Meditsinskiy sovet = Medical Council最新文献

{"title":"Antiseptic and hygienic preparation of patients for ear surgery with an endaural approach","authors":"W. H. Suaifan, K. Eremeeva, S. V. Morozova","doi":"10.21518/ms2024-096","DOIUrl":"https://doi.org/10.21518/ms2024-096","url":null,"abstract":"Introduction. Optimization of preoperative preparation protocols in otosurgery can reduce intraand postoperative infectious complications, improve surgical outcomes, which is important for the rehabilitation of patients with ear diseases.Aim. To determine the effectiveness of antiseptic and hygienic preoperative preparation of the surgical field during endaural otosurgical interventions.Materials and methods. The randomized study included 183 patients who underwent surgery via the endaural approach. The first part of the study evaluated the effect of 10% povidone-iodine solution treatment on the skin microbiome; the second part evaluated the need for ear canal depilation and before surgery and compared the methods.Results. Examination of skin microbiota of the external auditory canal in 85% revealed the growth of microorganisms:Staphylococcus – 115 (85.5%), fungal growth – 6 (4.4%), Corynebacterium – 8 (5.9%), etc. Microbial growth was not detected in 15%. Antiseptic treatment with 10% Povidone-iodine solution with endaural access reduces the degree of contamination and suppresses the growth of microorganisms in more than one third of patients. Inflammatory changes of the postoperative wound correspond to the degree of inflammation IA in both control and study groups. After depilation, visualization was assessed as optimal in 100% of cases and no inflammatory reactions were found. Average depilation time with scissors 113 sec, with an ear trimmer 32 sec.Conclusions. Preoperative antiseptic preparation reduces microbial contamination of the skin via endaural access, with no significant impact on wound healing process in the postoperative period. Depilation improved the view of the operative field in 100% of cases. Depilation with an ear trimmer is 3.5 times faster than with scissors.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"43 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141121965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience in the use of non-immunogenic recombinant staphylokinase in the treatment of massive pulmonary embolism","authors":"N. Semigolovskii, I. S. Simutis, D. S. Salygina, M. S. Danilov, A. Svetlikov, S. N. Semigolovskii","doi":"10.21518/ms2024-164","DOIUrl":"https://doi.org/10.21518/ms2024-164","url":null,"abstract":"The actuality of the problem of pulmonary embolism is due to the widespread occurrence of this complication with unpredictable consequences, including hemodynamic instability, arterial hypotension, shock, disability and sudden death. Pulmonary embolism is now considered in developed countries as the most common cause of preventable inhospital death and maternal mortality. Thrombolytic therapy is used for intermediate and high-risk pulmonary embolism with hemodynamic instability of the patient, however, there is also ongoing discussion about the possibilities of its implementation in normotensive patients under certain conditions. Currently, streptokinase, urokinase and alteplase (Actilize and Revelise in Russia) are used for thrombolytic therapy of pulmonary embolism. Indications for use in pulmonary embolism have been expanded recently for the already wellknown domestic thrombolytic non-immunogenic staphylokinase (Fortelizin®), which has proven itself in patients with acute myocardial infarction and acute ischemic stroke. A clinical case of delayed (on the 4th day of hospitalization) use of Fortelisin with a positive effect in a 49-year-old normotensive anemized patient with syncope in the PE debut with non-occlusive thrombosis of the posterior tibial veins without flotation of blood clots is presented. The features of Fortelizin, which favorably distinguish it from other thrombolytic agents, are: the highest fibrin selectivity; the possibility of bolus administration of a fixed dosage, independent of the patient’s body weight; safety of repeated administration; high rate of onset of effect; prevention of a significant decrease in blood fibrinogen levels, which reduces the risk of bleeding. Thus, the use of the domestic thrombolytic recombinant non-immunogenic staphylokinase drug Fortelizin, taking into account the data of the conducted studies and the described case, seems to be a successful example of import substitution in medicine.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141122281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Terlipressin using for intraoperative bleeding reduction during endoscopic rhinosinus surgery","authors":"I. Arustamyan, V. E. Pavlov, Y. Polushin, S. Karpishchenko, O. Stancheva, G. Efimenko","doi":"10.21518/ms2024-097","DOIUrl":"https://doi.org/10.21518/ms2024-097","url":null,"abstract":"Introduction. Endoscopic rhinosinus surgery stands out for its reduced complications and marked symptomatic improvement compared to open surgical approaches. However, local bleeding challenges may compromise the efficacy of minimally invasive procedures. Exploring terlipressin’s application in endoscopic rhinosinus surgery is a promising avenue, given its mechanism of action and successful use in obstetric and other medical practices.Aim. This study aimed to assess terlipressin’s efficacy in reducing intraoperative bleeding during endoscopic rhinosinus surgical interventions under general anesthesia.Materials and methods. A prospective randomized cohort study included 170 cases of endoscopic rhinosinus surgical interventions. The BT group (n = 89) received no terlipressin, while the T group (n = 81) had 200 mcg of terlipressin during surgery. Bleeding intensity was assessed on a 6-point scale. Heart rate, blood pressure, perfusion index, and bleeding intensity were recorded at 10th, 30th, and 60th minute into the operation (study points). Bleeding intensity ≥2 points was considered significant. Results. In the T group, mean BP was significantly higher at all study points than in the BT group. Perfusion index values in the terlipressin group were significantly lower throughout. ROC analysis highlighted perfusion index’s prognostic value at 30th and 60th minutes for predicting significant bleeding. Threshold perfusion index values associated with increased bleeding probability were 4.520 at 30th minutes and 5.040 at 60th minute. Multifactorial analysis linked intraoperative terlipressin administration to a lower likelihood of significant intraoperative bleeding.Conclusion. Intravenous terlipressin (200 mcg) effectively reduces intraoperative bleeding intensity without lowering arterial pressure during endoscopic rhinosinus surgical interventions under general anesthesia.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"37 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141122247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of a patent foramen ovale in patients with pulmonary embolism","authors":"A. V. Pavlova","doi":"10.21518/ms2024-012","DOIUrl":"https://doi.org/10.21518/ms2024-012","url":null,"abstract":"The phenomenon of a patent foramen ovale in patients with pulmonary embolism increases the risk of ischemic stroke. The clinical significance of this phenomenon should be taken into account to determine the diagnostic algorithm, management tactics and choice of secondary prevention. The prognosis of a patient with pulmonary embolism depends not only on the likelihood of recurrent pulmonary embolism, the formation of chronic pulmonary hypertension, but is also associated with an increased risk of ischemic stroke through the mechanism of paradoxical embolism due to the presence of a patent foramen ovale. A venous thrombus migrates through the patent foramen ovale as a result of the operation of an intracardiac right-left shunt. The purpose of the scientific review is to raise awareness of the problem of ischemic stroke in patients with pulmonary embolism. The results of studies and registries are presented, which reflect that the presence of patent foramen ovale increases the risk of developing ischemic stroke in patients with pulmonary embolism. Ischemic stroke can occur within 2–22 days after the onset of a pulmonary embolism clinic, and the risk of ischemic stroke remains within a year. Non-invasive transcranial dopplerography is recommended for diagnosis at the first stage of identification of the right-to-left shunt and is highly sensitive method (95–98%). Transesophageal echocardiography should be considered for the second stage of diagnosis. Thrombolytic therapy or surgical thrombectomy improves the prognosis for this category of patients. Тhrombolytic therapy may be given for up to 14 days in patients with pulmonary embolism. The use of thrombolytic therapy in the development of ischemic stroke becomes a possible option to improve the prognosis patients. The choice strategy for secondary prevention is important because patients have an increased risk of relapse.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"33 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141118787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New aspects in the diagnosis and treatment of polycystic ovary syndrome","authors":"V. V. Efimenko, M. Khachaturov, A. M. Gasanova, N. Martirosian, I. A. Kuzina, E. V. Goncharova, M. E. Telnova, N. Petunina","doi":"10.21518/ms2024-205","DOIUrl":"https://doi.org/10.21518/ms2024-205","url":null,"abstract":"Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder caused by both genetic and epigenetic factors. The relevance is associated with a high degree of prevalence and social significance this disease. The сombination of menstrual dysfunction, anovulatory infertility, metabolic disorders, biochemical and clinical hyperandrogenism cause the importance of this problem. In this regard, Adequate therapy and its timely intensification are the most important aspects. This article highlights basic information about diagnosis and treatment of polycystic ovary syndrome, analyzes in detail the changes in patient management tactic according to the clinical recommendations of ESHRE 2018 and 2023 the issues of the quality of life of women with PCOS. In this review, special attention will be paid to the role of metformin. According to new clinical guidelines, it can be used not only for patients with an increased body mass index (BMI), but also with a normal BMI in order to reduce insulin resistance. A new place of inositol in PCOS therapy is also considered, as an alternative way which increases the sensitivity of receptors to insulin. The treatment with aromatase inhibitors are given to solve such a problem as infertility. The article also highlights the development of treatment methods based on advances in genetics and epigenetics.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic background as the basis for comorbidity in patients with type 2 diabetes mellitus","authors":"T. Demidova, F. Ushanova","doi":"10.21518/ms2024-137","DOIUrl":"https://doi.org/10.21518/ms2024-137","url":null,"abstract":"The main cause of death among people with DM2 is atherosclerotic cardiovascular diseases (ARDS), the risk of which in this cohort increases 2–4 times. The features of the metabolic background in comorbid patients with type 2 diabetes mellitus are characterized by an aggressive course of dyslipidemia with a predominance of its atherogenic forms. Despite the achievement of lipid targets on the background of statin therapy, the residual risk of cardiovascular diseases in this group of patients remains quite high. The results of a number of major research papers indicate that hypertriglyceridemia may play an important role in this. In this regard, triglycerides (TG) are no less important for the prevention and control of cardiovascular risk in carbohydrate metabolism disorders, in addition to LDL. According to the consensus statement of the European Atherosclerosis Society, the risk of ASD becomes clinically significant at an empty stomach TG level >1.7 mmol/l. The main tool for controlling hypertriglyceridemia today is fibrate therapy. According to available data, the combination of statins and fenofibrate is more effective in reducing total cholesterol, LDL, TG and increasing HDL. To date, fenofibrate is the only molecule that has shown an optimal safety profile and reduced risk of cardiovascular diseases. In the Russian clinical guidelines on lipid metabolism disorders from 2023, it was proposed to divide patients into 3 main categories according to the severity of the increase in TG, on which the management tactics depend: 1.7–2.3 mmol/l; 2.3–5 mmol/l; ≥5 mmol/l. In individuals with TG levels >2.3 mmol/l on the background of moderate or high intensity statin therapy, the use of fenofibrate is recommended, preferably in combination with statins.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"110 37","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-glucose cotransporter type 2 inhibitors in the treatment of chronic heart failure: new evidence","authors":"V. N. Larina, M. V. Leonova","doi":"10.21518/ms2024-129","DOIUrl":"https://doi.org/10.21518/ms2024-129","url":null,"abstract":"Rational pharmacotherapy for chronic heart failure (HF) remains a relevant issue due to the unfavorable prognosis. Several major studies have confirmed the beneficial effect on reducing hospitalization rates and mortality of modern disease-modifying therapy, including sodium-glucose cotransporter type 2 inhibitors (SGLT-2 inhibitors or gliflozins), considered first-line therapy regardless of the left ventricular ejection fraction (LVEF) and diabetes mellitus in HF patients. The review presents the studied mechanisms of action of this group of drugs in HF, including metabolic, hemodynamic, and other pleiotropic effects, through which SGLT-2 inhibitors prevent the development and progression of HF with different LVEF. The possibilities of the influence of SGLT-2 inhibitors on clinical symptoms and quality of life of HF patients are discussed, as well as the change in the level of N-terminal pro-B-type natriuretic peptide as a target for rational clinical use justification. The concept of quadruple therapy, depending on the clinical situation, is presented, the basis of which is the rapid and simultaneous initiation of a combina-Rational pharmacotherapy for chronic heart failure (HF) remains a relevant issue due to the unfavorable prognosis. Several major studies have confirmed the beneficial effect on reducing hospitalization rates and mortality of modern disease-modifying therapy, including sodium-glucose cotransporter type 2 inhibitors (SGLT-2 inhibitors or gliflozins), considered first-line therapy regardless of the left ventricular ejection fraction (LVEF) and diabetes mellitus in HF patients. The review presents the studied mechanisms of action of this group of drugs in HF, including metabolic, hemodynamic, and other pleiotropic effects, through which SGLT-2 inhibitors prevent the development and progression of HF with different LVEF. The possibilities of the influence of SGLT-2 inhibitors on clinical symptoms and quality of life of HF patients are discussed, as well as the change in the level of N-terminal pro-B-type natriuretic peptide as a target for rational clinical use justification. The concept of quadruple therapy, depending on the clinical situation, is presented, the basis of which is the rapid and simultaneous initiation of a combination of major life-saving drug groups (angiotensin-converting enzyme inhibitors / sacubitril + valsartan, SGLT-2 inhibitors, beta-blockers, and mineralocorticoid receptor antagonists), aimed at improving the clinical condition and prognosis. Thus, a modern, effective approach to managing patients with HF and different LVEF necessarily includes the use of SGLT-2 inhibitors, which have sufficient evidence for their use in this category of patients.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"123 31","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antenatal dexamethasone treatment and long-term programming","authors":"A. V. Shaitarova, L. A. Suplotova","doi":"10.21518/ms2024-035","DOIUrl":"https://doi.org/10.21518/ms2024-035","url":null,"abstract":"Introduction. Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD) is one of the most common autosomal recessive disorders, affecting 1:9000-1:15000 live births. During the last twenty years in most countries prenatal DEXtreatment has been used to prevent genital virilisation and androgen excess outcome on sex brain differentiation of XX-foetus with 21-hydroxylase deficiency. Fetal DEX-treatment for the prevention of prenatal virilization of genitalia in girls affected by classic congenital adrenal hyperplasia (CAH) has been used in many medical centers worldwide since the mid-1980s. The treatment is effective in reducing virilization, but the potential long-term outcome has only been investigated in a minority of treated cases.Aim. To study possible long-term effects of prenatal glucocorticoid treatment on children cognition and physical development.Materials and methods. The prospective research of intellectual development patterns of 288 children from mothers prenatally treated with dexamethasone, and of 107 children (the observational group) from mothers, not treated with dexamethasone, with high biochemical markers of adrenal hyperandrogenism.Results. Significant differences of frequency of overweight and obesity (p = 0.04); of intellectual quotients (p = 0.0004) in schoolaged children have been revealed in the treatment group vs observational group. The level of general intelligence of school-aged children whose mothers have been treated with dexamethasone in I and II trimesters of pregnancy is considerably lower than that of children from the observational group (p = 0.004; p = 0.0005, respectively). The tendency of correlation between IQ quotients of school-aged children and the initiation date of prenatal dexamethasone treatment has been established (r = 0.27; p = 0.004).Сonclusion. Prenatal DEX-treatment at an early gestation can result in significant adverse effects on intellectual abilities and physical development of children furtheron. ","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"110 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional hypogonadism in men: key causes and neuroendocrine mechanisms of its development","authors":"V. Salukhov, S. V. Aisaeva","doi":"10.21518/ms2024-210","DOIUrl":"https://doi.org/10.21518/ms2024-210","url":null,"abstract":"Modern concepts of hypogonadism in men are undergoing significant transformation. The concept of functional hypogonadism, which is gaining increasing support among expert communities today, is based on the reversibility of symptomatic hypotestosteronemia after eliminating the causal factor or disease in men with an intact hypothalamic-pituitary-gonadal system. This makes the diagnosis of functional hypogonadism an exclusion diagnosis of organic hypogonadism, which can be congenital (genetic) or acquired (destructive or structural) irreversible disorder occurring at any level of the hypothalamic-pituitary-gonadal axis. Functional hypogonadism in men is becoming more common, attributed to its association with non-infectious pandemics such as obesity, type 2 diabetes, and other comorbid pathologies. Additionally, age-related hypogonadism meets the criteria of functional hypogonadism, as accumulating age-associated comorbidities have been shown to play a significant role in testosterone decline in aging men. Moreover, excessive physical activity, drastic calorie restriction, high psycho-emotional stress, injuries, surgeries, and the use of certain medications can also be causes of functional hypogonadism. Despite the wide range and heterogeneity of diseases and conditions underlying functional hypogonadism, the mechanisms driving its development are quite similar since in most cases, this androgen deficiency is secondary hypogonadotropic (central). However, in some cases, functional hypogonadism can be primary or mixed. Therefore, understanding the pathogenesis of functional hypogonadism is crucial as it involves a variety of biological pathways depending on the etiological factor or disease, which is detailed through a literature review. The article pays special attention to the evolutionary significance of the phenomenon of functional hypogonadism, an adapted classification of its causes, and describes the achievements of Russian researchers who have studied the impact of acute conditions and extreme influences on the hypothalamic-pituitary-gonadal system in men.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"116 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenylpiracetam: molecular mechanisms of effects in obesity","authors":"O. Gromova, I. Torshin, L. B. Lazebnik","doi":"10.21518/ms2024-204","DOIUrl":"https://doi.org/10.21518/ms2024-204","url":null,"abstract":"Metabolic syndrome (MS), including hyperlipidemia and obesity, is a proven risk factor not only for cerebrovascular diseases. Obesity is a dangerous comorbid condition in patients, complicating cerebrovascular pathology, asthenic conditions, diabetes mellitus, liver disease, alcoholism and other diseases accompanied by dysmetabolic disorders. Fundamental and clinical studies of the nootropic fonturacetam (Actitropil) have shown that the drug can be used not only for a wide range of cerebrovascular diseases, asthenia, etc., but also for obesity. The mechanisms of action of fonturacetam in producing pharmacological effects that reduce excess appetite and prevent the accumulation of excess body weight were studied in chemoreactomic analysis. Regulation of the metabolic effectiveness of Phenylpiracetam is based on multi-level correction of target transmitters and receptors that control the metabolism of fats and carbohydrates (influence on leptin, cannabinoid receptors, adrenoreceptors, peroxisome receptors). Phenylpiracetam activates the adrenaline, adenosine, glucagon-like peptide, sphingosine phosphate and peroxisome proliferators (PPARG) receptors and inhibits the cannabinoid, opioid, histamine, glutamate, nociceptin, orexin, neuropeptide Y receptors. The resulting pharmacological properties indicate important pathophysiological effects of phenylpiracetam for the treatment of obesity. A decrease in the rate of fat mass gain when taking Phenylpiracetam is noted due to an improvement in the quality of night sleep. Chemoreactomic analysis of Actitropil indicated new molecular mechanisms of the pharmacological action of the molecule, which reduces excess appetite and prevents the accumulation of excess body weight. Phenylpiracetam (Actitropil) is distinguished by a balance of effectiveness, a high safety profile with no addiction to the drug and safety. Thus, Phenylpiracetam is a racetam that exhibits nootropic, antiasthenic and lipotropic effects.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"122 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}