[Influence of chronic pain in osteoarthritis on the risk of cardiovascular diseases and modern methods of drug prevention]. / Vliyanie khronicheskoi boli pri osteoartrite na risk razvitiya serdechno-sosudistykh zabolevanii i sovremennye sposoby ikh lekarstvennoi profilaktiki.

The purpose of the review of scientific medical literature was to evaluate the data of the epidemiology of osteoarthritis (OA) and cardiovascular diseases (CVD) with the analysis of risk factors, pathophysiological and pathobiochemical mechanisms of the relationship between OA and the risk of developing CVD in the presence of chronic pain, modern strategies for screening and management of this cohort of patients, the mechanism of action and pharmacological effects of chondroitin sulfate (CS). Conclusions were drawn about the need for additional clinical and observational studies of the efficacy and safety of the parenteral form of CS (Chondroguard) in patients with chronic pain in OA and CVD, improvement of clinical recommendations for the treatment of chronic pain in patients with OA and cardiovascular risk, with special attention to interventions that eliminate mobility restrictions in patients and the inclusion of basic and adjuvant therapy with DMOADs to achieve the goals of multipurpose monotherapy in patients with contraindications to standard therapy drugs.

[Comparative analysis of the use of symptomatic slow acting drugs for osteoarthritis containing chondroitin sulfate or affecting its biosynthesis in patients with non-specific low back pain]. / Sravnitel'nyi analiz primeneniya simptomaticheskikh preparatov zamedlennogo deistviya, soderzhashchikh khondroitina sul'fat ili vliyayushchikh na ego biosintez, u patsientov s nespetsificheskoi bol'yu poyasnichno-kresttsovoi lokalizatsii.

OBJECTIVE: Retrospective comparative analysis of the use of SYSADOA preparations containing chondroitin sulfate (Chondroguard, 2 ml, 25 amp., glycosaminoglycan-peptide complex, 1 ml 25 amp., bioactive concentrate of small marine fish, 2 ml, 10 amp.) in patients with chronic non-specific low back pain (LBP) of lumbar and sacral localization caused by spondylosis and osteochondrosis of the lumbar spine, at the stage of outpatient care. MATERIAL AND METHODS: Data of medical records of patients (n=120; men - 32, women - 88, age - 54.1±7.6 years, duration of disease exacerbation 4.0±1.7 months) with nonspecific LBP were systematized according to the inclusion/exclusion criteria. All patients were divided into 4 groups: Group 1 (n=30) received Chondroguard im., 2 ml every other day, the course of treatment was 25 injections, 25 days; Group 2 (n=30) received glycosaminoglycan-peptide complex on the 1st day - 0.3 ml, on the 2nd day - 0.5 ml, and then 3 times a week for 1 ml, course of treatment - 25 injections, 25 days; Group 3 (n=30) received bioactive concentrate of small marine fish, 2 ml im., every other day, the course of treatment was 10 injections; repeated courses of treatment - after 6 months; Group 4 (n=30) received Amelotex (meloxicam) at a dose of 15 mg once a day for 15 days. All patients of the first 3 groups received Amelotex at a dose of 15 mg with the possibility of reducing the dose to 7.5 mg or completely discontinuing the drug if necessary. Retrospectively, dynamic monitoring was performed in the medical records of outpatients after 50 days and 6 months from the start of therapy according to the following parameters: intensity of pain according to VAS, short form of the McGill pain questionnaire, vital signs of patients (Oswestry Disability Index, version 2.1a [Oswestry Disability Index], and Roland-Morris questionnaire), propensity to chronic pain syndrome according to the STarT Back Screening Tool questionnaire, the presence and severity of comorbid fibromyalgia according to the Fibromyalgia Rapid Screening Tool questionnaire, the level of pain catastrophization according to the Pain Catastrophizing Scale, the severity of comorbid anxiety and depression according to the Hospital Anxiety and Depression Scale, the severity comorbid insomnia (Insomnia Severity Index), quality of life according to the SF-36 scale, the effectiveness of drugs according to the patient on a 5-point scale, the need to take NSAIDs and analgesics, tolerability on a 4-point system. The safety of therapy was monitored using the WHO and Naranjo scales. RESULTS: In patients with nonspecific LBP, a greater degree of reduction in the intensity of the pain syndrome, a smaller number of exacerbations of the pain syndrome over 6 months of observation, an improvement in the functional status and life activity, a tendency to a decrease in the severity of anxiety and depression, sleep disturbances and comorbid fibromyalgia, limiting the risk of chronicity and catastrophization of pain, the presence of a structure-modifying effect on IVD and degenerative changes in the facet joints, a significant improvement in the physical and mental components of health, high satisfaction and safety of therapy, which included taking Chondroguard with meloxicam, with a decrease in the need to take the latter by the 50th day observation period compared to other regimens. The effects of Chondroguard and meloxicam turned out to be long-term and were recorded by the 6th month in the absence of Chondroguard, which indicated the preservation of the influence of highly purified cholesterol on the pathogenetic mechanisms of the formation of LBP. CONCLUSION: The study allows us to recommend the use of a parenteral form of cholesterol (Chondroguard, CJSC «PharmFirma «Sotex¼, Russia) for the treatment of nonspecific LBP with moderate or severe pain, chronic relapsing or persistent course, in combination with NSAIDs and their subsequent cancellation or administration on demand.

[About the prognostic role of fibulin-5 protein in the progression of pathological vascular remodeling in patients with isolated sistolic arterial hypertension.]

Today, arterial hypertension (AH) is often associated with accelerated aging. In the structure of AH in persons over 65 years of age, the most common form is isolated systolic hypertension (ISAH), the mechanisms of development of which remain unexplained. Molecular regulation of remodeling of smooth muscle cells of vessels, changes in which, along with perivascular fibrosis and endothelial dysfunction, lead to increased sensitivity to procontractile mediators and calcification, forms the basis of mechanisms of vascular aging and rigidity. Clinically, this process is manifested in ISAH in individuals of an early period of old age and senile age. The search for new diagnostic molecular markers and the development of pharmacological correction of mechanisms of vascular wall aging in ISAH is an urgent and timely task. The review presents an analysis of current data from medical literature about the participation of fibulin-5 protein in the process of elastogenesis in the vascular wall, as well as in molecular pathological pathways of inflammation and aging of the vascular wall in ISAH. The role of multifunctional signal molecule fibulin-5 in the age-related loss of elasticity of the vascular wall is shown. Presented is the perspective of creating a drug from the group of senolitics based on fibulin-5 molecule, as well as modern application possibilities for preventing aging of the vascular wall of the drug Cytoflavin (active ingredients in 1 ml of solution: succinic acid, 100 mg; nicotinamide, 10 mg; riboxin, 20 mg riboflavin mononucleotide, 2 mg).

[The influence of citoflavin on molecular mechanisms of hypertensive encephalopathy development in patients with systolic arterial hypertension].

The molecular pharmacological effects of cytoflavin in patients with hypertensive encephalopathy (HE) and isolated systolic arterial hypertension (ISAH) have been investigated using the following methods: assessment of complaints, 24-hour arterial pressure monitoring, ultrasound diagnostics including echocardiography, measurement of lipid profiles and coagulograms, and molecular phenotyping by MALDI-TOF/TOF-MS. A combination of cytoflavin administration with standard therapy of HE and ISAH led to the most expressed return development of clinical symptoms, restoration of the hemodynamic, structural, and geometrical parameters of cardiovascular system, and normalization of the indices of lipid profiles and coagulograms in comparison to patients with HE and ISAH, which accepted only standard therapy. Molecular mechanisms of cytoflavin action have been revealed, which include control of the activity of cellular signaling pathways by means of intermolecular interactions. The optimized therapy of HE and ISAH is recommended for clinical application, which assumes a combined use of standard therapy and cytoflavin and provides a geroprotective action upon the cardiovascular system.

[The study of the effectiveness of drug prevention mechanisms of cardiovascular aging by cytoflavin].

The aim of the research was the search of the mechanism of Cytoflavin action in patients with isolated systolic arterial hypertension (ISAH) as the aging model. The following research methods were applied: the assessment of complaints, 24-hour arterial pressure monitoring, ultrasound diagnostic, volume sphygmography, lipid profiles and coagulogram, molecular phenotyping by MALDI-TOF-TOF-MS. The combination of Cytoflavin with standard therapy of ISAH led to the most expressed return development of clinical symptoms, the restoration of the haemodynamics, structural and geometrical parameters of cardiovascular system, indicators lipid profiles and coagulogram in the comparison with patients with ISAH, who accepted standard therapy and those of the control groups. Molecular mechanisms of Cytoflavin action, including regulation of the activity of cell signaling pathways through intermolecular interactions were found. We recommend using Cytoflavin together with the standard therapy in treatment of ISAH, which provides the action of geroprotectors for cardiovascular system.

[The study of dynamics of clinical and molecular phenotypes in the generalized form of myasthenia with optimized and combined treatment].

The aim of the study was the research of clinical and molecular phenotypes in the generalized form of myasthenia with optimized treantment, which includes the application of basic mode of the treatment and meglumine sodium succinate, and also the combined mode of the treatment, which includes the mode of the treatment and meglumine sodium succinate and ozonotherapy. The most epressed improvement of indicators of the clinical and neurologic status (the eliminaton of motoring breakdown, eye movement disrders, the weaknesses of mimic, respiratory and chewing muscles, bulbar syndrome, the doubling in eye and ptosis, pharyngeal violations and increase in volume of movement of eyes) was observed in the group of patients receiving the combined therapy. The reduction of the epressiveness of the defeat of the neuromotor device and the decrement of the amplitude of the various degree of M-answer in patients with myasthenla is revealed in the application of the combined therapy in the comparison with the application of the basic and optimized therapy. For the first time we have investigaed the dynamics of the intensity of the expression of specfic peptides and proteins in blood serum in patients with the application of basic therapy, reamberin and ozonotherapy, which have allowed to open the new mechanisms of the efficiency ofthe combined therapy of the disease.

[Personalized reamberin therapy in patients with decompensated LADA 1.5 diabetes mellitus].

The aim of the study was to develop a new strategy of dosing a Reamberine 1,5% infusion solution on an individual basis for patients with LADA 1.5 diabetes mellitus (DM) and new methods for estimating the regulation and functioning of metabolic pathways associated with the production and transformation of succinic acid. The use of Reamberin led to the reduction of average, maximum and minimum blood glucose and HBA1c levels. The study revealed a decrease of proteinuria, serum creatinine level, and albumin/creatinine ratio in urine Patients given intensive therapy with insulin and Reamberin underwent significant reduction of blood Na', K+ and chlorine levels and increased Na+/K+, Mg++ and Ca++ ratios. Morning and evening concentrations of ACTH decreased while cortisol levels increased at 8.00 and 18.00. IRI level decreased, T3 and T4 levels increased both at 8.00 and 18.00 when TSH concentration was reduced The percentage of patients unsatisfied with QL (based on the Diabetes QL scale) among those taking Reamberine diminished while that of the patients satisfied with QL increased. The first data on dynamics of plasma protein expression during Reamberin therapy are presented

[Proteomic profile and non-specific immunoprophylaxis of respiratory diseases in frequently sick children].

We have investigated efficacy of meglumine acridonacetate (Cycloferon) infrequently sick children (FSC) on the basis of serum proteomic profile dynamics; we have also studied epidemiologic efficacy of interferon inductor as a mean of non-specific immunoprophylaxis. FSC were subjects to follow up during 4-10 years. We have used recommended regimens of drug administration. Were analyzed: anamneses of FSC, clinical symptoms, infectious index calculation, stratification of children into 5 groups of FSC and separation of children with truly frequent recurrent respiratory viral diseases. On the basis of proteomic blood analyzes the following parameters of efficacy of treatment with meglumine acridonacetate were defined: expression intensity of Rho- and Ras-signaling pathways proteins. Epidemiologic efficacy of the drug was 2,9 (from 2,4 to 3,4), rate of protection--62,8% (58,5-67,1%).

[Frequently ill child syndrome].

The efficacy of cycloferon use in the treatment of frequently ill children (FIC) was estimated by the dynamics of the blood plasma proteomic profile. A group of FIC at the age of 4 to 10 years were observed. Cycloferon was administered according to the standard schemes. The results were analysed by the computer programme complex, including the anamnesis, clinical symptoms, infection index, findings of the electrophoretic and mass-spectrometric analyses of the blood plasma before and after the drug use. The intensity indices of the Rho and Ras proteins, the signal pathways, in the blood proteomic profile proved to be sensitive and specific parameters for estimating the regimens of the therapy and prophylaxis of respiratory tract infection in FIC. The epidemiologic efficacy of cycloferon, as an agent of nonspecific immunoprophylaxis for FIC during seasonal prevalence of respiratory tract infection and influenza cases was shown.