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Approaches to pharmacotherapy of vascular moderate cognitive disorders in patients of various age groups

Authors:
V.V. Zakharov 1 , A.I. Fedin 2 , E.A. Mkhitaryan 2, 3

1 FGAOU VO "First Moscow State Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
2 FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
3 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

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 10

Summary:
the article discusses the possibilities of pharmacotherapy of vascular moderate cognitive disorders in various age groups. The results of a double blind randomized clinical examination of MEMO using an antioxidant and anti -hyphyxant drug Mexidol are given. Using a set of tests for evaluating cognitive functions, the high efficiency of the sequential purpose of the parenteral and oral form of Mexidol in each of the three analyzed groups is shown: 40-60, 61-75 and 76-90 years. In all age groups, Mexidol demonstrated a high security profile.

Key words: vascular moderate cognitive impairment, chronic brain ischemia, antioxidants, Mexidol.

Features of pharmacotherapy of vascular cognitive impairment in elderly people

Author:
A.N. Bogolepova 1, 2

1 FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
2 FSBI "Federal Center for Brain and Neurotechnology" of the Federal Medical and Biological Agency of Russia, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 9

Summary:
the problem of pharmacotherapy of elderly and senile age is currently extremely relevant due to the aging of the population and the growth of the prevalence of cardiovascular diseases. One of the most serious problems of an elderly person is the development of a cognitive decline due to cerebrovascular pathology. However, in elderly patients, a large number of comorbid diseases are often observed, which leads to the difficulties of the diagnosis and conduct of these patients, and often to the development of polypragmasis, which can lead to a deterioration in functional status, cognitive impairment, side reactions and drug interactions. In addition, older patients may observe changes in pharmacokinetics and pharmacodynamics due to anatomical and physiological invoices. At the same time, drugs whose effectiveness and tolerance were evaluated precisely in elderly and senile patients, relatively few. In a randomized clinical examination of consistent parenteral and oral therapy, Mexidol's patients with moderate cognitive disorder of vascular genesis confirmed the positive effect of this therapy on various domains (cognitive, emotional, vegetative, motor) of chronic cerebrovascular disease, which allows us to recommend it for the use of elderly elderly elders. and senile age.

Keywords: vascular cognitive disorders, elderly patient, pharmacotherapy, ethylmethylhydroxyperidine succinate, Mexidol.

The influence of Mexidol on the improvement of cognitive status and quality parameters as part of the complex therapy of patients with chronic heart failure of the II - III functional class

Author:
V.V. Tolkacheva, L.V. Karapetyan, N.I. Khutsishvili, S.A. Galochkin, E.R. Kazamedov, railway Kobalava

FGAOU in Russian University of Friendship of Peoples named after Patrice Lumumba, Moscow, Russia

Place of publication:
cardiology and cardiovascular surgery, 2023, T. 16, No. 4

Summary:
Purpose of the study. Assessment of the effect of Mexidol, as part of the complex therapy of heart failure for 10 weeks on cognitive status, quality parameters, asthenic syndrome and anxiety level in patients with XN II-III functional class (according to NYHA classification). Material and methods. An open randomized study included 60 comorbide patients with coronary heart disease (coronary heart disease) and stable chronic heart failure (COL) with cognitive disorders (KN) ≤24 points on the Montreal scale for evaluating cognitive functions (MOCA). The average age of patients was 73.4 ± 8.6 years, 53% - male, the average release fraction of 43.5 ± 10.6%. 30 patients were included in the standard therapy group with the additional purpose of Mexidol (500 mg intravenously dropped 1 time per day for 14 days, then 250 mg 3 times a day 8 weeks) and 30 patients in a standard therapy group. Initially and at the end of the study, an assessment of the effect of therapy on the cognitive status of patients on the Montreal scale of assessment of cognitive functions (Mosa), anxiety level on the Bek scale, the degree of severity and the dynamics of asthenic syndrome on the subjective scale of astheny assessment (MFI-20), and health profiles according to the questionnaire was carried out EQ-5D-5L and quality parameters based on the results of the Essence on the Minnesotsky (MlHFQ), Kansas (Kansas City CardiOMYOPATHY QUESTIONNAIRA, KCCQ) and the SF36 questionnaire “Evaluation of the quality of life”. Results. In patients who received Mexidol, in addition to standard therapy, a reliable improvement of cognitive function by 21%was revealed, a decrease in anxiety-by 38%and the severity of asthenic syndrome-by 12%, improve the overall health of the EQ-5D-5L questionnaire-by 25%by 25% , as well as the qualities of life according to the Minnesotsky questionnaire - by 48%, according to the Kansas questionnaire - by 39%. Conclusion. Mexidol, when adding to standard therapy of patients with XN II-III, functional class, reliably improves cognitive status, quality parameters, reduces the severity of asthenic syndrome and anxiety level. Key words: heart failure, cognitive status, quality of life, Mexidol.

Increasing the efficiency of pharmacotherapy in comorbide patients with chronic brain ischemia on an outpatient basis

Authors:
T.L. Visil 1 , E.G. Arefieva 2

1 FSBEI in Kemerovo State Medical University of the Ministry of Health of Russia, Kemerovo, Russia;
2 GBOUZ "Kuzbass Clinical Cardiological Dispensary named after Academician L.S. Barbarash ", Kemerovo, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 3

Summary:
Purpose of the study. Studying the effectiveness and safety of consistent therapy with Mexidol preparations (500 mg 1 time per day for 14 days in/c) and Mexidol Fort 250 (Mexol Fort 250 by 250 mg 3 times a day, 60 days) in patients with chronic brain ischemia ( Chem) on an outpatient basis.

Material and methods. The open comparative study included 56 patients aged 46–74 years (average - 60.5 ± 7.9 years). In all patients, the diagnosis of Khim was confirmed by clinical and neuroizialization methods. Patients of the 1st group (n = 28) received basic therapy and Mexidol, the 2nd group (n = 28)-only basic therapy.

Results. Against the background of therapy in patients of the 1st group, there was a statistically significant improvement in the state of cognitive functions, a decrease in the severity of the symptoms of depression and anxiety, and manifestations of asthenia. The treatment was characterized by good tolerance, the absence of undesirable phenomena and cases of drug interactions.

Conclusion. Consistent therapy with Mexidol and Mexidol Forte 250 ensures the relief of the main clinical manifestations of chemicals, is characterized by good tolerance and safety.

Keywords: chronic brain ischemia, arterial hypertension, ethylmethylhydroxypyrididine Succinate, Mexidol, Mexidol Forte 250.

Features of the treatment and rehabilitation of patients who suffered Covid-19 with ischemic stroke

Authors:
G.S. Rakhimbayeva, Sh.R. Gazieva, M.K. Atyaniyazov, F.Kh. Muratov, D.S. Tolipov, U.D. Shodiev

Tashkent Medical Academy, Tashkent, Republic of Uzbekistan

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 3, Issue. 2

Summary:
Covid-19 development is associated with damage to various organs and systems of the body, including the development of acute ischemic stroke (AI). The article discusses modern ideas about the pathogenesis of AI at the Covid-19. The data on the choice of optimal therapy of patients with COVID-19 and acute AI, as well as the possibility of increasing the efficiency of rehabilitation measures, are analyzed. Information about the effectiveness of the use of the drug Mexidol in patients with COVID-19 and AI is given. Key words: ischemic stroke, Covid-19, treatment, rehabilitation, Mexidol.

The possibilities of multimodal neuroprotection in patients with chronic brain ischemia against the background of arterial hypertension and atherosclerosis

Authors:
I.A. Gribacheva, T.F. Popova, E.V. Petrova, A.V. Zvonkova

FSBEI in Novosibirsk State Medical University of the Ministry of Health of Russia

Place of publication:
neurology, neuropsychiatry, psychosomatics. 2023; 15 (2): 19–26

Summary:
chronic cerebrovascular pathology is manifested by a combination of cognitive, emotional and autonomic disorders. The correct timely assessment and accurate diagnosis of emotional and autonomic disorders and their timely correction are also important for slowing down the progression of cognitive deficiency.

The purpose of the study is to study the effectiveness and safety of the use of Mexidol, prescribed intravenously (500 mg 1 time per day) within 14 days, with the subsequent oral administration of the drug Mexidol Forte 250 in a dose of 250 mg 3 times a day for 60 days in middle patients with medium -sized patients with chronic ischemia of the brain (HIGM) against the background of arterial hypertension and atherosclerosis.

Material and methods. The open observation program included 60 patients aged 45 to 59 years with HIGM confirmed by the results of neuropsychological and neuroimaging examination, who received Mexidol in the beginning of intravenously (14 days), and then in the form of a tablet form - Mexidol Forte 250 (60 days) . Patients conducted neuropsychological testing, assessment of the level of reactive and personal anxiety (Spielberger-Khanin scale), the nature of vegetative support (the scale of the Vegetative reactions of A.M. Wein in the modification of V.L. Golubev), the severity of general, mental and physical asthenia (MFI- questionnaire 20) and qualities of life (questionnaire MOS SF-36).

Results. The results of the treatment made it possible to establish the relief of asthenic syndrome and autonomic disorders against the background of the use of Mexidol. The differences were statistically significant in nature both in comparison with the initial level, and when comparing with the control group (p <0.05). The use of Mexidol was accompanied by a decrease in the severity of complaints and subjective symptoms. The totality of positive effects has led to an increase in indicators characterizing the state of quality of life (p <0.05). Treatment was characterized by good tolerance.

Conclusion. Patients with HIGM have significant emotional, vegetative and asthenic disorders. The use of Mexidol allows you to reduce the severity of these disorders, which gives reason to recommend it to treat such patients.

Keywords: chronic brain ischemia; arterial hypertension; atherosclerosis; cognitive disorders; vegetative disorders; asthenia; Mexidol; Mexol Forte 250.

Oxidative stress in the pathogenesis of cerebral stroke and its correction

Authors:
M.Yu. Martynov 1.2 , M.V. Zhuravleva 3.4 , N.S. Vasyukova 5 , E.V. Kuznetsova 6 , TR Kameneva 7

1FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;

2FSBI "Federal Center for Brain and Neurotechnology" of the Federal Medical and Biological Agency of Russia, Moscow, Russia;

3FSBI “Scientific Center for Expertise of Medical Application” of the Ministry of Health of Russia, Moscow, Russia;

4FGAOU in "First Moscow State Medical University named after THEM. Sechenov ”of the Ministry of Health of Russia (Sechenov University), Moscow, Russia;

5FGBNU "Federal Scientific Center-the All-Russian Scientific Research Institute of Experimental Veterinary Medicine named after K.I. Scriabin and Ya.R. Kovalenko of the Russian Academy of Sciences ”, Moscow, Russia;

6GBU "Research Institute of Health and Medical Management" of the Department of Health of Moscow, Moscow, Russia;

7GBUZ "City Clinical Hospital named after M.P. Konchalovsky "Department of Health of Moscow, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 1

Summary:
the value of oxidative stress (OS) in the pathogenesis of ischemic (AI) and hemorrhagic (gi) stroke is considered. The role of OS in the development of programmable cell death, an increase in the permeability of the hematoencephalic barrier, the activation of astro- and microglia, and local inflammation is shown. The issues of neuro and cytoprotheiation and their broadcasting into clinical practice are considered. Examples of experimental and clinical studies show the effectiveness of the continued administration of a multimodal neurocytoprotector with an antioxidant effect - ethylmethydlhydroxypyridine of succinate (Mexidol) in the acute and early recovery periods of AI and GI.

Keywords: stroke, reperfusion, oxidative stress, programmable cell death, apoptosis, ferroptosis, hemoglobin, neuroprotection, ethylmethylhydroxypirinate, mexidol.

The results of clinical studies of the effectiveness and safety of the use of ethylmethylhydroxypyridine of succinate in patients with chronic brain ischemia

Authors:
M.V. Zhuravleva 1.2 , P.R. Kamchatnov 3 , N.S. Vasyukova 4 , V.V. Arkhipov 1 , E.V. Kuznetsova 5 , TR Kameneva 6 , S.Yu. Serebrova 1.2

1 FSBI “Scientific Center for Expertise of Medical Application” of the Ministry of Health of Russia, Moscow, Russia;
2 FGAOU VO "First Moscow State Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
3 FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
4 FGBNU "Federal Scientific Center-All-Russian Scientific Research Institute of Experimental Veterinary Medicine named after K.I. Scriabin and Ya.R. Kovalenko of the Russian Academy of Sciences ”, Moscow, Russia;
5 GBU "Research Institute for the Organization of Health and Medical Management" of the Moscow Department of Health, Moscow, Russia;
6 GBUZ "City Clinical Hospital named after M.P. Konchalovsky "Department of Health of Moscow, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2022, T. 122, No. 11

Summary:
chronic brain ischemia (Khim) - a common syndrome, which in the absence of adequate therapy is characterized by a progressive course, an increase in cognitive, emotional, motor and other disorders, which ultimately lead to persistent disability of the patient. In the treatment of patients with chemicals, the use of drugs with a multimodal neuroprotective effect is indicated. The results of an analysis of a series of clinical studies of Mexidol and Mexidol Forte in patients with chemicals are given. The effects of the drug are considered in relation to cognitive, emotional, asthenic, vegetative and other manifestations of chemical. The conclusion is drawn about the appropriateness of the consistent use of Mexidol and Mexidol Forte in such patients.

Key words: chronic brain ischemia, cognitive disorders, emotional disorders, mexidol, treatment.

The effectiveness of Mexidol in patients of different age groups with chronic brain ischemia with cognitive disorders (the results of subanalysis of the international multicenter randomized double blind placebo-controlled study of memes)

Authors:
V.V. Zakharov 1 , O.N. Tkacheva 2, 3 , E.A. Mkhitaryan 2, 3 , A.I. Fedin 2

1 FGAOU VO "First Moscow State Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
2 FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
3 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

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2022, T. 122, No. 11, Issue. 2

Summary:
Purpose of the study. To evaluate the effectiveness of consistent therapy with Mexidol and Mexidol Fort 250 compared to placebo in patients with chronic brain ischemia (chemical) of different age -related subgroups.

Material and methods. Subanalis of data of an international multicenter randomized double-centered placebo-controlled study of Memo, in which 318 patients (25% of men) aged 40 to 90 (median 60) years participated. The effectiveness of treatment was estimated in three age groups: 40-60 (n = 163), 61–75 (n = 141) and 76–90 (n = 13) years. As the primary final point of effectiveness, an increase in the dynamics of the amount of points on the MOCA scale in the form of an absolute difference between the amount of points before the start of treatment and on the 75th day of therapy was considered. As a secondary endpoint of efficiency, the speaker was considered the sum of the points on the following questionnaires and scales: a test for the replacement of digital characters, a questionnaire for the quality of life of the SF-36, the scale of the subjective assessment of asthenia MFI-20, the Vein’s autonomic questionnaire, the Bek anxiety scale, and the scale of motor activity of Tinetti .

Results. The positive dynamics of the severity of cognitive, emotional and motor disorders in groups 40-60 and 61–75 years after 75 days of therapy were detected in patients who received both Mexidol and placebo, however, in patients who received Mexidol, these changes were more pronounced, on What indicate the higher values ​​of the median of the absolute difference between the amount of points of the studied indicators.

Conclusion. The results of the study have shown that in patients with Khim, a significant improvement in cognitive and motor functions, improving the quality of life, a decrease in the severity of autonomic disorders, asthenia and anxiety after 75 days of therapy were observed against the background of the use of Mexido compared to placebo. The results indicate the appropriateness of the use of Mexidol for the treatment of patients of different ages with chemicals.

Keywords: cognitive disorders, chronic brain ischemia, Mexidol, Mexidol Fort 250, ethylmethylhydroxypyridine succinate, examination of memo.

Safety Mexidol® (ethylmethylhydroxypyridine of succinate) in adult patients of different age groups

Authors:
E.A. Ushkalova 1 , S.K. Zyryanov 1.2 , O.I. Buttranova 1

1 FGAOU VO “Russian University of Friendship of Peoples”
2 GBUZ “City Clinical Hospital No. 24 of the Department of Health of the city of Moscow”

Place of publication:
neurology, neuropsychiatry, psychosomatics. 2022

Summary:
To reduce the risk of developing unwanted phenomena and increasing the adherence of elderly patients, it is recommended to limit the total number of drugs prescribed by him as much as possible, using one drug to treat two or more pathologies if possible. LS, which meets the criteria for the use of elderly patients and/or patients with comorbidity, includes the original Russian drug Mexidol ® (ethylmethylhydroxypyridine succinate), which has multimodal mechanism of action and has multiple pharmacological effects. In order to study the safety of Mexidol in comparison with placebo in patients with chronic brain ischemia of different age groups, an aposteric analysis of the international multicenter randomized double -centered clamped placebo -controlled memo with adaptive design on evaluating the effectiveness and safety of sequential therapy Mexidol ® solution for intravenous and intramuscular administration, 50 MG/ml (NPK LLC Pharmasoft, Russia) and Mexidol ® Fort 250 tablets covered with a film shell, 250 mg (NPK LLC Pharmasoft, Russia) in patients with chronic brain ischemia) with the participation of 318 patients aged 40 to 90 years old. The comparable safety and tolerance of Mexidol with middle and elderly persons with chronic brain ischemia, including patients older than 75 years, has been demonstrated. Key words: adult patients of different age groups; elderly; Memo study; Mexidol ® ; Mexidol ® Fort 250; ethylmethylhydroxypyridine succinate; safety.

Hypoxia and oxidant stress with cerebrovascular failure and effective ways to correct them

Authors:

FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova 2022, T. 122, No. 8

Summary:
Cerebrovascular diseases (CVP) are one of the most common causes of the development of cognitive impairment. The occurrence of CVP is associated with the main factors of cardiovascular risk, leading to the development of hypoxia, oxidative stress, mitochondrial and endothelial dysfunction and, ultimately, apoptosis, the formation of degenerative changes in the brain. The most important mechanisms for the development of CVP are hypoxia and oxidative stress, which indicates the need to use agents with antihyplance and antioxidant activity. Such drugs include Mexidol (ethylmethylhydroxypyridine succinate). Mexol directly affects the pathogenetic factors of the formation of ischemic-hypoxic brain damage, and has high clinical efficiency in the treatment of various forms of CVP.

Key words: chronic cerebrovascular failure, hypoxia, oxidative stress, vascular cognitive disorders, endothelial dysfunction, Mexidol.

Cognitive disorders diagnostic algorithm in outpatient practice

Authors:
E.A. Mkhitaryan, M.A. ATTIC

Place of publication:
New therapeutic journal "Non Nocera", April/May 2022

Summary:
Diagnostics of cognitive disorders (KR) - an integral part of the work of primary doctors working with older persons. KR - an extremely heterogeneous group of conditions not only in gravity, but also by etiology. According to gravity, dementia (severe KR) and non -seal disorders, which are often the prodromal stage of dementia, are distinguished. According to etiology, the most frequent causes of the Kyrgyz Republic in the elderly are neurodegenerative (Alzheimer's disease, a disease of diffuse Taurus Levy) and vascular diseases of the brain, as well as their combination.

Study of the effectiveness and safety of the sequential use of Mexidol and Mexidol Forte 250 in the treatment of patients with acute ischemic stroke

Authors:
S.M. Karpov 1 , M.Yu. Morozova 2 , K.A. Muravyov 2 , I.A. Prisilova 1 , F.S. Kantemirova 3

1 FGOU VO "Stavropol State Medical University" of the Ministry of Health of Russia, Stavropol, Russia;
2 MBUZ "City Clinical Hospital No. 3", Stavropol, Russia;
3 Institute "Medical Academy named after S.I. Georgievsky "FGAOU in" Crimean Federal University named after V.I. Vernadsky ", Simferopol, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2022, T. 122, No. 3, Issue. 2

Summary:
Purpose of the study. To evaluate the effectiveness of the use of Mexidol to restore cognitive functions in patients after an ischemic stroke (AI).

Material and methods. 70 patients with acute AI were examined, who were randomized in two groups by random sample; The 1st group amounted to 40 patients (28 men, 12 women), who, against the background of the main standard therapy for 14 days, received Mexidol in/in a drop of 500 mg/day with a further oral administration of Mexidol Forte 750 mg/day for 60 days . The 2nd group included 30 patients (21 men, 9 women), who were carried out only standard therapy.

Results. The initial indicators in the MOCA and MMSE scales did not differ in two groups. Repeated testing showed that the improvement on these scales was statistically more significant in the 1st group. An analysis of the indicators of the caused P300 potential confirmed a more pronounced positive dynamics in the 1st group (p <0.01).

Conclusion. The use of consistent therapy with Mexidol is accompanied by a more complete restoration of cognitive functions in patients who have suffered AI.

Keywords: stroke, acute cerebrovascular disorders, cognitive disorders, Mexidol, Mexidol Fort 250.

The results of an international multicenter randomized double-blind-controlled study of evaluating the effectiveness of the effectiveness and safety of consistent therapy of patients with chronic brain ischemia with Mexidol and Mexidol Forte 250 (study of Memo)

Authors:
A.I. Fedin 1 , V.V. Zakharov 2 , M.M. Tanashian 3 , E.I. Chukanova 1 , E.N. Majidova 4 , L.A. Shchepankevich 5.6 , O.D. Ostroumova 7

1 FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
2 FGAOU VO "First Moscow Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
3 FGBNU "Scientific Center for Neurology", Moscow, Russia;
4 Tashkent Pediatric Medical Institute of the Ministry of Health of the Republic of Uzbekistan, Tashkent, the Republic of Uzbekistan;
5 FSBEI in Novosibirsk State Medical University of the Ministry of Health of Russia, Novosibirsk, Russia;
6 FGBNU "Federal Research Center for Fundamental and Transalized Medicine", Novosibirsk, Russia;
7 FSBEA 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, 2021, T. 121, No. 11

Summary:
Purpose of the study. To evaluate the effectiveness and safety of consistent therapy with the drug Mexidol intravenously and Mexidol Forte 250 orally in patients with chronic brain ischemia. Material and methods. In the international multicenteric randomized double-blind-controlled study, 318 patients with a chemical place from 40 to 90 years are included in 15 clinical centers, located in the territory of the Russian Federation and the Republic of Uzbekistan. Patients were randomized in 2 groups, patients of the 1st group received Mexidol intravenously 500 mg once a day for 14 days, then Mexidol Forte 250 was prescribed orally 250 mg 3 times a day for the next 60 days; Patients of the 2nd groups received placebo in a similar mode. As the primary criterion for effectiveness, the average value of the change in the point on the MOCA scale was chosen at the stage of completion of the study by the patient compared to the initial level. Results. Upon completion of the study between the 1st and 2nd groups, reliable differences were identified by the result of the MOCA scale (p <0.000001). The lower boundary of 95% of the trust interval for the difference in the average indicators of the main criterion for the effectiveness between the 1st and 2nd groups was 1.51, which allows us to state higher efficiency of the use of Mexidol. According to the secondary endpoints, a statistically significant advantage over the placebo at the final visit was achieved by the following parameters: a test of digital symbol replacements, an asthenia assessment scale, a Bek anxiety scale, a tineta questionnaire, a Tinetti scale, a SF-36 questionnaire (psychological component of health), and a psychological component of health). CGI scale (a general clinical impression scale). The comparable nature of the safety profile of Mexidol and placebo is established. Conclusion. The validity and expediency of the consistent use of Mexidol and Mexidol Forte 250 in the treatment of patients with chemicals are demonstrated. Keywords: chronic brain ischemia, cognitive disorders, neuropsychological testing, ethylmethylhydroxypyrididine succinate, Mexidol, Mexidol Forte 250, treatment of chemicals, examination of memes.

The effectiveness and safety of therapy of drugs Mexidol and Mexidol Forte 250 in patients with chronic brain ischemia

Author:
L.A. Shchepankevich 1.2 , Yu.A. Nikolaev 1 , E.V. Taneyeva 3 , M.A. Pervuninskaya 1 , M.S. Shchepankevich 1.2

1 FGBNU "Federal Research Center for Fundamental and Transalized Medicine", Novosibirsk, Russia;
2 FSBEI "Novosibirsk State Medical University" of the Ministry of Health of Russia, Novosibirsk, Russia;
3 GBUZ but "State Novosibirsk Regional Clinical Hospital", Novosibirsk, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2021, T. 121, No. 10

Summary:
Purpose of the study. Studying the effectiveness and safety of consistent therapy with Mexidol, used intravenously (500 mg 1 time per day) for 14 days, followed by the oral form of Mexidol Fort 250 at a dose of 250 mg 3 times a day for 60 days in elderly patients with Chronic ischemia of the brain (chem) against the background of arterial hypertension and atherosclerosis. Material and methods. An open avenue observation study includes 60 patients with a diagnosis of chemicals confirmed by the results of neuroimaging. All patients underwent an examination with the assessment of neuropsychological status (MOCA Test), the severity of asthenia (scale of MFI-20), emotional state (an alarm and depression scale), motor functions (formalized clinical scale for assessing the motor activity of the elderly thinetti). The effectiveness of the therapy was evaluated according to the quality questionnaire (SF-36). Results. The results of the study showed high efficiency and safety of consistent therapy with Mexidol in relation to the relief of asthenic and emotional disorders, improve the state of cognitive functions, and improve the quality of life of patients. The maximum effect took place after the end of the full course of therapy. The high commitment of patients on the therapy, the low frequency of undesirable phenomena are shown. Conclusion. The consistent use of intravenous administration of Mexidol, followed by the oral administration of the drug Mexidol Forte 250, is an effective and safe way to treat patients with chemicals. Keywords: chronic brain ischemia, arterial hypertension, atherosclerosis, ethylmethylhydroxypirinatin, Mexidol, Mexidol Forte 250, cognitive disorders.

Features of patients with traumatic brain injury

Authors:
M.L. Chukhlovina 1 , A.A. Chukhlovin 2

1 FSBEI "National Medical Research Center named after V.A. Almazova "of the Ministry of Health of Russia, St. Petersburg, Russia;
2 Russian Research Neurosurgical Institute. Prof. A.L. Polenova - branch of FSBEI "National Medical Research Center named after V.A. Almazova "of the Ministry of Health of Russia, St. Petersburg, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova 2021, T. 121, No. 9

Summary:
The review is devoted to the analysis of the characteristics of pathogenesis, diagnosis and therapy of traumatic brain injury (CHMT) from the point of view of a neurologist. The mechanisms of development of damage to the central nervous system, including neuro -sparks and oxidative stress, are considered, in persons carrying the ChMT, the connection of clinical manifestations with the severity of the injury. Particular attention is paid to the description of such consequences of the TSMT as structural pharmacoresistant epilepsy and post -traumatic stress disorder. The data is given that rehabilitation measures at the victims of the Civil Code are difficult and less accessible in the conditions of the Covid-19 pandemic. The need to include antioxidant/antihypoxant Mexidol in the complex CMT therapy was noted. In the conditions of the Covid-19, the role of a neurologist increases in the provision of assistance to victims with the CCT, especially at the outpatient stage, during therapy, and medical rehabilitation. Key words: traumatic brain injury, oxidative stress, structural pharmacoresistant epilepsy, post-traumatic stress disorder, infection SARS-COV-2, Mexidol.

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