Dynamics of eeg and psychophysiological indicators of acute poisoning neurotoxicants on the stage of rehabilitation on the background of different methods of treatment
Author:
I.YU. BEREZINA, A.V. BADALYAN, L.I. SUMSKY, YU.S. GOLDFARB
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
Summary:
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
Author:
Martemianova E. G.1,2
1LLC «Preobrazhenskaya Clinic». Ekaterinburg; 2LLC «IC Bivita». Ekaterinburg, Russia
Summary:
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
Author:
N.YU. BOROVKOVA1, A.S. ILYINA1, A.A. SPASSKY2, N.N. BOROVKOV1, G.V. KOVALEVA3
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»
Summary:
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
Author:
L.V. SHPAK, G.M. ZUBAREVA, S.N. LEBEDEVA
Tver State Medical Academy, Department of Internal Medicine and Department of Chemistry, FPAE
Summary:
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.
Antioxidant therapy in the correction of oxidative stress in the patients with coronary heart disease and type II diabetes
Author:
O.A. GORYUSHKINA, E.M. VASILYEVA
Voronezh State N.N. Burdenko Medical Academy
Summary:
Abstract: the paper describes the study of the state of LP0‐AOD system in the patients with coronary artery disease and type 2 diabetes and the effect of antioxidant therapy on metabolic factors. Timely correction of disorders contributed to the positive dynamics of metabolic processes, and on the background of this, reduced frequency of cardiovascular complications.
Keywords: LP0‐AOD system, coronary artery disease, type II diabetes, antioxidant therapy, cardiovascular complications.
Mexidol in comlex therapy of a stable angina
Author:
G.I. NECHAEVA1, S.D. KUROCHKINA2, A.D. TROTSENKO3, E.U. BULACHOVA2
Summary:
It is carried out research of quality of life and alarm at 130 patients with stable angina FC II conditions of policlinic branch BUZOO City Clinical Hospital 4 Omsk. We have studied functional parameters at sick by a stable angina, influence of disease on quality of life. We have studied efficiency of preparation Mexidol in complex treatment of patients with a stable angina. We have developed the differentiated approach to pharmacotherapy in view of quality of life and a level of alarm of person.
Keywords: ischemic heart disease, stable angina, quality of life.
An experience with neuroprotective therapy of primary open-angle glaucoma based on the use of different dosage forms of Mexidol
Author:
E.S. LEONOVA1, 2, S.V. POLYAKOV1, 2, М.А. POZDNYAKOVA2, Е.P. YARYGINA3, S.О. SEMISYNOV2
1Railway Clinical Hospital on the Station Gor’kiy, JSC Russian Railways, Inter Railway Center of Ophthalmology, 18 Lenina prospect, Nizhny Novgorod, Russian Federation, 603140; 2Nizhny Novgorod State Medical Academy, 10/1 Minina i Pozharskogo Sq., Nizhny Novgorod, Russian Federation, 603950; 3Nizhny Novgorod City Hospital No. 35, City Center of Glaucoma, 15 Osharskaya St., Nizhny Novgorod, Russian Federation, 603005
Summary:
Aim - to develop an algorithm to guide neuroprotective therapy in railway workers undergoing long-term follow-up for primary open-angle glaucoma (POAG) judging from the efficacy of sequential administration of intravenous dosage form of Mexidol and oral tablets. Material and methods. All sorts of JSC Russian Railways employees with stage I-III POAG and well-controlled intraocular pressure were enrolled. Mexidol was first to be administered intravenously by a dropper in a day hospital (250 mg daily for 5 days) and then taken orally at home (125 mg t.i.d. for 3 months). A comprehensive ophthalmic examination with hightechnology control was performed in all patients at their first, second, and third follow-up visits. Results. Data from 58 patients (96 eyes) were analyzed. Statistically significant improvements in perimetry and optical coherence tomography results were only obtained at a third visit, i.e. at the end of the course of Mexidol tablets. The treatment effect was most pronounced in stage I-II patients. Conclusion. The results suggest that combination therapy with intravenous and oral Mexidol received sequentially as well as long-term (3-month) administration of Mexidol tablets can both be recommended in POAG patients. It has been also found that neuroprotective therapy with Mexidol performs best for early stages of the disease.
Keywords: glaucoma, neuroprotective therapy, Mexidol, long-term follow-up.
Antioxidant agents in neuroprotection treatment of glaucoma
Author:
E.A. EGOROV1, A.A. GVETADZE1, N.G. DAVYDOVA2
1The Russian National Research Medical N.I. Pirogov University; 2Helmholtz Moscow Research Institute of Eye Diseases
Summary:
Purpose was to study efficiency and safety of mexidol in combined therapy in patients with primary open-angle glaucoma (POAG). 94 patients (185 eyes) at the age of 18—75 years old with POAG I—III stages were divided into 3 groups: 50 patients received combined therapy of mexidol 100 mg and picamilon 150 mg, 22 patients received combined therapy of mexidol 300 mg and picamilon 150 mg, 22 patients received only picamilon 150 mg. All medicine was administered qd during 14 or 21 days. Examination included standard ophthalmologic methоds, perimetry, electroretinography, retinal and optic nerve heard arterial blood flow. Improvement of visual acuity, perimetric, electrofisiological indicies and increased blood flow velocity of central retinal artery were registrated. Combined mexidol therapy allows improving results in treatment of patients with POAG.
Keywords: Mexidol, picamilon, primary open-angle glaucoma, glaucomatous optic neuropathy, optic nerve heard.
The influence of water soluble antioxidant agent (mexidol) on optic nerve and blood flow velocity in ocular and orbital arteries in patients with primary open-angle glaucoma
Author:
I.A. VOLCHEGORSKY1, E.V. TOUR1, O.V. SOLYANNIKOVA1, V.S. RYKOUN1, E.V. BERDNIKOVA1, M.S. SUMINA2, V.N. DMITRIYENKO2
1Chelyabinsk State Medical Academy; 2Chelyabinsk Regional Clinical Hospital
Summary:
The prospective single-blind placebo-controlled randomized trial is devoted to influence of mexidol (2-ethil-6-methil-3-hydroxipiridine succinate) on dynamics of optic nerve electrophysiologic profile and velocity indices of blood flow in ocular and orbital arteries in correlation with changes of retinal photosensitivity, visual acuity and visual field size during course of intravenous mexidol infusions and standard treatment of primary open-angle glaucoma. 2 weeks of intravenous infusions of 300 mg mexidol daily was found to cause depression of optic nerve electrical sensitivity threshold and widening of total visual field (16 mm2 test stimulus) after 14 days of treatment. These effects were not associated with changes of blood flow velocity in ocular and orbital arteries, were transient and came to initial indices 3 months after the end of treatment. Delayed vasotropic effect of mexidol manifested in increase of blood flow velocity in central retinal artery in 90 days after the end of infusions.
Keywords: mexidol, primary open-angle glaucoma, blood flow velocity in ocular and orbital arteries, optic nerve sensitivity.
Mexidol in complex treatment of glaucoma
Author:
E.A. EGOROV, N.G. DAVYDOVA, I.A. ROMANENKO, N.D. NOVIKOVA
FGU «MNII GB named after Gelmgoltsa Rosmedbiotechnology»
Department of Ophthalmology of Medical Faculty
GBOU VPO RNIMU Russian National Research Medical University
Moscow
Summary:
Purpose: to evaluate efficiency and safety of Mexidol solution in complex treatment in patients with POAG of I–III stages. Materials and methods: patients with POAG I–III stages with compensated IOP level (not more than 21 mmHg) were included into the study. All patients were divided into 3 groups: in 1st group Mexidol was prescribed on the background of standard treatment by 100 mg per day intramuscularly, in the 2nd group – on the background of standard treatment by 300 mg per day intramuscularly, 3rd group received standard treatment (picamilonum – by 1 tablet 3 times per day). Patients with I–II stages of glaucoma received treatment during 14 days, with III stage – 21 days. Evaluation of treatment effect was carried out in 30 days after it’s start. External eye examination, visometry, biomicroscopy, ophthalmoscopy, tonometry, computer perimetry, electrophysiologic examination, arterial pressure and heart rate measurements were proceeded on the first, intermediate and last control visits. Results: Visual acuity was improved in 1st and 2nd group more evidently than in the 3rd one. There was a tendency of improvement of the condition of the visual field (decreasing of the scotoma amount in patients which received Mexidol by 100 mg per day). Increased at the beginning electrosensitivity threshold in patients with I–III stages of glaucoma reduced by the end of the study, and decreased level of the electrical lability of optic nerve raised. Dosage of 300 mg per day was found more efficient than 100 mg per day. Conclusion: Mexidol could be recommended for inclusion into the complex treatment of patients with glaucomatous neuropathy.