Effect of mexidol on the efficiency of intravenous thrombolytic therapy for ischemic stroke during the therapeutic window
Author:
Knni K.S., Dyomin T.V., Adeeva L.B.
Interregional Clinical and Diagnostic Center, Kazan, Russia 12A, Karbyshev St., Kazan, Republic of Tatarstan 420101
Summary:
Objective: to evaluate the effect of intravenous mexidol on the efficiency of intravenous thrombolytic therapy (TLT) during the therapeutic window. Patients and methods. The retrospective study enrolled 123 patients with ischemic stroke (IS) who had undergone intravenous TLT in the vascular centers of the Republic of Tatarstan. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the time course of changes in their neurological status. According to the baseline severity of a neurological deficit, all the patients were divided into three subgroups: 1) mild IS (<8 NIHSS scores at admission); 2) moderate IS (>8 scores); and 3) severe IS (<16 scores). All the patients underwent X-ray computed tomography at admission, at 24 hours after TLT, and in case of worsening of their health status. Results. The prehospital use of mexidol followed by TLT in patients with IS had a positive effect on the regression of neurological deficit regardless of the severity of the disease. There were significant differences in the degree of regression of neurological deficit according to NIHSS at 24 hours and 10 days after hospital admission in patients with severe IS, who received intravenous mexidol at the prehospital stage and who did not take this drug before TLT. The pre-TLT use of mexidol contributed to higher regression of neurological deficit. There was a lower frequency of hemorrhagic transformations in the patients who used mexidol at the prehospital stage versus those who did not. Conclusion. The findings demonstrate the positive effect of mexidol on the efficiency and safety of TLT in patients with IS.
Keywords: ethylmethylhydroxypyridine succinate; intravenous thrombolytic therapy; ischemic stroke; neuroprotective therapy.
Experience with mexidol in neurological practice
Author:
O.A. GROMOVA, I.YU. TORSHIN, L.V. STAKHOVSKAYA, E.G. PEPELYAEV, V.A. SEMENOV, A.G. NAZARENKO
Federal Research Center «Informatics and Management», Institute of Pharmacoinformatics, RAS, Moscow, Russia; Research Institute of
Central Research Hospital of the Russian National Research Medical University. N.I. Pirogova, Moscow, Russia; FGBOU VO «Kemerovo
State Medical University» MH RF, Kemerovo, Russia; Federal State Autonomous Institution «National Medical Research Center for
Neurosurgery named after Academician N.N. Burdenko» of the Ministry of Health of the Russian Federation, Moscow, Russia
Summary:
Antihypoxic, antioxidant and nootropic effects of mexidol contribute to the improvement of patients with cerebrovascular pathology. The results of clinical studies show that the sequential scheme of using mexidol (first i.v. or i.m., then per os) is effective in the complex therapy of ischemic diseases of the brain, vascular surgery, therapy and rehabilitation of patients with degenerativedystrophic changes of the spine, treatment of neurodegenerative pathology (including multiple sclerosis, Parkinson’s disease and diabetic polyneuropathy), infectious neuropathies (ARVI, herpes, tick-borne encephalitis), neuropsychological and autonomic disorders.
Keywords: neurotransmission, GABA, acetylcholine, antihypoxants, nootropics, data mining, mexidol.
The efficacy of mexidol for transient ischemic attacks in the vertebrobasilar system in elderly patients with chronic cerebral ischemia
Author:
YU.V. ABRAMENKO
Tver State Medical University, Tver, Russia
Summary:
Objective. To evaluate the clinical efficacy, metabolic and membrane protective effects of mexidol for transient ischemic attacks (TIA) in the vertebrobasilar system in elderly patients with chronic cerebral ischemia (CCI). Material and methods. Fifty-three patients, aged from 60 to 74 years, with the first episode of TIA in the vertebrobasilar system and CCI were examined. Patients of the main group (n=33) received mexidol in the dose of 500 mg for 10 days along with standard therapy, patients of the comparison group (n=20) received only standard therapy. The clinical implications of TIA, laboratory indices of the state of oxidant and antioxidant systems and percentage absorption of lipid-phospholipid complexes in the infrared spectrum of blood serum were studied. The control group consisted of 20 healthy people. Results and сonclusion. The use of mexidol was associated with more rapid regression of the focal neurological deficit. Mexidol significantly reduced the intensity of lipid peroxidation and had a positive impact on the level of neuronal membrane phospholipids. Metabolic and membrane protective effects of mexidol and it’s positive impact on the regression of focal neurological deficit justify its inclusion into complex therapy of TIA in the vertebrobasilar system developed in patients with CCI, especially in elderly patients.
Keywords: transient ischemic attack, vertebrobasilar system, chronic cerebral ischemia, mexidol, lipid peroxidation, phospholipids.
Influence of mexidol and hemisuccinate 2-ethyl-6-methyl-3-hydroxypyridine on cerebral hemodynamics at hemorrhagic and ischemic damage of brain
Author:
I.N. KURDYUMOV1, T.S. GAN,SHINA1, D.V. MASLENNIKOV1, E.V. KURZA1, A.A. GORBUNOV1,2, A.I. TURILOVA1 and R.S. MIRZOYAN1
1 V.V. Zakusov State Institute of Pharmacology, Russian Academy of Medical Sciences, Moscow, ul. Baltiiskaya 8, Moscow. 125315 Russia
2 I.M. Sechenov First Moscow State Medical University (Sechenov University), ul. Trubetskaya 8, Moscow, 119881 Russia
Summary:
Comparative study of the effect of mexidol and hemisuccinate 2-ethyl-6-methyl-3-hydroxypyridine on the cerebral circulation of rats under conditions of hemorrhagic and ischemic brain lesions revealed significant differences in their cerebrovascular effects. Mexidol at a dose of 200 mg/kg i.v. better improves the local cerebral blood flow in modeling ischemia as compared to hemorrhagic brain damage. Hemisuccinate 2-ethyl-6-methyl-3-hydroxypyridine at a dose of 50 mg/kg better enhances the local blood supply to the cerebral cortex under conditions of hemorrhagic brain damage as compared to ischemic damage, since its cerebrovascular effect during cerebral ischemia occurs in a dose of 100 mg/kg. The mechanism of cerebrovascular anti-ischemic effect of 2-ethyl-6-methyl-3-hydroxypyridine hemisuccinate is mediated by GABAa receptors of the brain vessels, since bicuculline eliminates this effect.
Keywords: mexidol; hemisuccinate 2-ethyl-6-methyl-3-hydroxypyridine; bicuculline; cerebral circulation; hemorrhagic stroke model; global transient ischemia.
Arterial hypertension, cognitive disorders and dementia: a view of a cardiologist
Author:
O.D. OSTROUMOVA, M.S. CHERNIAEVA
Moscow State University of Medicine and Dentistry named after A.I. Evdakimov, Moscow, Russia; I.M. Sechenov First Moscow State
Medical University, Moscow, Russia; Central State Medical Academy of Department of Presidential Affairs, Moscow, Russia
Summary:
This article presents a review of Russian and foreign literature about the impact of arterial hypertension (AH) on the risk of cognitive impairment and dementia. Large studies have demonstrated the effect of blood pressure (BP) on the risk of vascular dementia and Alzheimer’s disease (AD) in elderly and oldest old people as well as a role of antihypertensive therapy. There is evidence of a negative effect of hypertension in middle age on cognitive functions in late-life. Observational studies as a whole have shown the positive effect of antihypertensive therapy on the prevention of cognitive function and dementia. However, there are a number of limitations that dictate the need for further research on this issue. The importance of the interdisciplinary approach to treatment of cognitive impairment by cardiologists and/or therapists, together with neurologists, as well as complex treatment regimens, including correction of risk factors and neuroprotective therapy, is highlighted.
Keywords: arterial hypertension, cognitive impairment, dementia, Alzheimer disease, antihypertensive therapy.
Preventive therapy with mexidol in toxic damage to the heart
Author:
M.D., ASSOCIATE PROFESSOR E.I. POLOZOVA
Ogarev Mordovia State University, Saransk, Russia
Summary:
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
Author:
V.I. GOLOVKIN, A.V. SVETLIKOV, A.S. SHAPOVALOV, L.O. POPOVA
North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg
Summary:
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
Author:
LYSENKO S.G.,
PhD of Biological Sciences, Associate Professor of department of biology of the Luhansk National university, Luhansk
KHOKHLOVA A.V.,
Master’s degree of department of Biology of the Luhansk National university, Luhansk
DEMIDENKO V.V.,
Manager by a surgical separation, Surgeon of higher category of the Luhansk municipal multi-field hospital 3, Luhansk
Summary:
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
Author:
A.P. VLASOV, E.K. SALAKHOV, O.YU. RUBTSOV
N.P. Ogarev Mordovia State University
Summary:
Keywords: relaparotomy, peritonitis, abdominal sanitation, enteral lavage, mexidol.
Characteristics of anxiety in patients of older age groups with different types of mild cognitive disorder
Author:
A.P. SIDENKOVA
Urals State Medical University, Ekaterinburg, Russia
Summary:
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.