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Insulin deficiency in type 1 diabetes (T1D) leads to an impairment of glucose metabolism and mitochondrial function. Actovegin is a hemodialysate of calf blood, which has been shown to enhance glucose uptake and cell metabolism in healthy human skeletal muscle. The objectives of this study were to determine the effects of Actovegin on skeletal muscle mitochondrial respiration and functional aerobic capacity in a T1D mouse model. Effects on the expression of mitochondrial proteins, body mass, and food and water consumption were also investigated. Streptozotocin-induced T1D male C57B1/6 mice (aged 3–4 months) were randomized to an Actovegin group and a control group. Every third day, the Actovegin and control groups were injected intraperitoneally with (0.1 mL) Actovegin and (0.1 mL) physiological salt solution, respectively. Oxidative phosphorylation (OXPHOS) capacity of the vastus lateralis muscle was measured by high resolution respirometry in addition to the expression levels of the mitochondrial complexes as well as voltage-dependent anion channel. Functional aerobic capacity was measured using a rodent treadmill protocol. Body mass and food and water consumption were also measured. After 13 days, in comparison to the control group, the Actovegin group demonstrated a significantly higher skeletal muscle mitochondrial respiratory capacity in an ADP-restricted and ADP-stimulated environment. The Actovegin group displayed a significantly lesser decline in functional aerobic capacity and baseline body mass after 13 days. There were no significant differences in food or water consumption between groups. Actovegin could act as an effective agent for facilitating glucose metabolism and improving OXPHOS capacity and functional aerobic capacity in T1D. Further investigation is warranted to establish Actovegin's potential as an alternative therapeutic drug for T1D. [ABSTRACT FROM AUTHOR]

The effects of actovegin on the mechanisms of oxidative stress (OS) developing in the blood of patients with type 2 diabetes mellitus (DM2) and cardiovascular autonomic neuropathy (CVAN) were investigated. The aim of the study was to establish the effectiveness of treatment with actovegin for the pro- and antioxidant balance impairment and changes in gene expression of HIF-1α and mTOR in the blood of patients with DM2 and CVAN. It was shown that intravenous injections of actovegin at a dose of 1000 mg per day for 10 days and further prolonged oral administration of this drug at a dose of 800 mg per day for 90 days led to a decrease in the content of secondary products of lipid peroxidation in blood plasma and H2O2 production in erythrocytes of patients with DM2 and CVAN. These changes were indicative of a weakening of OS intensity. It was also shown that treatment with actovegin promoted an increase in total plasma SOD activity as well as reduced glutathione and glutathione peroxidase activity in erythrocytes from patients. Treatment with actovegin also raised the gene expression of HIF-1α and reduced the gene expression of mTOR in leukocytes of patients with DM2 and CVAN. These genetic changes may serve as a protective mechanism against the development of OS, which acts through different metabolic pathways. So, actovegin administration counteracting OS development due to the impact on the different components of pro- and antioxidant system as well as on HIF-1α and mTOR genes expression may offer new clinical avenues for pharmacological treatment of patients with DM2 and CVAN. [ABSTRACT FROM AUTHOR]

One of the modern transfusiology tasks is to preserve the properties of erythrocytes after hypothermic storage. Worsening of their functional state due to the storage leads to deterioration of the transfusion medium quality and a number of clinical problems. Plausible protective effects of a human cord blood low-molecular fraction (CBF) and the Actovegin drug were evaluated in the present study in order to use them as components of recovery medium. Aim. The purpose of our study was to investigate the CBF and the Actovegin drug effect on erythrocytes morphology, energy balance, and oxygen transport function of erythrocytes after their hypothermic storage. Materials and methods. In the research erythrocyte mass from human donor blood was used, which was stored in hypothermia for 7–21 days. Every 7 days, the CBF or Actovegin (final concentration 0.6 mg/ml) were added to aliquots of erythrocyte mass and incubated for 1 h at 37 °C, followed by further studies. CBF was obtained from human cord blood by ultrafiltration and lyophilization. The erythrocytes morphology was assessed using light microscopy. The content of ATP and 2.3-DPG was determined by the amount of inorganic phosphorus and the photoelectrocalorimetric method. The indicators of erythrocytes oxygen transport function (saturation, oxygen and carbon dioxide tension) were assessed using an analyzer of blood gases and electrolytes IL GEM Premier - 3000. The ratio of hemoglobin forms was studied by photometry. Results. It was shown that both CBF and the Actovegin drug promoted to restore the morpho-functional characteristics of erythrocytes after 21 days of their storage at 24 °C. This was indicative as an increase in the normocytes number increase and restoration of oxygen tension, saturation, ATP and 2,3-DFG content, and normalization of the hemoglobin forms ratio. It was suggested that the mechanisms of the compared tested substances action were associated with ATP synthesis activation and 2,3-DFG formation. Conclusions. The use of media with containing CBF or the Actovegin drug enabled to restore effectively the properties of erythrocytes disturbed during their prolonged storage.

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Objective: to investigate the effectiveness of long-term oral administration of Actovegin in post-COVID patients with cognitive impairment (CI).Patients and methods. 444 patients (142 men, 302 women) with COVID-19 and CI participated in the study. One-half of the included participants – 222 patients (70 men and 152 women) – were prescribed with actovegin 400 mg 3 times a day in addition to the baseline therapy; 222 patients (72 men and 150 women) were randomized to the control group. Cognitive functions were assessed with Montreal Cognitive Assessment (Montreal Cognitive Assessment test, МоСA test), fatigue – with Multidimensional Fatigue Inventory (MFI-20), emotional disturbances – with Spielberger-Hanin test.Results and discussion. Post-COVID patients with CI in the Actovegin group after 60 days follow-up had higher mean MoCА scores (p

COVID-19 worsens the course of cerebrovascular diseases (CVD), including chronic cerebral ischaemia (CCI). The Actovegin drug, which has long been widely used in CCI treatment, has an antioxidant and endothelium protective effect. It makes sense to study the effect of Actovegin therapy on the clinical manifestations of CCI in patients with a recent experience of COVID-19.Objective: to evaluate Actovegin efficacy in the treatment of CCI in patients with a recent experience of COVID-19.Patients and methods. The study included 440 patients (234 female; 206 male) with a recent experience of COVID-19, suffering from CCI, their average age being 67.8 years (from 54 to 85 years). All patients were broken down into two groups of 220 people (the patients in Group 1 were administrated Actovegin, the ones in Group 2 – were not). All patients were followed up for 90 days; their condition was assessed by the severity of clinical manifestations of CCI, using special scales and questionnaires.Results and discussion. After 90 days of follow-up, the frequency of complaints of cognitive impairment, sleep disorder, dizziness, fatigue, emotional disorders, and headache in Group 1 was significantly lower than in Group 2 (p

A definite well-established term that would describe the full range of symptoms that patients who have had COVID-19 complain about does not exist. The terms “Post-COVID-19 syndrome”, “Long-COVID-19”, “Post-acute COVID-19” and “long-term effects of COVID-19” have been proposed. In the absence of clear diagnostic criteria, the potential consequences of the COVID-19 can be considered as symptoms that persist for 2–3 weeks or longer after the development of the first symptoms of COVID-19. Fatigue and cognitive impairment (CI) are one of the most common symptoms in patients with COVID-19. Fatigue is one of the most common symptoms among COVID-19 patients, which can persist for more than 100 days after the onset of respiratory symptoms. The risk factors for fatigue and CI in patients with COVID-19 have not been definitively established and continue to be studied. The pathogenesis of the development of asthenia and CI at the moment are currently in research, however, it is obvious that the pathophysiology is multifactorial. The ability of SARS-CoV-2 to damage nerve cells requires clarification. At the same time, it is obvious that an important role in the development of post-COVID-19 fatigue and CI is played by the endothelial dysfunction and microcirculation disorders, which, in turn, develop as a result of systemic inflammation and coagulopathy present in this infection. Approaches to the prevention and treatment of post-COVID-19 fatigue and CI are also currently in research. There are single papers that present the effectiveness of antiviral drugs; there is also no doubt about the need to correct the comorbid vascular risk factors of fatigue and CI. There is also evidence of an improvement in the condition of post-COVID-19 patients who recieved Actovegin therapy. A case series of patients who consulted a neurologist, who, due to persisting complaints of fatigue and CI, were prescribed Actovegin 600 mg/day was published. Within 1–3 months, all patients noted a decrease in the severity of cognitive and fatigue symptoms.

Diabetic encephalopathy is one of the late complications of diabetes mellitus arising from chronic hyperglycemia and cerebral macro- and microangiopathy. Cognitive impairment developing during diabetic encephalopathy and the associated maladaptation of patients become even more socially significant due to the rapid increase in the number of patients suffering from diabetes mellitus. In this regard, studies of drugs that improve cognitive functions in patients with diabetes mellitus are of the particular importance. Clinical case of a patient with cognitive impairment and diabetes mellitus treated with actovegin describes its effect on glucose utilization, as well as antioxidant, antihypoxant and other mechanisms of action that allow the drug to be used in patients with cognitive impairment CI on the background of diabetes mellitus.

Deproteinized calf serum (DCS) may have neuroprotective effects after ischemic stroke. The aim of this study is to investigate whether and how the DCS inhibits neuronal injury following cerebral ischemia. Rats were subjected to 2 h transient middle cerebral artery occlusion (MCAO). One dose of 0.125 mg/gbw DCS was given immediately after reperfusion. Neurological deficit and infarct volume at 24 h post-MCAO in DCS-treated rats were lower than those in vehicle-treated rats (p < 0.0005). In cultured neurons model, cell viability was decreased, and apoptosis was increased by oxygen-glucose deprivation/reperfusion (OGD/R) (p < 0.0005). These effects of OGD/R were attenuated by 0.4 μg/μl DCS (p < 0.05) that were validated by CCK8 cell viability assay, phycoerythrin–Annexin V Apoptosis Detection assay, and TUNEL assay. Furthermore, the increase of intracellular ROS level in cultured neurons was suppressed by DCS (p < 0.05). Compared with cells subjected to OGD/R, the expression level of Bax protein decreased, and bcl-2 protein increased after DSC treatment (p < 0.05). Overall, the neuroprotective effects of DCS following cerebral ischemia may in part be due to decreased ROS production and inhibition of apoptosis.

Deproteinized calf serum (DCS) may have neuroprotective effects after ischemic stroke. The aim of this study is to investigate whether and how the DCS inhibits neuronal injury following cerebral ischemia. Rats were subjected to 2 h transient middle cerebral artery occlusion (MCAO). One dose of 0.125 mg/gbw DCS was given immediately after reperfusion. Neurological deficit and infarct volume at 24 h post-MCAO in DCS-treated rats were lower than those in vehicle-treated rats (p < 0.0005). In cultured neurons model, cell viability was decreased, and apoptosis was increased by oxygen-glucose deprivation/reperfusion (OGD/R) (p < 0.0005). These effects of OGD/R were attenuated by 0.4 μg/μl DCS (p < 0.05) that were validated by CCK8 cell viability assay, phycoerythrin–Annexin V Apoptosis Detection assay, and TUNEL assay. Furthermore, the increase of intracellular ROS level in cultured neurons was suppressed by DCS (p < 0.05). Compared with cells subjected to OGD/R, the expression level of Bax protein decreased, and bcl-2 protein increased after DSC treatment (p < 0.05). Overall, the neuroprotective effects of DCS following cerebral ischemia may in part be due to decreased ROS production and inhibition of apoptosis. [ABSTRACT FROM AUTHOR]

Cognitive impairment (CI) is one of the leading causes of disability after stroke; CI is observed in more than half of patients and reaches a pronounced degree (of dementia) in every three to five patients. CI in poststroke patients is often caused not only by focal vascular lesions of the brain, but also by the presence of concomitant vascular and neurodegenerative diseases. The treatment and prevention of progressive CI are based on stroke prevention, non-drug and drug methods to improve cognitive functions. Blood pressure normalization during antihypertensive therapy is most effective in preventing the progression of CI in stroke patients. The use of Actovegin in patients with CI after stroke is discussed. The results of the author's own 5-year follow-up of 350 patients with stroke are presented.

Actovegin is a calf blood extract that contains more than 200 biologically active compounds. Experiments have shown that Actovegin reduces the neurotoxic effect of amyloid, neutralizes reactive oxygen species, and normalizes the endothelial function of small vessels. The drug has not been shown to stimulate tumor growth in the neuroblastoma model. Clinical experience with Actovegin suggests that the drug has an undoubted efficacy in treating moderate vascular cognitive impairment and chronic distal symmetric diabetic polyneuropathy and that it is used as additional therapy for primary degenerative and vascular dementia. The clinical efficacy of Actovegin in chronic obliterating diseases of the lowerlimb arteries is being actively studied now.

The aim of the article is to evaluate Bischofit gel reparative activity in a linear wound model in rats.Materials and Methods. The study was conducted on 36 male Wistar rats weighing from 193 to 218 grams. On the 8th day after modeling a linear wound defect 50±1 mm long, the reparative effect of bischofite, Actovegin and Contractubex in the gel compositions was evaluated. The evaluation was carried out using: the following methods: 1) studying the physicomechanical characteristics of the wound defect (a wound-tearing machine Metrotest REM-0.2-1); 2) morphological examination of the skin graft taken from the wound area (stained with hematoxylin-eosin and Van Gieson‘s solution); 3) determining the ratio of collagen types I and III in a polarizing microscope (the picrosirius was red); 4) cоlorimetric analysis of the hydroxyproline concentration in the wound surface tissues.Results. On the 8th day, the wound defects sampled from the bischofite treated animals, were characterized by the most pronounced strength (the average force at the rupture moment was 13.70 N), which was significantly higher (p Actovegin (0.67±0.017) > Control (0.56±0.012) > Contractubex (0.38 ±0.020).Conclusion. The carried out study showed that Bischofit has a pronounced ability to stimulate the regeneration of the skin wound defect. Hereby, the reference drug Actovegin showed less activity, and Contractubex worsened wound healing.

This paper presents the results of comparative studies of the impact of the low molecular weight (below 5 kDa) cattle cord blood fraction (CBF) and the comparator drug Actovegin on tissue regeneration after skin cryoablation in rats. Here, a local contact cryoexposure was shown to result not only in destruction of all skin layers, but secondary ischemic damage to deeper and adjacent tissues as well. The use of an injection solution of CBF as a therapy for simulated cryolesion proved its pronounced wound healing effect, manifested in accelerated reparation, improved trophicity in an injured area due to hypervascularization and prevention of sclerotic processes. The introduction of CBF and Actovegin to rats accelerated the normalization of clinical blood parameters (RBC and WBC counts, alkaline phosphatase activity) in shorter terms as compared with the control. The obtained effect may be compared with Actovegin action. [ABSTRACT FROM AUTHOR]

Background: The animal-derived nootropics, Cerebrolysin, Actovegin and Cortexin, may have potential in treating neurocognitive disorders. Although these drugs have international usage, reports on their efficacy have been conflicting. These agents have been suggested for all dementia types, but may have particular utility in vascular cognitive impairment (VCI). We used systematic review and meta-analyses to summarize evidence of efficacy in all cause dementia, with a subgroup analysis restricted to VCI. Methods: We searched multidisciplinary, electronic databases from inception to August 2020. We assessed risk of bias using the Cochrane tool and framed results using GRADE criteria. We used random effects models to create summary estimates. Our primary outcome was change in cognition based on any quantitative cognitive assessment scale using standardized mean difference (SMD). We assessed various secondary efficacy outcomes and a safety outcome of serious adverse events. We performed subgroup analyses limited to VCI. Results: Summary estimates suggested Cerebrolysin was potentially beneficial in improving cognition (8 trials,793 participants, SMD:-0.16, 95%CI:-0.30 to -0.03) and global function (4 trials,479 participants, OR:2.64, 95%CI:1.17 to 5.98) in the short term. There was no difference in incidence of serious adverse events (6 trials,1014 participants, RR:0.96, 95%CI:0.78 to 1.18). In our VCI subgroup, results were similar to the main analysis, with a beneficial effect on cognition (SMD:-0.22, 95%CI:-0.42 to -0.03) and clinical global impression (OR 2.99, 95%CI:1.02 to 8.73). The limited number of eligible studies for Actovegin (n = 2 trials,563 participants) and Cortexin, (n = 1 trial,80 participants) precluded meta-analyses but data suggested potential efficacy and no safety concerns. Across all included studies, risk of bias was moderate to high, there was imprecision, and certainty of evidence was considered low to very low. Conclusion: Although published data suggest potential benefits and relative safety of animal derived nootropics, the supporting evidence is weak. The size of the effects demonstrated were modest and probably less than would be considered clinically relevant.

Aim. The study of Actovegin effectin clinical presentations and hemorheological characteristics in patients with chronic cerebrovascular pathology (CCVP) and mild cognitive impairment. Materials and methods. The study group included 47 patients (25 male and 22 female), aged 61-75 years (mean age 63.8±5.4) with CCVP who were treated with Actovegin. The control group comprised 28 patients matched by gender and age, without associated cerebrovascular pathology. All patients along with thorough neurological examination underwent laboratory analyses (platelet and erythrocyte rheology), neurovisualization studies (functional magnetic resonance imaging of the brain). Depending on the dosage all patients were divided in two groups: Actovegin 1000 mg and 160 mg daily. Results and discussion. Overall, with Actovegin treatment in 81% of cases positive dynamics both in subjective symptoms, and somatic status was observed. A favorable effect on cognitive function in patients with CCVP was noted. The dose-dependent drug effect was demonstrated. The effect of Actovegin on blood cell functioning included the formation of smaller (Tf and Ts; p=0.0096 and p=0.016) and less solid (γ dis) erythrocyte aggregates (p=0.0034) both in the study and control group. The increase in erythrocyte deformability during therapy was significantly associated with cognitive improvement (via MoCA test, r=0.28). Conclusion. Complex (including neuropsychological and neurovisualizational) examination may not only help determine the cognitive status in patients with CCVP, but also assess the efficacy of neurometabolic therapy. New facts of Actovegin’s influence on erythrocyte aggregation and deformability have been identified, which may enhance micro - and macrocirculation. The acquired data may prove the wide spectrum of Actovegin’s pharmacological effect, which allows to use it in all forms of cerebrovascular pathology.

Post-stroke cognitive impairment (PSCI) is often characterized by a complex prognosis of neurorehabilitation, insufficient restoration of the functional status of patients, and a high risk of recurrent strokes and disability, which determines considerable health care costs. Objective: to carry out a comparative pharmacoeconomic analysis of the use of actovegin (Takeda Pharmaceuticals, Switzerland) in Russian patients with PSCI. Patients and methods. The investigation was conducted using a modeling method to determine the cost-effectiveness of competing treatment strategies: standard patient management; standard patient management and use of actovegin. Data from the ARTEMIDA clinical trial were used. Results and discussion. The use of actovegin was economically justified, which was expressed in more preferable cost-effectiveness indicators. Also, the use of actovegin in patients significantly reduced the risk of post-stroke dementia and, accordingly, the cost of treatment in future periods. Conclusion. The findings data indicate the clinical and economic feasibility of using actovegin in patients with PSCI.

The paper presents case report of mild cognitive impairment developed after lacunar infarct of thalamus due to arterial hypertension. Differential diagnosis of post-stroke cognitive impairment and clinical features of cerebral vascular and neurodegenerative diseases with intellectual disturbances is discussed. The paper shows approaches to management of patients with arterial hypertension and discusses common mistakes of it. New data about clinical efficacy of actovegin in post-stroke cognitive impairment get in ARTEMIDA study is also presented.

Cognitive disorder is one of the most disabling complications of ischemic stroke significantly impairing the patient’s commitment to rehabilitation and a life long treatment, reducing the quality of life of the patient and his relatives. This article discusses the epidemiology, etiology, pathophysiology of post-stroke cognitive impairment. Risk factors, classification, treatment and prevention of post-stroke cognitive disorders are discussed. The data of the study ARTEMIDA devoted to the possibility of therapy of post-stroke cognitive impairment and prevention of dementia after stroke with the use of the drug Actovegin are provided.

The article describes main principles of conservative treatment of chronic arterial insufficiency of the lower extremities. The role in treatment of metered physical load is underlined, we analyze the main pharmacological agents most often used for conservative treatment, their mechanism of action. Antiplatelet drugs, peripheral vasodilators (pentoxifylline, naftidrofuryl, dlostazol), sulodexide are considered. The of Actovegin, having a pleiotropic effect, is separately discussed.

Objectives. To study the N-acetylaspartate (NAA) content in the plasma of elderly patients with depression during treatment with antidepressants combined with Actovegin. Materials and methods. Nineteen patients – seven men, 12 women, age 70.5 ± 5.8 years – were treated in hospital conditions. Patients underwent clinical psychiatric evaluation using a series of psychometric scales, along with computerized tomography (CT) and biochemical assay of NAA. Patients received antidepressants (venlafaxine and fluvoxamine at therapeutic doses) and Actovegin for 28 days and were investigated before and after treatment (day 28). Results and conclusions. Decreases in blood NAA were found in pretreatment patients as compared with healthy subjects, with increases after treatment, which corresponded to a significant improvement in patients' status both clinically and on psychometric scales. Heterogeneity was found in the cohort of patients in relation to the nature of changes in contents (increases or decreases) of NAA, which was not linked with treatment efficacy but correlated with the burden of comorbid somatic diseases, especially vascular, and some CT features (leukoaraiosis). The authors emphasize the preliminary nature of the results. [ABSTRACT FROM AUTHOR]

Background: Actovegin is a biological drug with a controversial history of use in the treatment of sports injuries during the past 60 years. Particular concerns have been raised about its ergogenic potential to enhance performance, but some of these have been based on little more than anecdote. Objectives: In this article, we review the most recent scientific evidence to determine the clinical efficacy, safety profile, and legal status of Actovegin. Methods: We considered all studies directly commenting on experience with Actovegin use as the primary intervention within the past 10 years. Outcomes included mechanisms of action, clinical efficacy in enhancing muscle repair, any report of safety issues, and any evidence for ergogenic effect. Results: Our database search returned 212 articles, abstracts were screened, and after inclusion/exclusion criteria were applied, 25 articles were considered: Publications included 11 primary research articles (7 in vitro studies and 4 clinical trials), 8 review articles, 5 editorials, and a single case report. Conclusions: Current literature is still yet to define the active compound(s) of Actovegin, but suggests that it shows antioxidant and antiapoptotic properties, and may also upregulate macrophage responses central to muscle repair. Clinical efficacy was supported by one new original research article, and the use of Actovegin to treat muscle injuries remains safe and supported. Two articles argued the ergogenic effect of Actovegin, but in vitro findings did not to translate to the outcomes of a clinical trial. An adequate and meaningful scientific approach remains difficult in a field where there is immense pressure to deliver cutting-edge therapies. [ABSTRACT FROM AUTHOR]

Objective. To study the peculiarities of the realization of psychosomatic disorders in patients with gastroesophageal reflux disease with concomitant diabetes mellitus type 2 and to develop methods for their correction. Materials and methods. In order to obtain the results we conducted a study of two groups of patients suffering from GeRD with concomitant mild to moderate diabetes mellitus type 2 and isolated GeRD. The survey program included: determining the degree of carbohydrate metabolism compensation; state of aggression factor. For the evaluation of gastric secretion we used the daily pH-metry. also, all patients underwent an ultrasound investigation with water load. Indices of oxidative stress were assessed by the diameter of the celiac trunk and blood flow velocity in it. psychosomatic disorders and quality of life of the patients were estimated by conducting a survey using unified questionnaires. Results. We established that in patients with GeRD with concomitant diabetes mellitus there was a clear tendency towards stabilization of the glycemic profile. In patients of both groups, episodes of heartburn, frequency and intensity of belching, and dyspeptic phenomena decreased. We found that, after a 4-week course of therapy, oxidative stress levels in patients of both treatment groups decreased. The findings suggest that psychosomatic disorders are factors that not only make the course of GeRD and DM type 2 more difficult, but also take a direct part in the formation of GeRD itself in DM type 2. The results of our studies also clearly indicate that the additional assigning of actovegin in the general scheme of treatment for patients with DM type 2 with concomitant GeRD has an evident positive effect on the reduction of the onset of clinical remission of both DM type 2 and concomitant GeRD. Conclusions. The inclusion of actovegin in the general treatment scheme of patients with GeRD and DM contributes to a significant reduction in the recrudescence period of both DM and concomitant GeRD. [ABSTRACT FROM AUTHOR]

The article is a review of disorders associated with lesions in the occipital lobes and their pathways. The article stresses that the disorders can not be reduced only to the cortical blindness, as the problem has a more comprehensive nature. The article considers the mechanisms of disorders related to perception of colors and shapes of objects, movements, as well as achromatopia, prosopagnosia, topographagnosia, akinetopsia, mnestic and other pathologies. The focus is on the results of current methods of functional neuroimaging that allowed to better understand the mechanisms for the developmental of such disorders. For patients with such vascular or primary degenerative disorders, there are chances for a certain recovery of the lost functions, which is associated with the processes of neuroplasticity. The outcomes could also be improved by non-pharmacological methods and a number of medications that improve the oxidation/reduction processes, particularly actovegin.

Chronic endometritis (CE) - a common disease with no unified concept of pathogenesis, characterized by undulating and ever-progressive pathological process. Important pathogenic factors contributing to the development of CE, is immune deficiency and violation of endometrium angioarchitectonics. Currently has been widely discussed question of the pro- and antioxidant systems imbalance role in the pathogenesis of HE. From these positions, it is obvious that the stimulation of natural antioxidant systems, introduction of exogenous antioxidants - one of the essential moments in the treatment of CE. Actovegin is a one of the modern drugs which is best meets the requirements of CE pathogenic-based therapy and has an impact on the above links of pathogenesis. Actovegin contains components with high biological activity: amino acids, oligopeptides, nucleosides, oligosaccharides and glycolipides, enzymes, electrolytes, and a number of important macro- and micronutrients. Exacerbation of already existing chronic inflammation often occurs after an abortion and therapeutic surgical procedures. Therefore, an important measure to prevent the exacerbation of chronic endometritis, an essential part of the treatment of post-abortion or postpartum CE, treatment and diagnostic curettage is the rehabilitation of structural and functional state of the endometrium with the use of Actovegin.

The incidence of bed sores in patients in the developed countries is about the same and amounts to 16% of the complications of other diseases (US and UK). At the same time, according to the results of a specialized US study (Brandeis G.H., Morris J.N., 1990), if the caregivers were specially trained nurses and attendants, the prevalence of bed sores was reduced by 2-3 times. Mortality in patients with decubitus ulcers, according to different authors, varies widely (21-88,1%). Such patients died of wound sepsis.

Aim. To evaluate effects of Actovegin (deproteinized hemoderivative) on vasomotor and metabolic functions of microvascular skin endothelium in healthy volunteers during acute pharmacological test.Material and methods. 24 healthy male volunteers, aged 18-26 years (21,9±2,7), received Actovegin i.v. during 2 hour infusion through the left cubital vein. Right forearm skin laser Doppler flowmetry (LDF) with wavelet analysis of the microcirculatory oscillations was used initially and after 2 hour Actovegin infusion to assess microvascular endothelial responses (microcirculatory blood flow changes) to Actovegin. Saline infusion in 5 subjects used for control data receiving.Results. Actovegin significantly increased in maximal amplitude endothelial rhythm (at a frequency of 0.01 Hz) by 76% (p

The main manifestation of brain damage in hypertension is cognitive impairment. According to different authors, more than half of patients with hypertension have cognitive impairment beyond the age norm. The presence of causal relationship between cognitive impairment and hypertension is supported by clinical profiles of cognitive disorders and predominantly subcortical impairement: prevaling bradyphrenia, visual-spatial disorders and impaired control functions of the frontal lobes, comorbid emotional disorders. It is recommended for everyday clinical practice to carry out neuropsychological testing of cognitive impairment in patients with hypertension for the timely initiation of therapy. In the treatment of cognitive impairment without dementia, the priority is given to neurometabolic drugs.

Chronic cerebral ischemia is a common problem especially among the elderly. It gradually leads to social disability and invalidisation of those patients. One of the possible pathogenic mechanisms of this condition is the endothelial dysfunction. Thus, the attempt to repair the latter is one of the treatment goals. It is assumed that actovegin improves tissue microcirculation by expanding precapillary zone – the main marker of the metabolic activity in the microvascular endothelium. Actovegin activates anaerobic metabolism and oxygenation in endotheliocytes. Patients, treated by actovegin, showed improvement of cognitive functions and psycho-emotional state. Due to the absence of proteins, the drug has good tolerance and low toxicity.

It was demonstrated experimentally on mice that dimephosphon as well as actovegin, trental and mexidol in combined -one-fold local and two-fold (with 4h interval) intravenous administration - 24 h after pedicle flap increases its vitality. According to their protective activity the studied drugs can be placed as follows: trental > dimephosphon = mexidol > actovegin. According to the range of their therapeutic effect they can be placed like this - dimephosphon > trental > actovegin > mexidol. Trental is more effective when given in combination appart from dimephosphon, actovegin and mexidol. Topical and intraperitoneal administration of dimephosphon and referent actovegin during 20 days increases engraftment of free dermal autograft (ADA) and epithelization of the lesion (after origin of scab) on the 15-20 days of the investigation. According to their activity the preparations can be divided as follows by the 15th day - actovegin > trental = dimephosphon; by the 20th day - actovegin > dimephosphon = trental. Dimephosphon apart from actovegin and trental prevents the purulence in the area of free ADA.

Dermatoprotective activity (DPA) comparative evaluation of dymephosphone, actovegin, trental and meksidol under reduced blood circulation has been carried out. It has been proved that in experimental mice dymephosphone judging by DPA exceeds actovegin in quality by 2,8 times and is similar to meksidol. At the same time it is 5,2 times is worse than trental; as for its width of therapeutic activion (WTA) it is better than meksidol, trental and actovegin by 5.6, 1.8 and 2.9 times respectively. In experimental rats dymephosphone judging by DPA exceeds actovegin in quality by 3,6 times and is worse than trental and meksidol by 4.7 and 1.3 times respectively; as for the WTA it is better than actovegin, trental and meksidol by 3.8, 2.0, 5.5 times respectively.

The stimulator of tissue regeneration Actovegin is used in many diseases associated with blood circulation. It’s given to patients with neurological, endocrinological, cardiac and even ophthalmic diseases. Its efficacy is observed in disorders of the brain with the metabolic and vascular nature. It improves the trophism of tissues with injuries, burns and ulcers of the different etiology. It prevents the development of adverse effects as a result of peripheral vascular disorders. Actovegin has received the active application in patients with the long-standing diabetes as a prevention and the treatment of complications, particularly the vascular dementia and the diabetic distal polyneuropathy. The basis for these diseases is the hypoxic nature of the tissue damage. It’s mechanisms direct to the reduction of the influence pathological factors and the recovery of the antioxidant activity of cells.

Present study was aimed to investigate the role of oxidative stress in the formation mechanisms of gastroesophageal reflux disease in patients with diabetes mellitus type II and to develop methods for its correction. Two groups of people with mild and moderate severe diabetes mellitus type II with concomitant gastroesophageal reflux disease were observed. The first included 28 patients aged 35 to 45 years who received standard treatment and actovegin. The second group consisted of 25 patients of the same sex and age who received only basic therapy. The third experimental group included 27 patients with gastroesophageal reflux disease without concomitant pathology of the same age group. In all patients, the level of antioxidant protection, lipid peroxidation and regional blood flow in the celiac trunk were determined. In the course of the study, we found that while treating patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease both in patients of the first and second groups, a clear tendency of decreasing the clinical manifestations of the disease was determined, and the glycemic index was normalized. We found that after a 4-week course of therapy in patients of both treatment groups, the indices of antioxidant protection of esophageal mucosa increased, and the indices of lipid peroxidation decreased. In patients the diameter of the celiac trunk increased, and the blood flow velocity in it improved. While in patients of the second control group, who received only the standard treatment, the dynamics of blood flow in the celiac trunk was significantly less. The introduction of actovegin in the standard treatment regimen of patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease reduces the timing of the onset of clinical remission of both the underlying disease and concomitant disease, and also increases the activity of antioxidant protection of the esophagus. [ABSTRACT FROM AUTHOR]

The article is devoted to the treatment of diabetic neuropathy with Actovegin. Diabetes mellitus is widespread all around the world. Complications of the disease include nephropathy, retinopathy, and diabetic neuropathy. The most common and well known form of diabetic neuropathy is distal neuropathy. In recent years, new data was obtained on the effectiveness of treatment of distal neuropathy with neuroprotector Actovegin which exerts insulin-like effect and does not inhibit glucose transport. Actovegin was shown to be effective for distal neuropathy therapy, according to the two studies described. 6 months of Actovegin therapy demonstrated the following positive changes: effect on neuropathic symptoms, lower vibration sensitivity thresholds, higher peripheral nerve conduction velocity, reduced severity of pain and pain-free walking distance increase.

The article tells about current approaches to diagnosis and treatment of vascular cognitive impairment. The focus is on the administration of neurometabolic medicines.

The article deals with the treatment of diabetic polyneuropathy (DPN) using Actovegin. The results of research on the effectiveness of this drug in 200 patients with diabetes mellitus (aged from 19 to 88 years) are provided. As a result of pathogenetic therapy with Actovegin, it was able to reduce the severity of DPN — 32 % of patients with severe diabetic neuropathy moved to a group of patients with moderate DPN.

Cognitive impairment in elderly patients with diabetes is an important medical and social problem. The article covers aspects of pathogenesis and treatment approaches of cognitive impairment and diabetes mellitus; in particular Actovegin as a treatment option for correction of cognitive status in diabetic patients.

Acute and chronic brain ischemia is accompanied by complex metabolic rearrangements in the neurons. The ability of the cells to survive is largely determined by the presence of energy substrates and oxygen, the synthesis of neurotransmitters, and some other factors. The increasedpersistence of nerve tissue in ischemia and chances of recovering the impaired function can be achieved by the use of neuroprotective and neurotrophic agents. The efficiency of neurometabolic therapy is considered using Ceraxon and Actovegin as an example. It is emphasized that theefficiency of their administration can be achieved by the mandatory concurrent use of a wide range of nondrug treatments.

Aims: To evaluate two definitions of response and the predictive value of baseline covariates for response to actovegin treatment in type 2 diabetic patients with symptomatic diabetic sensorimotor polyneuropathy (DSPN).Methods: Response to 6-months treatment with actovegin or placebo was defined as a clinically meaningful decline from baseline to 6months in (1) both Neuropathy Impairment Score of Lower Limbs (NIS-LL) ≥2 points and Total Symptom Score (TSS) >50% and (2) NIS-LL ≥2 points only. Nineteen baseline covariates were evaluated using separate logistic regression models and either both NIS-LL and TSS or NIS-LL response definitions.Results: Intention-to-treat analysis included 567 patients. Actovegin treatment compared to placebo was associated with better odds of response (OR [95% CI] of 1.73 [1.21-2.48] for definition 1 and 1.94 [1.33-2.84] for definition 2). Significant interaction with actovegin treatment was noted only for baseline use of angiotensin receptor blockers (ARBs)/angiotensinogen converting enzyme inhibitors (ACEIs), resulting in a reduced treatment response (P=0.03).Conclusions: Actovegin treatment was associated with a clinically meaningful response in neuropathic symptoms and/or impairments in patients with symptomatic DSPN. Since only one predictor of response to actovegin treatment was identified, this drug seems an appropriate therapy for the majority of patients with DSPN. [ABSTRACT FROM AUTHOR]

Background: No drug treatment to date has shown convincing clinical evidence of restoring cognitive function or preventing further decline after stroke. The ongoing ARTEMIDA study will evaluate the efficacy and safety of Actovegin for the symptomatic treatment of post-stroke cognitive impairment (PSCI) and will explore whether Actovegin has any disease-modifying effect by assessing whether any changes are sustained after treatment. Design: ARTEMIDA is a 12-month, multicentre trial in patients (planned a total of 500, now recruited) with cognitive impairment following ischaemic stroke. The study consists of a baseline screening (≤7 days after stroke), after which eligible patients are randomised to Actovegin (2,000 mg/day for up to 20 intravenous infusions followed by 1,200 mg/day orally) or placebo for a 6-month double-blind treatment period. Patients will be followed up for a further 6 months, during which time they will be treated in accordance with standard clinical practice. The primary study endpoint is change from baseline in the Alzheimer's Disease Assessment Scale, cognitive subscale, extended version. Secondary outcomes include: Montreal Cognitive Assessment; dementia diagnosis (ICD-10); National Institutes of Health Stroke Scale; Barthel Index; EQ-5D; Beck Depression Inventory, version II, and safety. Conclusion: There is a clear need for effective treatments for PSCI. ARTEMIDA should provide important insights into the use of a novel drug therapy for PSCI.

Inflammatory diseases occupy leading positions in the list of gynaecological pathology. Inflammatory diseases of the pelvic organs (PID) recorded in 60-65% of women of reproductive age have a very negative impact on the female reproductive function, and cause chronic pelvic pain syndrome in 24% cases, infertility in 40%, miscarriage in 45%, and ectopic pregnancy in 3% of cases [1-3, 5, 7-9, 12, 13, 15-17, 20, 23]. Among inflammatory diseases in gynecology, endometritis and cervicitis account for about 70-80% of cases; however, the asymptomatic nature of the majority of endometritis and cervicitis cases (chronicity of the inflammatory process) and the fact of their being diagnosed only at routine gynecological exams, lead us to suggest that their incidence is much higher [4, 6, 10, 11, 14, 18, 19, 21, 22].

Cerebrovascular disease is one of the most common causes of disability and mortality among the population. The diseases are divided into acute cerebrovascular disorders and chronic brain vascular diseases (CBVD), which in this country are more widely known as "dyscirculatory encephalopathy" (DE). This term is used to denote cerebrovascular pathology that develops in the event of multiple focal and/or diffuse brain lesions, while the progression of neurological and psychiatric disorders may be conditioned by a stable and long lasting cerebrovascular insufficiency and/or repeated dyscirculation events occurring as acute clinical symptoms (acute cerebrovascular disorders) or subclinically.

Diabetes mellitus (DM) is widespread all around the world; in the U.S., for example, diabetes was diagnosed in 12% of the population aged 60 and above, while in Europe - in 8-10% of the same population group. The prevalence of diabetes is growing, outstripping the worst predictions of the early 21st century; moreover, there is a "rejuvenation" of diabetes type 2. In diabetes mellitus, metabolic disorders caused by hyperglycemia and pathology of blood flow in the vessels of microcirculatory system lead to multiple lesions of the organs and systems of the body. Nephropathy, retinopathy and distal symmetric motor and sensory polyneuropathy (DSMSP) are the traditional complications of diabetes; DSMSP is the most frequent complication found in DM patients[1].

The article discusses the problem of treatment of cerebrovascular diseases (CVD). There are definitions of CVD, chronic cerebral ischemia (CCI) and dyscirculatory encephalopathy (DE). The place of DE in the ICD-10, its diagnostic criteria, clinical pattern and stages are highlighted. The importance of evaluation of cognitive functions, prevention and correction are emphasized. Treatment of cognitive disorders in DE should be aimed primarily at the prevention of further damage of brain vessels and brain substance, improvement and long-term stabilization of cognitive functions. It is essential to prescribe neurometabolic and neuroprotective drugs; the importance of thrombolytic therapy in the treatment of chronic dyscirculatory encephalopathy and stroke prevention, as well as in the correction of asthenic conditions and manifestations of insomnia, is stressed.