No 8 (2011)

Current problems of antiarrhythmic therapy (limited effectiveness, arrhythmogenic action extracardiac side effects, etc.) determine the need for new therapeutic approaches. From this perspective, examination of potentials for use of ω-3 polyunsaturated fatty acids (PUFA) in arrhythmias is of the utmost interest. Results of such examination are presented in this review. The maximal antiarrhythmic effect of ω-3 PUFAs seem to be expected in patients with coronary artery disease and ventricular arrhythmia without structural myocardium changes, with normal or moderately reduced left ventricular ejection fraction. Two large randomized controlled trials established the effectiveness of prolonged therapy with ω-3 PUFA at a dose of 1 g/day in 90% of cases in preventing adverse cardiovascular events in patients with myocardial infarction and congestive heart failure, often associated with cardiac arrhythmias.

The article discusses the problem of magnesium deficiency manifesting as seizures. Biochemistry of muscle contraction, physiological role of magnesium, the relationship of magnesium deficiency and seizures, as well as particularities of magnesian therapy and synergistic effect of magnesium and one of its pharmaceutical carriers - orotic acid are considered

Modern concept of the mechanisms of regulation of metabolic processes by the circadian system is based on the hypothesis of British scientists E.M. Scott and P.J.Grant. They have suggested the violation of an ancient, evolutionarily fixed adaptation to seasonal environmental changes. It is estimated that violation of the seasonal and diurnal rhythms is an essential condition for the development of overweight, arterial hypertension and type 2 diabetes mellitus. Melatonin plays an important role in this system, and causes the rhythmic expression of clock genes (Clock/Bmal) in peripheral organs through their receptors (M1, M2, NMRs) and synchronizes physiological processes in human body with environmental conditions by impact on metabolism (glucose homeostasis, lipid synthesis, adipogenesis) and hemodynamic parameters (blood pressure (BP), procoagulant activity). Phenomenon of light constancy, which is not subject to seasonal and diurnal fluctuations, is of great importance in the structure of circadian disorders.

Treatment of neuropathic pain (NP) remains an important medical, social, and economic problem. Modern Russian and international guidelines for treatment of various forms of NP have been developed; but against the background of use of modern pharmacological therapies, pain remains intense, disturbing socioenvironmental and labor adaptation. In recent years, new generation of anticonvulsants - gabapentoids - have been emerged and successfully used for the treatment of NP. One of the most popular drugs in this group is gabapentin, with great experience of use. Randomized double-blind, placebo-controlled trials on the efficacy and safety of gabapentin in the most common clinical variants of NP showed that the drug is significantly more intensively reduces the severity of pain as compared with placebo.

The study was aimed to assess therapeutic action of citicolin on cognitive impairment without dementia in 48 patients with Parkinson's disease. Control group included 20 individuals not receiving medication. On completing treatment, neuropsychological test have shown a reduction in cognitive decline (mean MMSE score increase from 27.2 ± 1.2 to 28.7 ± 1.1) in experimental group against the background of citicolin use. In addition, these patients showed improvement of attention, memory, and regulatory functions. At the same time, cognitive improvement was not observed in the control group (MMSE score 27.4 ± 1.1 and 27.8 ± 1.2, at starting and on completing treatment, respectively). During the period of observation, citicolin was well tolerated, only 1 (2.1%) case of motor excitement and 2 (at 4.2%) cases of dizziness were registered.

In the study, including 212 women with early menopause, assessed the effectiveness of the drug Vitrum Cardio Omega-3 (Unipharm Company Inc., USA) in the treatment of metabolic disorders. The results of the treatment confirmed its positive influence on lipid and carbohydrate metabolism, as well as state of the endothelium. This showed considerable clinical improvement, normalization of biochemical and hormonal parameters, significantly improved quality of life of patients with early menopause.