The review is dedicated to the investigation of the role of A.B. Fokht, who was one of the most famous scientist, teacher and doctor during the period of the development of clinical oriented approach pathophysiology. The article examines new vectors in clinical medicine development of the second half of the 19th century. It is pointed out in the article that Russian scientists of that time instead of aiming at history rewriting or repeating the traditions of the West-European science finally formed their own rational ideas and tried to provide unique scientific research. What is more, the article contains biographical information about Fokht’s family, his teachers and colleagues. The article describes the main principles of Fokht’s scientific school, which became the most remarkable in Russia in the beginning of the 20th century, and also achievements of his followers, who had been working in the largest laboratories and chairs of Great Britain, the USA, Poland etc. Moreover the article contains information about the influence which the results of Fokht’s research had on recognition of Russian independent medical science worldwide. The article emphasizes the Fokht’s political and civil position against the educational and scientific reforms, which had been conducted by the Russian government in the beginning of the 20th century. Finally, the article describes Fokht’s personality and his activities in other spheres.
The role in the body and the biological significance of the pineal hormone melatonin is discussed. Data are presented on the effect on biological rhythms in humans and animals, as well as on the sleep in general. In diurnal humans and animals, melatonin acts on the suprachiasmatic nuclei of the hypothalamus to dampen the wake-stimulating signal of the internal clock, thereby promoting sleep. Data are presented on the clinical use of melatonin in sleep disorders: Circadian Rhythm Sleep-Wake Disorders (jet lag syndrome, delayed sleep phase syndrome, irregular cycle), parasomnias (Rapid-Eye Movements Sleep Behavior Disorder) and insomnia. A significant effect of melatonin preparations with a high level of evidence was confirmed in Circadian Rhythm Sleep-Wake Disorders, less pronounced in Parasomnias. The effects of melatonin, used as a drug for jet lag, have the greatest degree of evidence. The melatonin preparation is recommended to be taken both before the flight and at the new place of stay in accordance with the time of its evening secretion in this time zone. In delayed sleep phase syndrome, the onset of melatonin secretion is delayed, reflecting a general lag in the body’s internal clock. Taking melatonin preparations leads to a shift in the sleep-wake cycle to an earlier time. In REM sleep behavior disorder, melatonin preparations to reduce excessive motor activity are preferred over benzodiazepines, since this disorder manifests itself in people of older age groups, and an undesirable effect on cognitive functions should be avoided. In chronic insomnia, the effect of melatonin significantly exceeds the placebo effect and is most pronounced in people of older age groups.
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