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Authors:
L.V. Stakhovskaya ¹ , E.A. Mkhitaryan ² , O.N. Tkachev ^1.2 , T.M. Ostroumova ³ , O.D. Ostroumova ^3,

¹ FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
² Russian Gerontological Scientific and Clinical Center of the FGAOU in the Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
³ FGAOU in the First Moscow State Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
⁴ FSBEI of DPO “Russian Medical Academy of Continuing Professional Education” of the Ministry of Health of Russia, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2020, T. 120, No. 8, Issue. 2

Summary:
Purpose of the study. To evaluate the effectiveness and safety of prolonged sequential therapy with Mexidol with a hemisphere ischemic stroke in acute and early recovery periods in patients of various age groups. Material and methods. The study is an additional analysis of age groups among 150 patients who took part in a randomized double blind multicenter placebo-controlled in parallel groups of the epic study. The entire study of the study (62 men and 88 women) was divided into subgroups by age: under 60 years old, 60–75 years old, 76–90 years. Also, all participants in the study were divided into 2 populations: ITT (Intent to Treat Population, patients who received at least one dose of the drug/placebo drug) and PP (Per Protocol Population, patients who received the drug in accordance with the research protocol). The results were evaluated on the modified Rankin scale (MSHR) at the end of the course of therapy, the Bartel index, the Bek depression scale, and the European questionnaire for assessing the quality of life. Results. The effectiveness of Mexidol on all the scales used did not differ depending on age. At the time of the end of the therapy, the average MSHR score was lower in patients 76–90 years (in both populations) compared to placebo (p <0.001). The dynamics of reducing the average score in MSHR (1-5th visits) was more pronounced in patients of 60–75 years (p = 0.025), including patients with diabetes. In patients 76–90 years old and patients with diabetes mellitus compared to placebo, the severity of cognitive-affective symptoms of depression (p = 0.049 and p = 0.02, respectively), the share of patients with lack of problems with everyday affairs, increased statistically significant (P = P = P = P = P = P = P = P = P = P = P. 0.007 and p = 0.02, respectively). In patients with diabetes, the level of everyday activity (p = 0.023) has also increased statistically significantly significantly increased and the quality of life has improved (p = 0.045). There were no reliable differences in the frequency of unwanted phenomena in all studied groups. Conclusion. It is recommended that the use of Mexidol in the acute and early recovery periods of ischemic stroke in all age groups, including patients with diabetes mellitus. Key words: ischemic stroke, Mexidol, ethylmethylhydroxypyridine succinate, effectiveness and safety, ischemic stroke, acute period, early recovery period, epic.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova 2020, T. 120, No. 8, S. 1-7

Summary:
Vascular cognitive disorders (TFR) are one of the urgent problems of clinical neurology and the second most common cause of dementia. TFR cover a number of disorders in which vascular factors cause or contribute to a decrease in cognitive functions. Among the main risk factors for the development of the Investigative Committee, elderly age and vascular factors are considered, leading to endothelial dysfunction and damage, which in turn can cause neurovascular dysfunction, increased permeability of the hematoencephalic barrier and microsyuded thrombosis. One of the most important mechanisms for the development of the Investigative Committee is oxidative stress, which indicates the need to use agents with antioxidant activity. Such drugs include Mexidol (ethylmethylhydroxypyridine succinate). Mexidol has pronounced antioxidant and antihypoxic properties. The clinical effectiveness of Mexidol in relation to the Investigative Committee was established in many studies. Key words: chronic cerebrovascular failure, oxidant stress, vascular cognitive impairment, endothelial dysfunction, Mexidol.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2020, T. 120, No. 6

Summary:
Chronic brain ischemia (Khim) - a common cerebrovascular syndrome, the development of which is associated with a high risk of increasing cognitive, behavioral, motor disorders, the formation of the patient's dependence on outsider. The timely start of treatment can slow down the course of the disease, make it more favorable. The review presents an analysis of the results of clinical studies devoted to the effectiveness of ethylmethylhydroxypyridine of succinate (Mexidol) in patients with chemicals. The effectiveness of the drug was noted when stopping cognitive, affective and motor disorders. Information about good tolerance of ethylmethylhydroxypyridine of succinate is given. Keywords: chronic brain ischemia, cognitive disorders, affective disorders, ethylmethylhydroxypyridine succinate, mexidol, treatment.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova 2020, T. 120, No. 3, P. 87-91

Summary:
an analysis of the clinical efficiency and safety of the use of ethylmethylhydroxypyridine of succinate (Mexidol) in a complex of rehabilitation measures in patients who have undergone ischemic stroke (AI). It is shown that with the terminal use of the drug in patients, restoration of neurological functions is improved, regression of neurological deficiency and cognitive disorders, including improving memory, reducing the manifestation of asthenic syndrome, increasing the level of socio-household adaptation, and improving the psychoemotional state of patients, a decrease in spasticity, increasing spasticity, and increasing the motor and speech activity, praxis, reliable elimination of ignoring syndrome. In patients who have suffered AI, there was a decrease in the blood level of total cholesterol and low-density С-lipoproteins, a decrease in the severity of hypercoagulation. The results of the studies convincingly showed the feasibility of using ethylmethylhydroxypyridine of succinate (Mexidol) at all stages of restoration treatment of patients who suffered AI. Keywords : ethylmethylhydroxypyrididine succinate, Mexidol, rehabilitation, recovery, stroke.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2020, T. 120, No. 3 issue. 2

Summary:
Purpose of the study. Assessment of the effectiveness and safety of prolonged sequential therapy with Mexidol and Mexidol Forte 250 for a functional outcome in patients with ischemic stroke (AI) in the basin of the internal carotid artery. Material and methods. The study includes 50 patients with the first AI in the carotid pool, which were hospitalized in the SOKB on the 1st day from the onset of the disease. Patients of the main group (n = 25) received Mexidol 500 mg intravenously dropped 1 time per day for 14 days, then Mexidol Forte 250 in tablets of 250 mg 3 times a day for 60 days. Patients of the comparison group (n = 25) received standard basic therapy. The reliability of intergroup differences was evaluated using the Mann-Uiite criterion, the exact criterion of Fisher, and the calculation of relative risk (OR). Statistically significant were the differences at the level of p <0.05. Results. After 14 days of therapy, both groups of patients demonstrated positive dynamics regarding the initial indicators. At the same time, patients who received Mexidol had a higher score on the MOS scale (U = 173.5, P = 0.006) showed a lower score when performing tasks for dynamic praxis (U = 214.0, P = 0.028) and optical Spatial disorders (U = 170.5, p = 0.003), the better strength of memorization (181.5, p = 0.006), and also better performed tasks for generalization (U = 200.5, p = 0.014). By the 74th day, the absence of moderate cognitive disorders (MOS> 26 points) was diagnosed in 17 (68%) patients of the main group and 14 (56%) patients of the comparison group. Differences without a statistically significant difference. At the same time, patients of the main group had a statistically lower score on the NIHSS scale (U = 124.0, p <0.001) and a lower degree of disability: the total score on the MRS 0-2 scale was reached in 19 (76%) patients of the main group and only In 12 (48%) patients of the comparison group (OR = 3.34, F = 0.07, P <0.05). Also, patients who received prolonged sequential therapy with Mexidol and Mexidol Forte 250 had more mild spatial disorders than patients of the comparison group. Conclusion. Conducting consistent therapy with Mexidol and Mexol Forte 250 in the acute and early recovery periods of AI positively affects the regression of focal neurological symptoms, increases the likelihood of independence in everyday life by 3.34 times, and helps to reduce the severity of optical, neurodynamic disorders and memory impairment. Key words: ischemic stroke, Mexidol, Mexidol Fort 250, cognitive impairment, functional outcome.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova 2020, T. 120, No. 3, Issue. 2, S. 60-65

Summary:
Purpose of the study. Studying the effectiveness and safety of therapy with Mexidol, used intravenously (500 mg 1 time per day) for 14 days, with the subsequent administration of orally, Mexidol Forte 250 in a dose of 250 mg (1 tablet) 3 times a day for 60 days in patients with patients with Chronic ischemia of the brain (Khim) against the background of arterial hypertension and atherosclerosis of brachiocephalous arteries. Material and methods. The observation program includes 52 patients with an established diagnosis of chemicals confirmed by neuroizializational research methods. The main group included 26 patients who, in addition to basic therapy, Mexidol and Mexidol Forte 250. The comparison group consisted of 26 patients who received only basic therapy. Results and conclusion. The high efficiency and safety of consistent therapy (parenteral administration and then taking the tablet form of the drug Mexidol Forte 250) are shown. Against the background of treatment, an improvement in emotional and cognitive statuses, a decrease in static-locomotor disorders, as well as the severity of subjective neurological symptoms is noted. The high commitment of patients on the therapy is shown. Keywords: chronic brain ischemia, arterial hypertension, atherosclerosis of brachiocephalous arteries, Mexidol, Static-Locomotor disorders, cognitive disorders.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2019, T. 119, No. 12, Issue. 2

Summary:
Purpose of the study. The study of the effectiveness and safety of therapy with Mexidol, prescribed intravenously (500 mg 1 time per day) for 14 days, followed by the oral administration of Mexidol Forte 250 in 250 mg 3 times a day in patients with chronic brain ischemia (chemical). Material and methods. The study includes 56 patients with chemicals, which developed against the background of a combination of arterial hypertension and atherosclerosis. They evaluated the results of physical examination methods (level of blood pressure, heart rate, etc.), complaint dynamics, indicators on the scales of the general clinical impression (CGI), Mosa, asthenia MFI 20, anxiety and depression of Hamilton, Tinnetti. Results and conclusion. The results of the study showed the effectiveness and safety of intravenous administration of Mexidol, followed by the oral administration of Mexidol Forte 250. The specified scheme of therapy contributed to the regression of objective and subjective symptoms of HIM, and led to improvement in the emotional, cognitive and motor spheres. Key words: chronic brain ischemia, atherosclerosis, arterial hypertension, motor disorders, cognitive disorders, Mexidol, Mexidol Fort 250.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2019, T. 119, No. 9

Summary:
Purpose of the study. Studying the effectiveness and safety of therapy with a medicine (LP) Mexidol, used intravenously (500 mg 1 time per day) in the form of infusions for 14 days, followed by orally orally Mexidol Fort 250 in a dose of 250 mg (1 tablet) 3 times a The day for 60 days in patients with chronic ischemia of the brain against the background of arterial hypertension and atherosclerosis. Material and methods. The open observation program includes 60 patients with an established diagnosis of chronic brain ischemia, confirmed by neuroimaging research methods. Results and conclusion. The results of the study showed high efficiency and safety of sequential therapy (injections and then taking the tablet form of the LP Mexol Forte 250). Against the background of treatment, an improvement in emotional and cognitive status, a decrease in motor disorders, as well as the severity of subjective manifestations are noted. High commitment to patients to the therapy is shown. Keywords: chronic brain ischemia, arterial hypertension, atherosclerosis, ethylmethylhydroxypyrididine succinate, mexidol, cognitive disorders.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2019, T. 119, No. 8

Summary:
one of the leading causes of mortality, disability and pronounced maladaptation of patients is an ischemic stroke, which accounts for about 80% of all types of acute cerebrovascular accident. At the same time, approximately 2/3 of patients detect residual phenomena of cerebrovascular circulation disorders of varying degrees of severity. Currently, the problem of ischemic stroke is given great attention, and one of the aspects of work in this area is the developed international and domestic recommendations for the prevention of stroke, treatment and rehabilitation of patients who have undergone stroke. The article provides an overview of the latest clinical recommendations for the early management of patients with acute ischemic stroke of the American Association on the Problems of the Heart and the American Association for the Treatment of Stroke, as well as the features of the therapy and prevention of stroke in Russia, European and the USA. Key words: ischemic stroke, clinical recommendations, therapy of ischemic stroke.

Place of publication:
Bulletin of Otorinolaryngology, 2019, T. 84, No. 6

Summary:
with vascular etiology of neurosenate hearing loss, hearing changes can occur as a result of the vertebral-baslar failure of various etiologies. Features of the etiology and pathogenesis of chronic neurosenate hearing loss allow us to consider very promising the use of neuroprotective drugs in the therapeutic complex that can activate the structure and function of neuronal structures of the analyzer trace. Ethylmethylhydroxypirinidine of succinate, possessing comprehensive pharmacological capabilities and a wide spectrum of effects realized at neuronal and vascular levels can be used in the therapy of hearing impairment and intelligibility of speech. Keywords: hearing loss, neurosenate hearing loss, rehabilitation of the auditory function, ethylmethylhydroxypyridine succinate.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova Stroke No. 4/2019

Summary:
the review presents data on the combined use of Mexidol in combination with drugs of various pharmacotherapeutic groups. Possessing the multimodal action mechanism and a wide range of pharmacological effects, Mexoling enhances the main effect of drugs both in the experiment and in the clinic, increases the effectiveness of therapy prescribed by patients in accordance with current federal standards, and also helps to reduce the severity of complications of diseases. The data on the efficiency and pathogenetic validity of the course combination therapy with other preparations presented in the review indicate the advisability of this approach for the treatment of cerebrovascular and cardiovascular diseases, diseases of the nervous system, open-angle glaucoma, alcohol intoxication and a number of other diseases. Key words: Mexidol, combined therapy, free radicals, lipid oxidation, ischemic stroke, myocardial infarction, coronary heart disease, epilepsy, glaucoma, alcohol intoxication.

Place of publication:
special release of the journal of neurology and psychiatry named after S.S. Korsakov Stroke No. 3.2/2019

Summary:
Purpose of the study. To study in dynamics the rheological properties of blood in patients with acute ischemic stroke (AI) when Mexidol is included in complex therapy. Material and methods. 60 patients with acute AI examined. Mexidol (500 mg/day intravenously within 20 days) received 32 patients, 28 patients received magnesium sulfate (2000 mg/day intravenously for 20 days). The control group included 20 patients without a history of cardiovascular pathology. Assessment of rheological indicators of blood (whole blood viscosity, plasma viscosity, hematocrit, aggregation and deformability of red blood cells, the level of fibrinogen in plasma) was carried out in patients three times: during the first 12 hours, on the 3-5th day and on the 18-20th day and on the 18th-20th day After hospitalization. Results. All patients with a stroke observed a high viscosity syndrome. A statistically significant decrease in blood viscosity was detected in patients receiving Mexidol, by the 3-5th day of the disease at low shift speeds and by the 18-20 days at the speed of the shift from 3-100 S1. By the 18-20th day of the disease, reliable differences in the value of hematocrit (p = 0.026) and the content of fibrinogen (p = 0.017) were revealed in groups of patients receiving various therapy. A reliable increase in the erythrocyte deformability index in patients who received the therapy with Mexidol by the 3-5th day at the shift speeds of 90 and 890 S-1, by the 18-20th day at the shift speeds 90–360 S-1, was recorded. Conclusion. The study shows the effect of Mexol's drug on blood fluidity in the dynamics of acute cerebral ischemia and its effectiveness is proved in reducing blood viscosity by reducing the level of hematocrit and fibrinogen, as well as an improvement in the deformation ability of red blood cells. Keywords: acute ischemic stroke, rheological indicators of blood, blood viscosity, erythrocyte deformability, Mexidol (2-ethyl-6-methyl-3-hydroxypirinate), treatment of brain ischemia.

Place of publication:
New therapeutic journal "Non Nocera" No. 11, 2018

Summary:
cognitive violations of varying degrees are laid by severe economic and emotional burden on the families of patients and society as a whole. Modern methods of therapy in most cases reduce the severity of violations and increase the duration of an active independent life.

Place of publication:
“Neurology, neuropsychiatry, psychosomatics”, 2018; 10 (3): 86–90

Resume:
The purpose of the study is to assess the influence of intravenous administration of Mexidol during the “therapeutic window” on the effectiveness of intravenous thrombolytic therapy (TLT). Patients and methods. A retrospective study includes 123 patients with an ischemic stroke (AI) who conducted intravenous TLT in the conditions of the vascular centers of the Republic of Tatarstan. To assess the dynamics of neurological status, they used the scale of the severity of the National Institute of Health (National Stroke Scale (Nihss). Depending on the initial severity of the neurological deficiency, all patients were divided into three subgroups: with mild severity (Lee) and an assessment by NIHSS at admission <8 points; with moderate severity (si) - with an assessment> 8 and <16 points; With heavy AI (TI) - with an assessment> 16 points. X -ray computed tomography was performed by all patients at the time of admission, 24 hours after the TLT, as well as with a deterioration in the condition. Results. The use of Mexidol at the prehospital stage, followed by TLT in patients with AI positively affects the regression of neurological deficiency, regardless of the severity of the disease. Reliable differences in the degree of regression of the neurological deficiency according to NIHSS 24 hours and 10 days after receipt of patients with TI who were introduced by Mexidol at the prehospital stage were revealed and who did not receive this drug before the implementation of TLT. The use of Mexidol before TLT promotes greater regression of neurological deficiency. A lower frequency of development of hemorrhagic transformations has been established in patients who received Mexidol at the prehospital stage, in comparison with patients who did not use this drug. Conclusion. The data obtained demonstrate the positive effect of Mexidol on the effectiveness and safety of TLT in patients with AI. Keywords: ethylmethylhydroxypyridine succinate; intravenous thrombolytic therapy; ischemic stroke; Neuroprotective therapy.

Place of publication:
neurology, neuropsychiatry, psychosomatics. 2018, No. 10

Summary:
The purpose of the study is to assess the effectiveness of the inclusion of Mexidol in complex drug therapy in patients in the acute period of ischemic (AI) and hemorrhagic stroke. Patients and methods. 60 patients aged 60–74 years with a first -aimed stroke were examined: 34 of them were diagnosed with AI, in 26 - intra -core hemorrhage (Navy). The main group was 31 patients who received, in addition to therapy in accordance with the standards adopted in the Russian Federation, Mexidol. The comparison group included 29 patients who were prescribed only standard therapy. Before and against the background of intravenous drip administration of Mexidol, 500 mg for 10 days, indicators were assessed by the stroke scale of the American National Institute of Health (National Institutes of Health Stroke Scale, NiHSS), the Rivermide mobility index and the Rankin scale and the Bartel index. The percentage absorption of lipid phospholipid complexes in the infrared spectrum of blood serum was also investigated. The control group amounted to 20 practically healthy persons. Results and discussion. It was found that the dynamics of lipid phospholipid complexes of the blood serum correlate with the type of stroke. The inclusion of Mexidol in complex drug therapy in elderly patients in the acute period of AI and Navy contributed to the regression of focal neurological deficiency, improving daily activity and functional independence. Mexidol's reception had a positive effect on the level of phospholipids of neuronal membranes. Conclusion. Mexidol’s positive effect on the level of blood serum phospholipids was noted. The conclusion was made about the effectiveness of its inclusion in the complex therapy of the acute period of AI and hemorrhagic stroke, especially in the elderly. Key words: ischemic stroke; intracassium hemorrhage; therapy; Mexidol; phospholipids.

Place of publication:
“Journal of Neurology and Psychiatry”, 10, 2018

Summary:
antihypoxic, antioxidant and nootropic effects of Mexidol contribute to improving the condition of patients with cerebrovascular pathology. The results of clinical studies show that the sequential scheme for the use of the drug (first intravenously or intramuscularly, then orally) is effective in the complex therapy of ischemic diseases of the brain, vascular surgery, therapy and rehabilitation of patients with degenerative-dystrophic changes in the spine, with neurodegenerative pathology, infectious neuropathies, a and Also in therapy of neuropsychological and autonomic disorders.