[Results of a pilot study of the structure and evaluation of the therapy for chronic sleep disorders in comorbid patients with chronic cerebral ischemia].

Objective: To evaluate the effect of the drug Cortexin on the clinical course and treatment of comorbid insomnia.

Material And Methods: The study included 50 patients, average age 50.4±2.

[The use of neuropeptides of animal origin in the treatment of neurological diseases].

The issues of effective treatment of neurological diseases remain relevant to this day. Neuropeptide preparations have been used in domestic neurological practice for more than 20 years. The physiological activity of neuropeptides is many times greater than that of non-peptide compounds.

[A complex of B vitamins, choline and inosine in the treatment of chronic pain].

Chronic pain is an independent disease associated with multiple changes in the nervous, endocrine and immune systems. The use of B vitamins is pathogenetically justified. Unlike others, the CompligamB complex contains almost all fractions of B vitamins, inosine and para-aminobenzoic acid, which provides an additional therapeutic effect.

Drug Synergism as the Basis of Rational Neuroprotection.

Optimization of the choice of neuroprotective therapy regimens in patients with cerebrovascular diseases (CVD), taking into account the synergism of drug interactions, is a basic approach in clinical practice. Unfortunately, modern pharmacology has no unified way of establishing synergistic spectra of drug actions, which would allow systematic investigation of the effects of combinations of drugs. An approach based on studying detailed mechanisms of action suggested combinations of drugs with the greatest possible synergism (by summation and potentiation of effects) for various directions in the treatment of neurological diseases.

[Pathogenetic approaches to the treatment of sleep disorders in comorbid patients].

The sharp increase in cardiovascular disease is associated not only with known risk factors, but also with a massive increase in sleep disorders. with insomnia, it triggers a pathogenic vicious circle: insomnia-inflammation-disturbance of the hypothalamic-pituitary-adrenal axis-neurodegeneration-cognitive dysfunction. Currently, a number of pharmacological modulators have been described that can activate the cell survival system.

[Mitochondrial dysfunction].

Hypoergos-energy deficiency, i.e., a mismatch between the body's (tissue, organ, cell) need for energy and the limited amount of macroergs (ATP) that can currently be used to maintain the structural integrity and functional activity of a tissue or organ.

[Prospects of use of research results for drugs with anitihypoxic and antioxidative properties in neuroprotective treatment strategies (Opinion of the Council of Experts dated 26 March 2022)].

Cerebrovascular diseases are one of the main causes of death and permanent disability. Effective and timely neuroprotective therapy can reduce the burden of cerebrovascular disease. The possibilities of neuroprotection as a method of prevention and medical rehabilitation of acute and chronic cerebrovascular diseases are addressed.

[Possibilities of individual choice of NSAIDs on the example of the oxicam class, taking into account clinical and pharmacological characteristics].

Nonsteroidal anti-inflammatory drugs (NSAIDs) are traditionally used to relieve pain syndromes. The class of NSAIDs includes oxicams (meloxicam, tenoxicam, lornoxicam) - drugs with pronounced analgesic and anti-inflammatory effects. Oxicams have common properties of the class, but at the same time, due to structural differences from all other NSAIDs, they differ in a number of clinical and pharmacological characteristics, knowledge of which will help to individualize the choice of the drug.

[Drug synergism as a basis for rational neuroprotection].

Optimization of the choice of neuroprotective therapy regimens in patients with CVD, taking into account the synergism of drug interactions, is basic in real clinical practice. Unfortunately, in modern pharmacology there is no unified way to establish the synergistic spectrum of action of drugs, which would allow systematic investigation of the effects of combinations of drugs. By the method of studying the subtle mechanisms of action, combinations of drugs that are as synergistic as possible (summation and potentiation of effects) for various therapies of neurological diseases are proposed.

[COMPASS study results as a foundation for new treatment approach for neurological patients. Opinion of the expert council of december 18, 2021].

The resolution of the Council of Experts devoted to the discussion of the effectiveness of the use of a combination of rivaroxaban 2.5 mg 2 times a day and acetylsalicylic acid 100 mg per day to prevent recurrent non-coronary ischemic stroke results of the COMPASS study is presented. The advantages of this combination and the safety of its use are considered.

[Determination of the prevalence of postcovid syndrome and assessment of the effectiveness of the drug Cortexin in the treatment of neurological disorders in patients with postcovid syndrome. Results of the multicenter clinical and epidemiological observational program CORTEX].

Objective: To study the prevalence of clinical manifestations of postcoid syndrome in patients at an outpatient neurological appointment, to evaluate the effectiveness of therapy regimens using Cortexin at doses of 10 mg and 20 mg IM for 10 days.

Materials And Methods: 674 neurologists from all regions of the Russian Federation, Azerbaijan, Kyrgyzstan and Kazakhstan took part in the study. A total of 979 COVID-19 patients were recruited.

[The result of prospective randomized study CITADEL - the efficacy and safety of drug cytoflavin in postcovid rehabilitation].

Objective: To investigate the structure of postcovid syndrome, age and gender characteristics of its course, and to assess the effect of Cytoflavin on the clinical course of neurological disorders in patients who have undergone COVID-19.

Material And Methods: The study included 100 patients, the average age was 40.4±11.

Direct and Indirect Neurological Signs of COVID-19.

To systematize the neurological manifestations of COVID-19. A systematic computerized analysis of all currently available publications on the neurological manifestations of COVID-19 was undertaken (2374 reports in PubMed) by topological data analysis. A set of interactions between infection with SARS-CoV-2, metabolic impairments affecting neurotransmitters (acetylcholine, dopamine, serotonin, and GABA), enkephalins, and neurotrophins, micronutrients, chronic and acute inflammation, encephalopathy, cerebral ischemia, and neurodegeneration (including demyelination) was described.

[Asthenic disorders as a manifestation of chronic fatigue syndrome].

The article explains the changes in terminology and diagnostic criteria for asthenic disorders as manifestations of chronic fatigue syndrome CFS (myalgic encephalomyelitis). Chronic fatigue syndrome is defined as neuroimmune endocrine dysfunction with a purely clinical diagnosis. Probably, viral infections can play a leading role in the pathogenesis.

[Prospects for pharmacological adaptation of neurovascular unit in conditions of neurotropic viral infection].

The article discusses the prospects for pharmacological conditioning as a method for adaptation of neurovascular unit in conditions of neurotropic viral infection. A step-by-step mechanism for development of preconditioning and postconditioning is presented with a detailed description of it's main stages (trigger, signal and effector). The role of neuroinflammation as the leading mechanism of damage and the possibility of influencing the brain neurotrophic factor are considered.

SARS-CoV-2 (COVID-19) as a Predictor of Neuroinflammation and Neurodegeneration: Potential Treatment Strategies.

The SARS-CoV-2 (COVID-19) pandemic has attracted attention to the challenge of neuroinflammation as an unavoidable component of viral infections. Acute neuroinflammatory responses include activation of resident tissue macrophages in the CNS followed by release of a variety of cytokines and chemokines associated with activation of oxidative stress and delayed neuron damage. This makes the search for treatments with indirect anti-inflammatory properties relevant.

[Locomotive syndrome: from paradigms to clinical reality].

Locomotive syndrome is an unsatisfactory condition of patients over 60 years of age who need or may require outside help in the near future due to functional deterioration of the musculoskeletal system, including pathology of bone tissue, joints, muscles and nervous tissue. In real clinical practice, one often has to deal with the following manifestations of locomotive syndrome: osteoarthritis, sarcopenia, balance disorders, chronic musculoskeletal pain. Today, there is a clear understanding that drug therapy should be long-term, include comprehensive support for muscle tissue, balance training, and mandatory cognitive-behavioral therapy.

Cutaneomeningospinal Angiomatosis (Cobb Syndrome) in a Young Patient.

Cobb Syndrome (Spinal Arteriovenous Metameric Syndrome 1-31 (SAMS 1-31)) is a rare, non-hereditary disorder. Approximately 100 cases of CS have been described to date. The actual incidence may be much higher since only symptomatic patients were documented.

[Acute cerebrovascular accidents associated with SARS-CoV-2 coronavirus infection (COVID-19)].

Acute cerebrovascular accidents (ACVIs) associated with COVID-19 coronavirus infection are one of the most talked about problems in the medical community. To date, the true incidence of stroke in patients with COVID-19 remains unclear. So far, the published literature has been limited to case reports, case series, and observational cohort studies.

[Direct and indirect neurological manifestations of COVID-19].

Objective: To systemize the neurological manifestations of COVID-19.

Materials And Methods: A systematic computer analysis of all currently available publications on the neurological manifestations of COVID-19 (2374 publications in PUBMED) using algorithms of topological data analysis was performed.

Results: A complex of interactions between SARS-CoV-2 infection, metabolic disorders of neurotransmitters (acetylcholine, dopamine, serotonin and GABA), enkephalins and neurotrophins, micronutrients, chronic and acute inflammation, encephalopathy, cerebral ischemia and neurodegeneration, including demyelination, was described.

[SARS-CoV-2 (COVID-19) as a predictor of neuroinflammation and neurodegeneration: potential therapy strategies].

The pandemic caused by the SARS-CoV-2 virus (COVID-19) made it necessary to evaluate in more detail the processes of neuroinflammation as an integral component of the pathogenesis of viral infection. The acute neuroinflammatory response includes the activation of resident tissue macrophages in the CNS and the subsequent release of various cytokines and chemokines, which probably activates oxidative stress, causing long-term neuronal damage. This makes urgent the search for drugs with indirect anti-inflammatory effects with proven effectiveness.

[Difficulties in diagnosing sacroiliitis in young patients].

In real clinical practice, back pain in young patients is associated with neurological manifestations of degenerative changes in the lumbosacral spine. However, such complaints may be a manifestation of a lesion of the sacroiliac joint-sacroiliitis, and degenerative changes in the spine may accompany it, but not cause pain. Sacroiliitis is an inflammatory lesion of the sacroiliac joint, which can develop as an independent disease or as a symptom of another nosology.

[Choice of neuroprotective therapy regimens in patients with chronic cerebral ischemia, taking into account the synergy of drug interactions].

Objective: Optimization of the choice of neuroprotective treatment regimens in patients with chronic cerebral ischemia that takes into account the synergy of drug interactions gives the doctor an opportunity for personalized approach that increases the effectiveness of treatment.

Material And Methods: Differential chemoreactomic analysis of the synergism of ethyl methyl hydroxypyridine succinate (EMHPS) and a number of monocomponent neuroprotective agents (piracetam, vinpocetine, citicoline, choline alfoscerate); proteomic analysis of polypeptide neuroprotectors (cerebrolysin, etc.); an expert analysis of multicomponent neuroprotector Cytoflavin.

[A personalized selection of choline precursors in evidence - based medicine].

The analysis of mechanisms of the neuroprotective effect of choline precursors reveals the primary effects of citicoline on the processes of repair of neuronal membranes, a decrease in the degeneration of free fatty acids, and choline alfoscerate, an increase in the production of the neurotransmitter acetylcholine. Although citicoline has a lesser effect on choline secretion than choline alfoscerate, the combination of choline and cytidine in its composition is a universal tool to reduce symptoms of cerebral ischemia, to stabilize cognitive status, superior to the standard benefits of choline. Various mechanisms of the action of citicoline enable to recommend it as a drug effective both in the acute phase of the disease and in the delayed period, giving it the status of a universal nootropic compound.