[Pathogenetic approaches to the correction of vascular homeostasis in patients with COVID-19: A review].

The adverse outcomes in patients with COVID-19 in the initial phase of the disease are often due to the development of cytokine storm, endothelial dysfunction, shifts in the hemostasis system, microangiopathy, angiocentric inflammation, and pathological angiogenesis, which require targeted therapy. Unfortunately, to date, there is still no drug with proven high efficacy. This review is to analyse the literature data on the pathogenesis of vascular homeostasis lesions and possible ways to correct the existing shifts in patients with COVID-19. When the oxygen content in the tissue decreases, one of the most important mechanisms of adaptation is the activation of the succinate oxidase pathway, but under conditions of prolonged hypoxia and intoxication, the succinate reserve is rapidly depleted. That is why exogenous of succinic acid can enhance the adaptive capabilities of the organism and improve the prognosis in patients with COVID-19. Succinic acid preparations contribute to normalization of energy exchange and reduction of oxidative stress, especially in combination with inosine, nicotinamide and riboflavin and are widely used in clinical practice in various nosological forms. Taking into account the analysis of data on the mechanisms of clinical effects of succinate-containing preparations, this group of drugs can be considered as promising with regard to the correction of vascular disorders in COVID-19.

Infections, Pandemics, and Sleep Disorders.

Studies of the neurological symptoms and signs associated with the acute and late phases of infectious diseases are important in pandemic conditions. The novel coronavirus infection (COVID-19) pandemic has increased the number of patients with sleeplessness, this being an adverse prognostic factor for infections. This review addresses the factors and mechanisms of sleep impairments and their relationship with inflammation and immune system dysfunction in infectious diseases. In particular, impairments to the functioning of the melatoninergic system are discussed as the cause of sleeplessness during pandemics. The relevance of developing measures for rehabilitating patients, particularly use of Sonnovan to restore normal sleep, which plays a fundamental role in supporting people's mental and physical health, is emphasized.

[Infections, pandemics and sleep disorders]. / Infektsii, pandemii i narusheniya sna.

The study of neurological symptoms and signs connected with acute and long-term periods of infectious diseases is relevant during pandemics. The COVID-19 pandemic has increased the number of patients suffering from insomnia. Sleep disturbance is an unfavorable prognostic factor for infections. Risk factors and mechanisms of sleep disturbance, their relationship with inflammation and dysfunction of the immune system in infectious diseases are presented. In particular, dysfunction of the melatonergic system as the cause of insomnia during pandemics is considered. The authors highlight the relevance of measures aimed at the rehabilitation of patients, in particular, the use of sonnovan to restore normal sleep, which is important for a person's mental and physical health.

[Agomelatine in the treatment of major depressive disorder: assessment of the efficacy and tolerability]. / Agomelatin pri lechenii bol'shogo depressivnogo rasstroistva: otsenka éffektivnosti i perenosimosti.

Agomelatine is an antidepressant agent with an innovative unique pharmacodynamic profile, including melatonergic receptor agonism (MT1 / MT2) and antagonistic effects on serotonergic 5-HT2C receptors. According to the results of meta-analyzes of clinical studies of the acute phase of a major depressive disorder, the antidepressant effect of agomelatine itself is significantly higher than that of placebo, but somewhat inferior to a number of other antidepressants (especially SSRIs and venlafaxine). To date, there is some uncertainty regarding the efficacy of agomelatine for the prevention of recurrence of MDD and its hepatotoxicity profile. In this regard, agomelatine is not considered as a drug of first choice in treatment of MDD. However, the heterogeneous clinical manifestations of MDD and the unique mechanism of action of agomelatine with the ability of the drug to have a modulating effect on sleep, make it possible to effective use it for treating such disorders. In addition, agomelatine has a more favorable safety profile, which allows considering it as a drug of choice in patients who have contraindications to other antidepressants or in the absence of therapeutic response to another antidepressant therapy.

[The efficacy of remaxol as a hepatoprotective agent in long-term psychopharmacotherapy]. / Primenenie remaksola v kachestve gepatoprotektora pri dlitel'noi psikhofarmakoterapii.

AIM: Evaluation of the efficacy of psychopharmacotherapy with the hepatoprotector remaxol. MATERIAL AND METHODS: A study was conducted on 60 male patients diagnosed with 'Paranoid schizophrenia, continuous progression type course' who received therapy for the underlying disease with traditional antipsychotics in a psychiatric inpatient setting. During the 12 days of the study, 30 patients (main group) received neuroleptic therapy in combination with intravenous infusions of remaxol (400.0 ml), the remaining 30 patients (control group) received 'active placebo' (0.9% sodium chloride solution, 400.0 ml). RESULTS AND CONCLUSION: A decrease in the frequency and severity of astheno-vegetative, dyspeptic, hemorrhagic, cholestatic syndromes and hepatomegaly was shown. The absence of side-effects along with an improvement in the general well-being of the patients is extremely important in long-term psychopharmacotherapy of psychiatric patients.

[Inflammatory diseases of scrotal organs in patients with brucellosis: Improvement of therapy].

AIM: To evaluate the efficacy of cycloferon used in the combination treatment of scrotal inflammatory diseases (SID) in patients with brucellosis. SUBJECTS AND METHODS: A total of 150 male patients with chronic brucellosis (CB) were examined. Inquiry, questioning, physical and ultrasound examinations, and spermiogram analysis were used to detect of diseases of the reproductive system. Twenty-two CB patients with SID were examined over time (before and after cycle therapy). In Group 1, combination therapy included 2 cycles of five intramuscular injections of cycloferon 0.25 g in each at a 10-day interval. In Group 2, a package of therapeutic measures meets the generally accepted standards. and Incorporation of cycloferon into the combination therapy of SID patients with CB positively affected the time course of clinical changes and spermatogenesis, declines the number of SID exacerbations, improved quality of life, and failed to cause side effects. CONCLUSION: The findings allow us to recommend cycloferon as the drug of choice in treating CB patients with SID.