second group (n=30) was obtained cortexin 20 mg (10+10) in the two courses each for 10 days with an interval between them in 10 days, patients of the third group - only basic therapy. For objectification severity used NIH stroke scale, modified Rankin scale, the Barthel index, the Rivermead mobility index, MMSE. RESULTS AND CONCLUSION: Appointment in acute hemispheric ischemic stroke drug cortexin repeated course leads to more complete regression of neurological deficit, compared to the comparison group and the group of patients who received one course of medication cortexin, for all acute and early recovery period of ischemic stroke from 11-13 days of illness.

[EFFECT OF CORTEXIN ON THE QUALITY OF LIFE IN THE EARLY REHABILITATIVE PERIOD AFTER HEMISPHERIC ISCHEMIC STROKE].

AIM: To study the neuroprotective effect of a repeated course of low dose cortexin therapy on the quality of life in the early rehabilitative period after hemispheric ischemic stroke (IS). MATERIALS AND METHODS: 90 patients were divided into group 1 treated with cortexin (10 mg i/m twice daily (morning and afternoon) in addition to basal treatment, group 2 given the repeated course of the same treatment, and control group (basal therapy alone). The standard SF-36 questionnaire was used to assess the quality of life. RESULTS: Treatment of patients following acute hemispheric ischemic stroke with cortexin (10 mg i/m twice daily) and the repeated course of the same treatment after 10 days resulted in the accelerated and more complete normalization of the quality of life in the early rehabilitation petriod (starting from days 21-27 days after the onset of disease) than in the patients given a single course of cortexin therapy or basal treatment alone.

[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.

[Clinical and morphologic efficacy of a complex antioxidant and energy correction therapy of different duration in brain infarction: results of a multicenter randomized trial].

AIM: To compare clinical and morphological results of treatment of ischemic stroke in three groups of patients which differed by the forms and duration of an antioxidant therapy. MATERIAL AND METHODS: A randomized clinical trial was performed in 8 vascular centers of the Russian Federation in 2010-2014. It included 373 patients with ischemic stroke in the carotid territory. Patients were randomized into 3 groups to receive different regimens of antioxidant therapy as an adjunct to standard therapy: control group (ascorbic acid; 132 patients); cytoflavin (20 ml per day for 10 days; 133 patients); cytoflavin (the dose was decreased to 10 ml per day from 11th to 20th day) (108 patients). Patient's condition was assessed in 1, 10 and 21 day by a complex of clinical, laboratory and instrumental methods. RESULTS AND CONCLUSION: The analysis of CT in 1th and 21th day revealed a significant 1,5-1,7- fold decrease in the cerebral ischemic lesion in both groups treated with cytoflavin with no significant morphologic changes in the ascorbic acid group. The percentage of patients with ischemic lesion, increased during days 1-21, was 2-fold higher in the ascorbic acid group compared to cytoflavin groups. Morphologic changes were correlated with clinical variables and outcome. In patients with ≥14 points on NIH scale on admission, prolonged 20 day cytoflavin therapy was associated with a more prominent improvement of neurologic, functional and cognitive status compared to 10-day cytoflavin infusion. No differences in clinical variables were observed in patients with mild symptoms (<14 points on NIH scale on admission) receiving cytoflavin for 10 and 20 days.

[The effect of vasonit on the structural/functional state of erythrocyte cytoplasmic membrane in patients with ischemic stroke].

OBJECTIVE: To study the effect of vasonit on the structural/functional state of erythrocyte cytoplasmic membrane in patients with ischemic stroke (11) using atomic-power microscopy in vitro. MATERIAL AND METHODS: We examined 45 patients with II. Patients of the main group (n=30) received vasonit and standard treatment, 15 patients of the comparison group received only standard treatment. To assess the severity of patient's condition, we used the NIH stroke scale, modified Rankin scale, the Barthel index and the Rivermead Mobility index. Dried erythrocyte preparations were made to study erythrocyte cytoplasmic membrane. Scanning was performed using an atomic-power microscope manufactured by "SOLVER P47-Pro" (NT-MDT, Russia). RESULTS AND CONCLUSION: A statistically significant positive dynamics of neurological deficit and patient's functional state was found in the 14" day of the study. A significant decrease in Young's modulus value was identified in the main group that suggested the increase in the elasticity of erythrocyte cytoplasmic membrane.