[Possibilities of individual choice of NSAIDs on the example of the oxicam class, taking into account clinical and pharmacological characteristics]. / Vozmozhnosti individual'nogo podkhoda k vyboru nesteroidnogo protivovospalitel'nogo preparata dlya komorbidnogo patsienta s uchetom kliniko-farmakologicheskikh kharakteristik preparata na primere klassa oksikamov.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are traditionally used to relieve pain syndromes. The class of NSAIDs includes oxicams (meloxicam, tenoxicam, lornoxicam) - drugs with pronounced analgesic and anti-inflammatory effects. Oxicams have common properties of the class, but at the same time, due to structural differences from all other NSAIDs, they differ in a number of clinical and pharmacological characteristics, knowledge of which will help to individualize the choice of the drug.

[Drug synergism as a basis for rational neuroprotection]. / Sinergizm lekarstvennykh preparatov kak osnova ratsional'noi neiroprotektsii.

Optimization of the choice of neuroprotective therapy regimens in patients with CVD, taking into account the synergism of drug interactions, is basic in real clinical practice. Unfortunately, in modern pharmacology there is no unified way to establish the synergistic spectrum of action of drugs, which would allow systematic investigation of the effects of combinations of drugs. By the method of studying the subtle mechanisms of action, combinations of drugs that are as synergistic as possible (summation and potentiation of effects) for various therapies of neurological diseases are proposed. Examples of rational neuroprotection are considered on the preparations Cortexin, citicoline, antioxidants.

Drug Synergism as the Basis of Rational Neuroprotection.

Optimization of the choice of neuroprotective therapy regimens in patients with cerebrovascular diseases (CVD), taking into account the synergism of drug interactions, is a basic approach in clinical practice. Unfortunately, modern pharmacology has no unified way of establishing synergistic spectra of drug actions, which would allow systematic investigation of the effects of combinations of drugs. An approach based on studying detailed mechanisms of action suggested combinations of drugs with the greatest possible synergism (by summation and potentiation of effects) for various directions in the treatment of neurological diseases. Examples of rational neuroprotection are considered, using Cortexin, citicoline, and antioxidants.

[The result of prospective randomized study CITADEL - the efficacy and safety of drug cytoflavin in postcovid rehabilitation]. / Effektivnost' i bezopasnost' Tsitoflavina pri reabilitatsii bol'nykh s postkovidnym sindromom: rezul'taty prospektivnogo randomizirovannogo issledovaniya TsITADEL''.

OBJECTIVE: To investigate the structure of postcovid syndrome, age and gender characteristics of its course, and to assess the effect of Cytoflavin on the clinical course of neurological disorders in patients who have undergone COVID-19. MATERIAL AND METHODS: The study included 100 patients, the average age was 40.4±11.7 years, there were statistically more men than women. The duration of the transferred SARS-CoV-2 days is from 30 to 90 days from the date of recovery). By random sampling, the patients were divided into two groups, the main group, received Cytoflavin tablets, a course of 25 days, 2 tablets 2 times a day. Comparison group - other drugs (vitamins, nootropic drugs). All patients were examined on the day of treatment and 25-30 days after the end of therapy. The status was assessed using Asthenia Assessment Scale (MFI-20), Brief Mental Status Assessment Scale (MMSE), Quality-of-Life Questionnaire (EQ-5D), General Health Assessment Scale, and Pittsburgh Sleep Quality Index (PSQI). The analysis of laboratory parameters was carried out retrospectively. RESULTS AND CONCLUSION: Postcovid syndrome was more common in men, among comorbid conditions arterial hypertension and atherosclerosis prevailed, neurocognitive and autonomic disorders predominated. Appointment of Cytoflavin made it possible to achieve a pronounced anti-asthenic effect with the correction of cognitive impairments, which was reflected in a significantly more significant positive dynamics of indicators of all scales. An additional effect of Cytoflavin was revealed - a decrease in the severity of thrombocytopenia. During the observation period, no patient had any serious adverse events or side effects associated with taking the drug. Prescription of the drug does not require age-related dose adjustment and is well combined with basic therapy for concomitant pathology.

[Prospects for pharmacological adaptation of neurovascular unit in conditions of neurotropic viral infection]. / Perspektivy farmakologicheskogo konditsionirovaniya neirovaskulyarnoi edinitsy v usloviyakh neirotropnoi virusnoi infektsii.

The article discusses the prospects for pharmacological conditioning as a method for adaptation of neurovascular unit in conditions of neurotropic viral infection. A step-by-step mechanism for development of preconditioning and postconditioning is presented with a detailed description of it's main stages (trigger, signal and effector). The role of neuroinflammation as the leading mechanism of damage and the possibility of influencing the brain neurotrophic factor are considered. It is shown that different medications including neurotrophic drugs (cerebrolysin) can serve as inducers of conditioning. Usage of neurotrophic drugs in different doses for preconditioning and postconditioning is pathogenetically justified.

[Locomotive syndrome: from paradigms to clinical reality].

Locomotive syndrome is an unsatisfactory condition of patients over 60 years of age who need or may require outside help in the near future due to functional deterioration of the musculoskeletal system, including pathology of bone tissue, joints, muscles and nervous tissue. In real clinical practice, one often has to deal with the following manifestations of locomotive syndrome: osteoarthritis, sarcopenia, balance disorders, chronic musculoskeletal pain. Today, there is a clear understanding that drug therapy should be long-term, include comprehensive support for muscle tissue, balance training, and mandatory cognitive-behavioral therapy. Maximum safety of long-term drug therapy can be ensured by the use of vital micronutrients, which include highly purified forms of chondroitin sulfate and glucosamine sulfate, which have a wide range of anti-inflammatory and regenerative effects.

[Change in the Nature of the Course of Arterial Hypertension in Patients With Chronic Arterial Insufficiency of the Extremities in Acute Thrombotic Occlusion].

The article is devoted to the investigation of the mechanisms of the development of arterial hypertension (AH) in patients with atherosclerosis of the abdominal aorta and the formation of chronic lower limb ischemia (Lerish syndrome). With the development of thrombotic occlusion of arteries of the lower extremities, the nature of the course of hypertension worsens. The operational recovery of the main blood flow in the limbs positively influences the course of hypertension in the majority of patients.

[Level of nitrous oxide in peripheral blood serum in patients with various severity of arterial hypertension].

AIM: To elucidate the role of nitrous oxide (NO) in development of severe primary arterial hypertension (AH) including malignant hypertension and concomitant ischemic heart disease (IHD). MATERIAL AND METHOD: Patients with diagnosis of primary 1-3 degree AH (n=62, 21 men, 41 women aged 39-87 years, mean age 63.7+/-2.7 years) and 28 subjects with normal arterial pressure (AP) (n=28, 13 men, 15 women aged 30-85 years, mean age 57.5+/-7.8 years). Blood serum levels of NO stable metabolites (nitrates and nitrites) were measured by reaction of their reduction in the presence of vanadium chloride and by reaction of diazotization of sulfanilamide by generated nitrite (modification by R.M.Miranda et al., 2001). RESULTS: NO level (level of its stable metabolites) was substantially elevated in patients with various severity of AH compared with subjects with normal AP. Severe and malignant course of AH was not associated with substantial lowering of NO level in blood serum. Relation between NO level and age found in subjects with normal AP, was not observed in patients with labile and stable course of AH. In patients with AH, normal serum NO level and signs of chronic involvement of cardiovascular system the disease was several times more often associated with atrial fibrillation and class II-III angina than in patients with high NO levels. Patients with AH combined with IHD more often had signs of heart failure and history of myocardial infarction.