The effect of mexidol in the combination with antidepressants on sleep disturbance in young patients with panic disorder

Kirov Academy of Military Medicine, St.-Petersburg

We studied 70 patients with panic disorder, 30 men and 40 women, mean age 34,5±1,8 years. All patients had insomnia. Patients were classified into the main and control groups. Patients of the control group received antidepressants only (fevarin in dosage 150 mg daily). Patients of the main group were additionally treated with mexidol (375 mg daily). The treatment duration was two weeks. A clinical and instrumental (polysomnography) examination revealed that the use of mexidol enhanced the decrease in anxiety disorders, autonomic disturbances and insomnia and improved quality of life of the patients.

Keywords: panic disorder, antidepressant, mexidol.

Preventive therapy with mexidol in toxic damage to the heart

Ogarev Mordovia State University, Saransk, Russia

The purpose of this study was to efficacy of mexidol in the prevention of toxic damage to the heart in acute pancreatitis. Material and methods. The paper presents the results of experimental studies conducted on 30 adult mongrel adult dogs, which simulated acute focal pancreatic necrosis. We studied the influence of mexidol in the complex therapy for changes in the qualitative and quantitative composition of the lipid tissue structures of the heart, the intensity of processes of lipid peroxidation, antioxidant capacity, phospholipase A2 activity and morphofunctional state of the heart muscle in experimental acute focal pancreatic necrosis. The results and discussion. The preventive use of antioxidant drug mexidol in complex treatment of acute focal pancreatic necrosis, which limits the development of endogenous intoxication, increased intensity of lipid peroxidation and restores antioxidant capacity, reduces leading to phospholipase activity in tissue structures of the heart, corrigiruet lipid metabolism and morphofunctional state of the heart, and, consequently, toxic damage to the heart during endotoxic.

Keywords: pancreatitis, endogenous intoxication, heart, mexidol, antioxidant system, lipid.

The efficacy of mexidol in carotid endarterectomy procedure in patients with cerebral atherosclerotic stenosis

North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg

Objective - to determine the antihypoxic efficacy of mexidol in carotid endarterectomy (CE) procedure in patients with cerebral atherosclerotic stenosis using cerebral oximetry. Material and methods. Clinical/psycho/neurological monitoring was performed in 109 patients with internal carotid artery stenosis of 69±7.0% and neurological symptoms of cerebral ischemia, 2-3 degree, in pre- and postoperative periods. Cerebral oximetry was carried out perioperatively. Fifty-four patients were treated with mexidol in a dose of 1000 mg/day for 14—15 days and 55 patients did not received mexidol. Results and conclusion. The difference in initial brain oxygenation (rSO2) between the main and comparison groups was shown (60.8±5.0 and 47.29±5.5%, respectively). During operation, the degree of blood oxygenation in these groups decreased by 57% and 41%, respectively. On day 7, significant differences in the Schulte test in two groups of patients with similar neurological status were found considering efficiency of work and mental stability before and after operation. No differences were found in the comparison group. Mexidol used for antihypoxic brain protection in carotid endarterectomy of patients with cerebral atherosclerotic stenosis significantly reduces the degree of cerebral hypoxia, decreases the duration of surgery, improves neurological status of patients and performance of psychological tests in postoperative period.

Keywords: cerebral stenosis, cerebral ischemia, carotid endarterectomy, cerebral oximetry, mexidol.

To efficiency of the use of mexidol for patients by a chronic pancreatitis in the stage of intensifying

PhD of Biological Sciences, Associate Professor of department of biology of the Luhansk National university, Luhansk
Master’s degree of department of Biology of the Luhansk National university, Luhansk
Manager by a surgical separation, Surgeon of higher category of the Luhansk municipal multi-field hospital 3, Luhansk

Abstract. Studied the problems of treatment and modern prophylaxis for the patients of suffering a chronic pancreatitis. Influence of mexidol is analysed on the biochemical indexes of blood, glucose of blood. Proved, that mexidol applied in a complex with standard therapy, able to influence reparative processes in a pancreas. On the basis of undertaken a study it is suggested to apply mexidol authors additionally with basic therapy, for patients by a chronic pancreatitis, with the purpose of facilitation of flow of this disease and decline r risk of development of complications requiring an.

Keywords: chronic pancreatitis; mexidol; amylase; thymol test; urea; blood glucose; treatment; preventive maintenance; reparative.

Increase of relaparotomy efficacy in peritonitis manapement

N.P. Ogarev Mordovia State University

Keywords: relaparotomy, peritonitis, abdominal sanitation, enteral lavage, mexidol.

Characteristics of anxiety in patients of older age groups with different types of mild cognitive disorder

Urals State Medical University, Ekaterinburg, Russia

Objective. To study the structure of anxiety symptom complex in patients of older age groups with amnestic, disregulatory and polymodal types of mild cognitive impairment (MCI) and determine the clinical efficacy of 2-ethyl-6-methyl-3-hydroxypyridine succinate (mexidol). Material and methods. Thirty-two patients over 55 years of age with MCI (ICD-10 item F 06.7) seeking medical help due to anxiety were included in the study. Inclusion criteria were the compensation of concomitant diseases, absence of relevant stressful events during the last year, absence of depression. Clinical-psychopathological method and psychometric scales (HAM-A, GDS, MMSE, CGI-S, CGI-I) and a stressful life events list were used. Reduction of the total score on the HАМ-А was the main criterion of the efficacy of 4-week treatment with mexidol (375 mg daily). Results and conclusion. At baseline, mean scores on the HAM-A and MMSE were 39,9+3.18 and 25.7+0.6 respectively. The study of the anxiety structure in patients with amnestic, disregulatory and polymodal types of MCI revealed the different phenomenology of anxiety symptom complex. Repeated assessment of anxiety on the HAM-A was performed on 1, 2 and 4 week of treatment with mexidol. The improvement of mental state was noted in all types of MCI but the better results were obtained in disregulatory and polymodal types. The rate of anti-anxiety effect was higher in the disregulatory type of MCI. In all patients, mexidol improved attention stability and autonomic function.

Keywords: anxiety in the elderly, mild cognitive disorder, neuropsychological types MCI, comorbidity MCI and anxiety, mexidol.

Dynamics of eeg and psychophysiological indicators of acute poisoning neurotoxicants on the stage of rehabilitation on the background of different methods of treatment

Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department, Moscow, Russia;
Russian Medical Academy of Postgraduate Education, Federal Public Educational Institution of Additional Professional Postgraduate Education of Russian Federation Healthcare Ministry, Moscow, Russia

Objective: To evaluate the dynamics of functional activity of brain structures underlying cognitive functions in patients with encephalopathy due to poisoning with neurotoxicants on the stage of rehabilitation. Material and methods: Fifty-six patients were examined. The main group consisted of 40 patients treated with intravenous injections with mexidol (n=10), combination of mexidol with non-pharmacological methods – mesodiencephalic modulation (MDM) (n=10), hyperbaric oxygenation (HBO) (n=10) and the combination of MDM and HBO (n=10). The comparison group included 16 people. All patients underwent neurophysiological (EEG, auditory event-related potentials) and neuropsychological examinations. Results: Marked EEG changes were noted in all patients. The domination of disturbances of functional activity on the diencephalic or mesodiencephalic levels was observed. After treatment, positive changes were found in 60% of patients. The positive dynamics was observed in 80% patients when the combination of mexidol, MDM and HBO was used. The negative dynamics was noted in 5 (12,5%) of patients of the main group, in particular when mexidol only was used. The results of the primary neuropsychological study revealed that cognitive impairment of different severity was found in 97,5% of patients of the main group and 100% of patients of the comparison group. After treatment, performance on neuropsychological tests improved by 62,5%, N200 and P300 latencies reduced, while the amplitudes increased, in the patients of the main group. Conclusion: The use of mexidol, MDM and HBO in the treatment of patients with encephalopathy due to poisoning with neurotoxicants on the stage of rehabilitation improved the indicators of functional brain activity and cognitive functions.

Keywords: encephalopathy, acute poisoning with neurotoxicants, electroencephalography, auditory event-related potential (P300), psychophysiological testing, mexidol, mesodiencephalic modulation, hyperbaric oxygenation.

Clinical aspects of ethylmethylhydroxypyridine succinate in elderly patients with cardiovascular pathology

Martemianova E. G.1,2
1LLC «Preobrazhenskaya Clinic». Ekaterinburg; 2LLC «IC Bivita». Ekaterinburg, Russia

Aim. To evaluate efficacy and safety of original ethylmethylhydroxypyridine succinate (Mexidol) in cardiological patients ≥75 year old. Material and methods. In the observational study, according to ethical standards of Khelsinki Declaration, with informed consent, 24 patients participated, age 75-88 y. o. Inclusion criteria: age ≥75 y. o.; already diagnosed coronary heart disease (CHD) and/or chronic heart failure (CHF); Mexidol usage. Exclusion criteria: absent informed consent, severe comorbidities. Mean age of the patients at inclusion 80,33±4,06 y. o.; 16 (66,7%) females and 8 (33,3%) males. Patients consequently visited office of cardiologist with the diagnoses: chronic CHD (I25.0-I25.9), CHF with preserved systolic function (I50.0-I50.9). All patients were consulted by neurologist, had an established diagnosis of cerebrovascular disease (I65-67). To reduce the symptoms of frailty, among the neurologist recommendations, with accordance to routine clinical practice, the original Mexidol was included. Mexidol was prescribed by a scheme of manufacturer: intravenous infusions 500 mg x 5 days, then per os 125 mg t. i.d.; overall treatment — 8 weeks. Results. Statistically significant results were noted in 6 months from the study start. There was significant increase of 6 minute walking distance in men from 304,00±87,09 to 388,63±92,28 m (р=0,01), in women from 346,06±56,81 to 427,69±76,87 m (р=0,003); also there were less signs of frailty. No one patient showed significant worsening of the condition; during the overall follow-up, patients did not call emergency or primary care physicians and did not hospitalize. Conclusion. In comorbidity patients aged ≥75 y. o. at Mexidol treatment, there was increase of 6-minute walking test distance, decrease of asthenia signs, that witness for the medication efficacy. All patients showed good tolerability of the drug that witness for safety. Obviously, there are broad trials needed to sum up a gerontological algorithm of CHD and CHF patient management in outpatient setting.

Keywords: Mexidol, heart failure, frailty.

Cytoprotective therapy for kidney injury in patients with ST-elevation myocardial infarction

1Federal State Budgetary Educational Establishment of Higher Training «Nizhny Novgorod state medical academy» of the Ministry of Public Health; 2Federal State Budgetary Educational Establishment of Higher Training «The Pirogov Russian National Research Medical University» of the Ministry of Public Health; 3State Budgetary Institution of Health Nizhny Novgorod region «Nizhny Novgorod Regional Clinical Hospital named after NA Semashko»

Aim. To study an effectiveness of mexidol (ethylmethylhydroxypyridine succinate) for kidney injury in patients with ST-elevation myocardial infarction (STEMI). Material and methods. The study involved 55 STEMI patients. Acute renal injury (ARI) was determined according to basal creatinine, serum creatinine, glomerular filtration rate, cystatin C and NGAL. In STEMI patients standard therapy was supplemented by antioxidant (cytoprotector) mexidol from the 1st to the 10th day 750 mg/day intravenously. ARI values were assessed after treatment. Results. There were 36 ARI patients among 55 patients with STEMI. Therapy with mexidol significantly decreased ARI severity (urine creatinine, cystatin C and NGAL values) after 48 hours. Conclusion. Mexidol may be used in addition to standard therapy in STEMI patients to reduce ARI severity.

Keywords: cytoprotectors, myocardial infarction, acute renal injury.

Mexidol influence on the parameters of infrared spectrometry of blood lipid complex in case of acute coronary syndrome

Tver State Medical Academy, Department of Internal Medicine and Department of Chemistry, FPAE

It was analyzed the mexidol influence on phospholipid metabolism in acute coronary syndrome (ACS). The study included 70 patients. Intravenous mexidol infusions were included in the complex therapy in 30 cases. Conventional clinical and laboratory data, as well as the absorption of lipid phospholipid complexes in the infrared spectrum of blood serum were evaluated. The study established a mechanism of phospholipids autoregulation as a wave-like fluctuations of their concentration in the blood serum with early increasing (compared with healthy) in the first hours and days of development of ACS. It was observed the maximum rise by the 4th day and a moderate decline by the 10 day of observation reflecting the degree of adaptation systems stress. Regardless on the clinical form of ACS mexidol application eliminates oscillatory nature of the phospholipids dynamics. It is stabilizing their rise at a level sufficient to ensure the power and plastic needs of the organism and myocardium that improves the results of combined treatment.

Keywords: acute coronary syndrome, homeostasis, phospholipids, mexidol, infrared spectrometry.