Medium-term antifungal effects of methylene blue versus flavin mononucleotide in the treatment of moderate toenail onychomycosis.

BACKGROUND: Methylene blue (MB) and flavin mononucleotide (FMN)-mediated photodynamic therapy (PDT) have demonstrated local antimicrobial effect, but no direct comparative study has been published so far for the treatment of toenail onychomycosis. OBJECTIVES: To directly compare the short and medium-term efficacy of MB versus FMN as photosensitizers in PDT for toenail onychomycosis by applying them in a 40% w/w urea cream in two different dye concentrations. METHODS: Forty toenails with distal and lateral subungual moderate onychomycosis due to dermatophyte fungi were randomised to receive 10 weekly sessions of PDT mediated by four topical formulations including MB or FMN at two different concentrations: Group I: 0.1% w/w MB; Group II: 2% w/w MB; Group III: 0.1% w/w FMN; and Group IV: 2% w/w FMN. Photographs were used for onychomycosis severity index (OSI) estimation allowing clinical assessment at any point of the study. Microscopic and microbiological evaluations were carried out at baseline, 27- and 35-week follow-ups. Side effects were recorded along with patient satisfaction. RESULTS: At week 27, mycological cure rates were 60%, 30%, 50% and 40% and complete cure rates were 0%, 20%, 10% and 20%, for Groups I, II, III and IV respectively. At week 35, mycological cure rates were 70%, 70%, 70% and 60% and complete cure rates were 30%, 50%, 70% and 30%, for Groups I, II, III and IV respectively. All cream formulations were safe and patients were fairly satisfied. CONCLUSIONS: Results of the present work confirm PDT as a therapeutic alternative for onychomycosis. Although all cream formulations were safe and effective, with a good degree of satisfaction, higher cure rates were obtained with 2% w/w MB cream and 0.1% w/w FMN cream.

[The successful use of Cytoflavin in the patient with postaveny syndrome]. / Uspeshnoe primenenie Tsitoflavina u patsientki s postkovidnym sindromom.

A clinical observation of the use of Cytoflavin according to a two-stage scheme (10.0 ml intravenously drip per 200 ml of 0.9% sodium chloride solution for 10 days, followed by a transition to a tablet form of 2 tablets 2 times/day for 25 days) in a patient with postcovid syndrome with pronounced vegetative and neurocognitive disorders. The effectiveness of therapy was confirmed by an improvement in heart rate variability and a decrease in the severity of depression, anxiety (on the HADS scale) and the level of autonomic dysfunction (on the COMPASS-31 scale). The significant changes in levels of fatigue (on a scale MFI) is not marked. The obtained results can serve as a basis for further research.

Retrograde response to mitochondrial dysfunctions associated to LOF variations in FLAD1 exon 2: unraveling the importance of RFVT2.

Flavin adenine dinucleotide (FAD) synthase (EC 2.7.7.2), encoded by human flavin adenine dinucleotide synthetase 1 (FLAD1), catalyzes the last step of the pathway converting riboflavin (Rf) into FAD. FLAD1 variations were identified as a cause of LSMFLAD (lipid storage myopathy due to FAD synthase deficiency, OMIM #255100), resembling Multiple Acyl-CoA Dehydrogenase Deficiency, sometimes treatable with high doses of Rf; no alternative therapeutic strategies are available. We describe here cell morphological and mitochondrial alterations in dermal fibroblasts derived from a LSMFLAD patient carrying a homozygous truncating FLAD1 variant (c.745C > T) in exon 2. Despite a severe decrease in FAD synthesis rate, the patient had decreased cellular levels of Rf and flavin mononucleotide and responded to Rf treatment. We hypothesized that disturbed flavin homeostasis and Rf-responsiveness could be due to a secondary impairment in the expression of the Rf transporter 2 (RFVT2), encoded by SLC52A2, in the frame of an adaptive retrograde signaling to mitochondrial dysfunction. Interestingly, an antioxidant response element (ARE) is found in the region upstream of the transcriptional start site of SLC52A2. Accordingly, we found that abnormal mitochondrial morphology and impairments in bioenergetics were accompanied by increased cellular reactive oxygen species content and mtDNA oxidative damage. Concomitantly, an active response to mitochondrial stress is suggested by increased levels of PPARγ-co-activator-1α and Peroxiredoxin III. In this scenario, the treatment with high doses of Rf might compensate for the secondary RFVT2 molecular defect, providing a molecular rationale for the Rf responsiveness in patients with loss of function variants in FLAD1 exon 2.HIGHLIGHTSFAD synthase deficiency alters mitochondrial morphology and bioenergetics;FAD synthase deficiency triggers a mitochondrial retrograde response;FAD synthase deficiency evokes nuclear signals that adapt the expression of RFVT2.

Roseoflavin, a Natural Riboflavin Analogue, Possesses In Vitro and In Vivo Antiplasmodial Activity.

The ability of the human malaria parasite Plasmodium falciparum to access and utilize vital nutrients is critical to its growth and proliferation. Molecules that interfere with these processes could potentially serve as antimalarials. We found that two riboflavin analogues, roseoflavin and 8-aminoriboflavin, inhibit malaria parasite proliferation by targeting riboflavin metabolism and/or the utilization of the riboflavin metabolites flavin mononucleotide and flavin adenine dinucleotide. An additional eight riboflavin analogues were evaluated, but none were found to be more potent than roseoflavin, nor was their activity on target. Focusing on roseoflavin, we tested its antimalarial activity in vivo against Plasmodium vinckei vinckei in mice. We found that roseoflavin decreased the parasitemia by 46-fold following a 4 day suppression test and, on average, increased the survival of mice by 4 to 5 days. Our data are consistent with riboflavin metabolism and/or the utilization of riboflavin-derived cofactors being viable drug targets for the development of new antimalarials and that roseoflavin could serve as a potential starting point.

[The effectiveness of cytoflavin in complex therapy of patients with the coronavirus infection COVID-19]. / Effektivnost' primeneniya Tsitoflavina v kompleksnoi terapii patsientov s COVID-19.

OBJECTIVE: To study therapy, including a sequential course of the drug Cytoflavin, on the dynamics of neurological and general status in patients with new coronavirus infection COVID-19. MATERIAL AND METHODS: 47 patients with a new coronavirus infection COVID-19, admitted to the hospital and having a state of moderate severity, according to the criteria of the Interim Guidelines of the Ministry of Health of the Russia for the prevention, diagnosis and treatment of a new coronavirus infection (COVID-19, version 9 of 10.26.2020). Clinical and neurological research, laboratory and instrumental examination methods were used before and after the course of therapy. RESULTS: When a sequential Cytoflavin regimen is used in patients with COVID-19 infection, along with standard therapy, a significant improvement in neurological and general status is observed, as well as a significant positive dynamics in the results of laboratory and instrumental research methods (markers of a systemic inflammatory response, hemostasis and oxygenation disorders), which indicates on the influence of the significant effect of Cytoflavin on the processes of inflammation and hypercoagulability in COVID-19 infection. CONCLUSION: The use of the drug Cytoflavin in the complex therapy of patients with COVID-19 infection is pathogenetically justified and expedient. The data obtained make it possible to recommend the inclusion of Cytoflavin in the treatment protocols for patients with COVID-19 coronavirus infection to optimize therapy and improve the course and outcome of the disease, as well as a longer use of Cytoflavin and repeated courses of its use in patients with COVID-19 infection.

[Cytoflavin as a modulator of rehabilitation treatment of patients with ischemic stroke complicated by post-intensive care syndrome]. / Tsitoflavin kak komponent reabilitatsionnogo lecheniya patsientov s ishemicheskim insul'tom, oslozhnennym PIT-sindromom.

OBJECTIVE: To assess an effect of cytoflavin on the results of rehabilitation treatment and the increase in exercise tolerance in patients with stroke complicated by post-intensive care syndrome (PICS). MATERIAL AND METHODS: The data of 53 patients who underwent neurorehabilitation in the ICU after ischemic stroke were analyzed. Depending on the treatment regimen, the patients were divided into two groups. Group 1 (main, n=36) received cytoflavin (iv drip in a volume of 10 ml of a solution for injections per 200 ml of a 0.9% solution of sodium chloride) for 10 days in addition to the complex of neurorehabilitation measures. Group 2 (control, n=17) included patients, who had only a standard set of neurorehabilitation measures for 10 days. The efficacy of the therapy was evaluated using indirect calorimetry, and the oxygen and energy load price index was calculated. To assess the tolerability of rehabilitation methods, a verticalization test was used. Treatment tolerance was assessed by the incidence of adverse reactions in each group. RESULTS AND CONCLUSION: The components of the energytropic effect of cytoflavin can have a positive modulating effect, increasing the tolerance of rehabilitation measures for the treatment of PICS in patients with ischemic stroke. Further research is required.

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

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

[Possibilities of using Cytoflavin in the treatment of cognitive and emotional disorders in patients with tension headaches]. / Vozmozhnosti primeneniia Tsitoflavina pri lechenii kognitivnykh i émotsional'nykh narushenii u patsientov s golovnymi boliami napriazheniia.

OBJECTIVE: To evaluate the efficacy and safety of Сytoflavin in the treatment of cognitive and emotional disorders in patients with tension headache. MATERIAL AND METHODS: Fifty patients with tension headache, aged from 18 to 50 years, were studied. The following methods and tests were used: neurological examination, NPRS, STAI, CFQ, RAVLT, TOVA, electroencephalography (routine and spectral analysis). The patients were treated with Сytoflavin. RESULTS: After the treatment, clinical improvement was observed in 62.0% of the patients. A significant decrease in trait anxiety and inattention, as well as an improvement of memory performance were observed. A comparative analysis of neurophysiological results before and after the treatment showed a decrease in the manifestations of dysfunction of nonspecific regulation of the brain. CONCLUSION: The results of this study demonstrate the efficacy of Cytoflavin in the treatment of tension headache and associated emotional and cognitive impairments.

[Clinical efficacy of neurometabolic therapy of dissomical disorders in asthenic syndrome]. / Klinicheskaia éffektivnost' neirometabolicheskoi terapii dissomnicheskikh rasstroistv pri astenicheskom sindrome.

AIM: To analyze the efficacy of cytoflavin in the complex treatment of sleep disorders in asthenic syndrome. MATERIAL AND METHODS: One hundred patients with sleep disorders and asthenic syndrome of various etiology and severity were studied. The patients were divided into three groups depending on the type of therapy: the first group received intravenous infusions of cytoflavin for 10 days; the second group, in addition to cytoflavin, received per os melatonin (3 mg or 5 mg) at bedtime; the third group in addition to cytoflavin received per os zopiclone (7.5 mg) at bedtime. RESULTS: On the 14th day of the study, a decrease in severity or complete relief of asthenia manifestations (according to the SHAS scale) and, accordingly, improvement or normalization of sleep in 97% of patients was found. At the same time, during polysomnographic study, the data obtained are characteristic for improving the quality of sleep phases mainly in the first and second groups of patients and, to a lesser extent, in the third group. CONCLUSION: Cytoflavin effectively suppresses the main manifestations of asthenic syndrome, including sleep disorders.

[Substantiation of the drug «Cytoflavin¼ application and cognitive-behavioral therapy in complex treatment of deforming coxarthrosis in elderly patients.]

The article presents the results of a study of the effectiveness of the addition of a standard course of conservative therapy to 104 patients of the older age group with coxarthrosis deforming the drug «Cytoflavin¼ and cognitive-behavioral therapy courses. It was found that such 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.

[Variants of postoperative delirium suppression in elderly patients.]

To study the effectiveness of the inclusion of Cytoflavin in the management of postoperative delirium treating in elderly patients. Analyzed the results of treatment of 89 elderly patients (65-74 years) who, according to similar emergency indications, underwent surgery and postoperatively showed signs of delirium (according to the DDS scale ≥8 points). Depending on the treatment regimen, the patients were divided into three groups: in the first (n=32) group, bromodihydrochlorophenylbenzodiazepine was administered intravenously (1-5 min) in a dose of 1 mg in the 1st group (n=32) to the group (patients of the 2nd group (n=28) with the same purpose and at the same time cytoflavin was injected: 10 ml of the drug in dilution per 200 ml of 10% glucose solution intravenously at a rate of 140 drops (7 ml) per minute. Patients of 3rd group (n=29) were injected with ethylmethylhydroxypyridine succinate intravenous (within 5-7 min) at a dose of 200 mg. The condition was assessed using the SOFA, DDS and RASS scales. The inclusion of drugs with antioxidant/membrane-protective action (Cytoflavin and ethylmethylhydroxypyridine succinate) in the treatment regimen of postoperative delirium in the elderly increases the effectiveness of treatment, which is manifested in more rapid relief of the condition. When comparing the efficacy of Cytoflavin and ethylmethylhydroxypyridine succinate, it was noted that in a number of indicators (restoration of spontaneous breathing, improvement after the first dose and complete relief of signs of delirium) both drugs showed comparable results, however, when assessing the depth of sedation (on the RASS scale), Cytoflavin was more effective (p=0,001).The obtained results of the effectiveness of cytoflavin in combination with good patient tolerance allows us to recommend the inclusion of the drug in the treatment regimens of this pathology.

[Possibilities for optimizing the pathogenetic therapy of purulent meningitis in children]. / Vozmozhnosti optimizatsii patogeneticheskoi terapii gnoinykh meningitov u detei.

AIM: To assess an effect of the combined use of Cytoflavin and Sulodexide on the course and outcomes of purulent meningitis in children. MATERIAL AND METHODS: Fifty children with purulent meningitis, aged from 5 to 17 years 11 month, were studied. Thirty patients of the treatment group (n=30; mean age 6,8 ± 2,2 years) received Cytoflavin (0,6 mcg/kg once a day) during 5 days with the following treatment with Sulodexide (250 LSU/day in children 5-12 years, 500 LSU/day in children above 12 years). Patients of the comparison group (n=20), aged 5,9±1,8 years, received standard antibacterial treatment. Duration and persistent of fever, cerebral, meningeal symptoms, the recovery period of CSF, the normalization of the number of desquamated epithelial cells (DEC), D-dimer were estimated. Outcomes of purulent meningitis were assessed using a working scale representing a modification of Rankin's, Fisher's, and Glasgow scales. RESULTS AND CONCLUSION: The combination of drugs reduces the duration of cerebral and meningeal symptoms, leads to the normalization of hematological parameters (the level of leukocytes, desquamous epithelial cells, D-dimer) and improves outcomes.

[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.

[Cytoflavin in the complex therapy of multiple sclerosis]. / Tsitoflavin v kompleksnoi terapii rasseiannogo skleroza.

AIM: To evaluate the efficacy of cytoflavin inclusion in the complex therapy of patients with multiple sclerosis in the remitting form during the period of exacerbation. MATERIAL AND METHODS: The results of therapy of 41 patients matched for sex, age and parameters of clinical and laboratory data were analyzed. Depending on the scheme of therapy, patients were divided into 2 groups: patients of the first group (n=22) received hormonal therapy with methylprednisolone. Patients of group II (n=19) received cytoflavin. The efficacy of treatment was assessed by a set of clinical and laboratory indicators in dynamics - before the start of therapy, with a 10-day interval and after treatment. The neurological status was assessed with the most commonly used scales (functional system scale (FS), EDSS scale), also neuroimaging data were assessed. RESULTS AND CONCLUSION: The inclusion of cytoflavin as an antioxidant and neuroprotective agent in the therapy of patients with multiple sclerosis in the acute phase increased the efficacy of basic (hormonal) therapy, which is manifested in a significant decrease in the severity of neurologic symptoms and visual system disorders and fewer cases of non-response to treatment.

[The use of citoflavin in neonatology and pediatrics as a factor improving therapeutic efficacy in patients with central nervous system lesions of various etiology]. / Primenenie preparata tsitoflavin v neonatologii i pediatrii kak faktor povysheniia éffektivnosti terapii patsientov s porazheniem tsentral'noi nervnoi sistemy razlichnoi étiologii.

Possibilities of increasing the therapeutic efficacy in patients with perinatal central nervous system (CNS) lesions of hypoxic-ischemic and infectious etiology are considered. Some questions of pathophysiological features of hypoxic-ischemic CNS disorders in newborns and their connection with further cascade of pathological changes in organs and systems are highlighted. In this light, the authors substantiate the need for adequate and effective neuro- (cerebro-) protection by the timely antioxidant energy correction and antihypoxic therapy with cytoflavin. The use of cytoflavin is justified in terms of efficacy and safety and can be recommended for use in practical health care in neonatology and pediatrics.

[Modern approaches to components of therapy of patients with diabetes mellitus operated on for malignant neoplasms of small pelvic organs]. / Sovremennye podkhody k komponentam terapii bol'nykh sakharnym diabetom, operiruemykh po povodu zlokachestvennykh novoobrazovanii organov malogo taza.

The purpose of this study was assessment of the effect of cytoflavin preparation inclusion in surgical treatment of patients with malignant neoplasms of small pelvic organs and diabetes mellitus. A prospective examination of 51 patients aged 56 to 76 years suffering from diabetes mellitus and malignant neoplasms of the pelvic organs was performed. Patients were divided into two groups: the first group consisted of 27 patients whose adaptive potential was characterized by tension of adaptation mechanisms, the second one - 24 patients with poor adaptation. In turn, in each group, patients were divided into subgroups depending on the treatment regimen: in the main subgroup of the first group (14 people) the treatment program was supplemented with cytoflavin (10 ml 2 times a day), in the main subgroup of the second group were 13 patients with cytoflavin supplement (20 ml 2 times a day). Patients of control groups underwent standard therapy. State of energy deficiency was assessed by methemoglobin, carbohemoglobin, P50, oxygen delivery, consumption and extraction. Concentration of glucose, lactate, lactate dehydrogenase was assessed. The results of the study showed clear relationship between the nature of changes in transport and oxygen consumption, adaptation adaptive reactions, allowing to identify mechanisms that characterize formation of various types of energy deficiency in perioperative period in patients with malignant diseases of the pelvic organs and diabetes. Use of cytoflavin contributed to a qualitative and effective correction of energy deficiency as well as reduction in the patients stay in the hospital.

SURGICAL PREVENTION AND TREATMENT OF POSTOPERATIVE HYPOPARATHYROIDISM IN PATIENTS OPERATED ON THYROID GLAND.

The objective of the research was to develop and evaluate the algorithm of prevention and treatment of postoperative hypoparathyroidism (PHPT) based on determining parathyroid glands (PTG) viability and the use of antihypoxant-antioxidant therapy in the postoperative period. The research was based on the results of a comprehensive examination and treatment of 60 patients who were operated for thyroid gland diseases. The patients underwent inpatient treatment at the surgical department of Ivano-Frankivsk Central City Clinical Hospital and Ivano-Frankivsk Regional Oncology Center from 2015 to 2017. We proposed an algorithm for surgical prevention and treatment of PHPT during thyroid gland surgeries which consisted in the following. We performed a visual assessment of PTG intraoperatively and evaluated each gland from 0 to 3 points according to the degree of its viability affection. If the gland was evaluated at 0-2 points, we left it in situ, since there was a high probability of maintaining its function. If it was evaluated at 3 points, its autotransplantation was performed. Cytoflavin drug was applied in a dose of 10 ml per 200 0.9% NaCl intravenously once a day during 7 days in the postoperative period for the purpose of antihypoxant-antioxidant therapy. 2 groups of patients were formed in order to evaluate the effectiveness of the algorithm. Each group consisted of 30 people. Patients of Group I underwent surgery on thyroid gland according to generally accepted rules. Patients of Group II underwent interventions according to the above-mentioned algorithm. The use of our proposed algorithm (intraoperative assessment of PTG viability and antihypoxant-antioxidant therapy in the postoperative period) significantly reduces the frequency of permanent PHPT justifying indications to its application.

[An influence of cytoflavin on oxidative stress and activity of Na/K-ATPase of erythrocytes after brain trauma]. / Vliianie tsitoflavina na okislitel'nyi stress i aktivnost' Na/K-ATFazy éritrotsitov posle cherepno-mozgovoi travmy.

AIM: To study the efficacy of cytoflavin in correction of oxidative stress and the activity of Na/K-ATPase in posttraumatic craniocerebral trauma (CCT) in rats. MATERIAL AND METHODS: The study was performed on white non-linear female rats with a modeled CCT. An effect of cytoflavin on free radical oxidation and plasma antioxidant system, processes of plasma lipid peroxidation and antioxidant properties of red blood cells and erythrocyte Na/KATPases activity was studied on 1, 3, 7- and 12th day after CCT. RESULTS AND CONCLUSION: CCT identified the growth of free-radical processes in blood plasma and an increase in lipid peroxidation in plasma and red blood cells as well as a reduction in the activity of catalase and Na/K-ATPase. Introduction of cytoflavin reduced oxidative stress from the 3rd day and normalized free radical oxidation and lipid peroxidation in plasma and red blood cells to the 7th day of the study against the background of the high total antioxidant capacity of blood and erythrocyte catalase activity. The effect of cytoflavin led to an increase in the activity of Na/K-ATPase on the 3rd-7th day of the study compared with the reduced activity of the enzyme in the control. Recovery of pro- and antioxidant balance under the action of cytoflavin associated with increased activity of Na/K-ATPase aimed at optimizing and reducing the homeostatic mechanisms of secondary damage in the post traumatic period.

[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.

[Prevention and correction of cognitive dysfunction after general anesthesia]. / Profilaktika i korrektsiia kognitivnykh narushenii posle obshchei anestezii.

AIM: To evaluate clinical efficacy of intraoperative use of cytoflavin in the prevention and correction of cognitive functions in surgical patients with no history of neurological and psychosomatic disorders. MATERIAL AND METHODS: The study included 60 female patients who underwent surgery on the thyroid gland. Patients were stratified into two equal groups matched for main indices. Patients of the main group received infusions of cytoflavin (20 ml in 200 ml of 5% glucose solution). Patients underwent thyroidectomy with general inhalation anesthesia using desflurane. Cognitive testing was performed one day before operation and 6, 24 and 48 h after. Waking time after stopping desflurane administration and time prior tracheal extubation were recorded. RESULTS AND CONCLUSION: The use of cytoflavin promoted the early post anesthesia adaptation and more rapid recovery of initial cognitive status of the patients.