Open Controlled Study Research Articles

The effectiveness of therapy with valsartan and hydrochlorothiazide and its effect on the left atrial myocardium condition in women with arterial hypertension in postmenopause

Purpose - to evaluate the effectiveness of the combination of valsartan and hydrochlorothiazide and its effect on the structural and functional parameters of the left atrial myocardium in postmenopausal women with arterial hypertension.Materials and methods. An open prospective controlled study included 100 postmenopausal women with uncomplicated arterial hypertension. Transthoracic and speckle tracking echocardiography was performed on a Vivid E9 XDClear Console 4D Expert 100 ultrasound scanner (General Electric, USA) with ECG-synchronization. Ambulatory blood pressure monitoring was performed using the device ABPM-04 (Meditech, Hungary). After 6 months of treatment with the antihypertensive combination of valsartan and hydrochlorothiazide, all women were re-examined in full. Statistical analysis of the results was performed using the Statistica 13.0 software package. All tests were two-way, statistically significant considered differences at P < 0.05.Results. As a result of our study, office systolic and office diastolic blood pressure in postmenopausal women with arterial hypertension significantly decreased (P < 0.001) due to a 6-month treatment with valsartan and hydrochlorothiazide. The target level of blood pressure, according to office measurements, was reached by 64 % of patients. A significant decrease of the SBP time index in the daytime in 1.6 times (P = 0.012), morning rise of SBP (P = 0.021) and the average pulse blood pressure (P = 0.012) was observed. Analysis of the LA deformation dynamics under the 6-month antihypertensive therapy did not reveal significant changes in the longitudinal strain of the LA in postmenopausal women with AH, unlike left ventricular strain.Conclusions. Combined antihypertensive therapy with valsartan and hydrochlorothiazide in postmenopausal women is effective, safe and well-tolerated. The use of this therapy for 6 months does not significantly affect the size and deformation properties of the left atrium, in contrast to the positive structural and functional remodeling of the left ventricle.

Effect of indapamide and bisoprolol monotherapy on cerebrovascular reactivity in hypertensive patients with rheumatoid arthritis

Aim. To investigate the effect of indapamide and bisoprolol monotherapy on cerebrovascular reactivity (CVR) in patients with combined hypertension (HT) and rheumatoid arthritis (RA).Materials and Methods. A total of 66 patients with HT grade 1-2 and RA (average age of 59.0 ± 7.5 years) were included in an open-controlled randomized study in parallel groups. Group 1 included 33 patients treated with indapamide 2.5 mg/day. Group 2 included 33 patients treated with bisoprolol 6.0 ± 2.6 mg/day. We performed 24-h blood pressure monitoring and transcranial Doppler ultrasound of the middle cerebral arteries (MCA) with assessment of CVR during hyperoxia and hypercapnia tests before and after 24 weeks of treatment.Results. Indapamide treatment improved CVR parameters during hypercapnia test. The MCA peak systolic velocity increased significantly from 53.7 [34.8; 67.8] to 55.8 [37.6; 69.0] сm/s (p = 0.017). Bisoprolol treatment worsened CVR parameters during hypercapnia test. The speed modification of MCA blood flow velocity decreased significantly from 0.10 [0.05; 0.19] to 0.08 [-0.01; 017] cm/s2 (p = 0.032). The index of recovery of MCA blood flow velocity decreased significantly from 1.11 [0.95; 1.27] to 0.84 [0.78; 1.08] (p = 0.006)Conclusion. Indapamide treatment improved CVR parameters, but bisoprolol treatment worsened CVR parameters during hypercapnia test in patients with combined HT and RA.

Contribution of anticoagulant therapy adherence to the risk of complications of atrial fibrillation

Aim.To study compliance and its role in the development of the fatal complications of anticoagulant therapy in patients with atrial fibrillation (AF).Material and methods. Antithrombotic therapy and compliance were studied in an open observational controlled prospective study with 109 AF patients. The dynamics and presence of thromboembolic and hemorrhagic complications were recorded.Results. For the first time in patients with AF, we detected a significantly high relative risk of development of life-threatening and lethal complications of anticoagulant therapy with warfarin with insufficient compliance (RR=8,0; [1,728;37,027]; p&lt;0,05) and drug therapy (RR=70; [1,493;32,819]; p&lt;0,05). At the same time, patients with AF could not detect any links between the level compliance and the risk of treatment with directly acting oral anticoagulants (DAOC) — patients who achieved a common primary endpoint had no association between the relative risk and the level of compliance (RR=1,0; [0,106;9,445]; p&lt;0,05).Conclusion.The study showed for the first time that in patients with AF, the most unfavorable prognostic factor in the development of life-threatening and lethal complications with warfarin taking is low adherence to lifestyle modification and drug therapy. At the same time, in patients with AF, who receive DAOK as anticoagulants, there was no connection between compliance and the development of hemorrhagic or thromboembolic complications.

The influence of BESTFertil towards male reproductive function in idiopathic fertility

The study objectiveis to evaluate the influence of complex BESTFertil on the fertility in men with idiopathic pathospermia.Materials and methods. Ninety males (from 25 to 45years old) took part in the open prospective controlled study: 60 males with idiopathic fertility were given BESTFertil (2 caps “Morning” and 2 caps “Evening” per day for the period of 3 month). Other 30 males belong to controls. The efficacy of therapeutics was evaluated according to spermatogram analysis (volume of ejaculate, sperm concentration, percentage of progressive-motile sperm (grade A + B), and percentage of degenerated forms).Results.After 3 month of treatment the ejaculate volume increased to 1,7 time, and exceeded controls up. The sperm concentration increased to 33 % (before treatment) and exceeded controls to 39 %. The percentage of progressive-motile sperm (grade A + B) was 6 times more as it was before treatment, and 89,8 % as compare to the controls. The percentage of degenerated forms of spermatozoids decreased to 32,3 % (before treatment) and was 2,9 % less then in the control group.Conclusions. Administration of BESTFertil in treatment plan of male idiopathic fertility may consider to be a promising type of therapy, which increased the records of spermatogram and promotes conception among the married couples.

Influence of Eclipta alba on serum alanine aminotransferase and aspartate aminotransferase activity in rabbits

Background: Paracetamol is a recognized antipyretic, analgesic drug which produces hepatic necrosis in high doses. Eclipta alba elaborates a vast array of biologically active compounds that are chemically diverse and structurally complex.Methods: Randomized open controlled experimental study Estimated levels of Serum aspartate aminotransferase (AST), Serum alanine aminotransferase (ALT) and Hepatoprotective action of in High doses of Paracetamol on serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activity.Results: ALT in all the groups including Control group (A) was (51.8±4.56IU/L). Paracetamol treated group (B) the ALT level increased at 48 hours and continued to be high up to 60 days (136.4±20.73IU/L) then decreased to (113.7±11.35IU/L) at 90 days. AST in all the groups including Control group (A) was (22.5±1.23IU/L). Appropriate antioxidant in appropriate doses as a matter of routine whenever hepatotoxic or potentially hepatotoxic drugs are prescribed. In Paracetamol treated group (B) the AST level increased at 48 hours and continued to be high up to 60 days (99.4±9.73IU/L) then decreased to (85.4±7.39IU/L) at 90 days.Conclusions: Appropriate antioxidant in appropriate doses as a matter of routine whenever hepatotoxic or potentially hepatotoxic drugs are prescribed.

Computational technology of daily blood pressure monitoring results comparison in patients with arterial hypertension

The evaluation of treatment effectiveness and further patient with arterial hypertension (AH) monitoring require the target level of arterial pressure achievement and its control by means of daily monitoring of blood pressure (DMBP).Purpose of the work involves development, software implementation and practical approval of computational technology in order to compare the results of patient’s two daily monitoring of blood pressure (DМBP).Material and methods. The open controlled study included 10 patients with AH at the third stage in long term after a cerebral stroke. Patients were treated according to the regulatory basis. DBPM was conducted using device АВРМ-01 (Meditech, Hungary) twice (before the treatment and after 1 year).Results comparison of the first and repeated DMBP was carried out by means of proposed computational technology and its own software ArtHyper in which the technology was implemented. The technology is based on the comparison of DMBP indices distribution functions using the two-sample Kolmogorov test and the Wilcoxon test.Results. The proposed technology work was demonstrated in terms of two patients. The target level of arterial pressure was achieved only for the first patient. The majority of DMAT indices distribution for this patient did not change in a year, in other words, the blood pressure and heart rate remained stable due to the treatment. The level of PBP slightly decreased, but in this case it was a positive factor. The second patient didn’t follow the complete course of treatment and didn’t achieve the target level of blood pressure. His levels of diastolic blood pressure and heart rate increased.Conclusions. The computational technology of two patient’s DMBP results comparison was developed. Its practical testing was carried out on real data and demonstrated the effectiveness of technology to detect changes in the second results monitoring and the possibility of its application for the evaluation of rehabilitation and treatment efficiency in patients with arterial hypertension.

MONITORING OF THE EFFICACY AND SAFETY OF HIGH-DOSE ATORVASTATIN IN ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

Aim. To study the effectiveness of achievement of lipid profile target levels and safety of therapy with atorvastatin in different doses in patients with acute ST-segment elevation myocardial infarction (STEMI). Material and methods. The open prospective controlled single-center study included 90 patients with STEMI aged 32 to 65 years. In the first 24-96 hours from the disease onset the patients were randomized into two groups: the first group included 43 patients who received high-dose statin therapy – atorvastatin 80 mg/day (Group 1), the second group (Group 2) – 47 patients receiving atorvastatin 20 mg/day. Examination of patients with STEMI included the assessment of plasma lipid profile, blood levels of hepatic transaminases, creatine phosphokinase (CPK), C-reactive protein (CRP), brain natriuretic peptide (BNP), creatinine, glucose and glomerular filtration rate calculation. Results. A decrease in the level of low density cholesterol (LDC) by 52.4% (p 50% from the baseline – in another 26%. LDC decreased by 33% in Group 2 (p 50% – in 15% of patients. After 24 weeks, a statistically significant decrease in hepatic transaminase activity was found in the both groups in comparison with the baseline level. The level of CRP decreased 9.1 times (p<0.001) in Group 1, and 7.8 times (p<0.001) – in Group 2. Reduction in the level of BNP was also found in Group 1 by 60% (p=0.005), and in Group 2 – by 33.8% (p<0.001). The levels of CPK, creatinine and GFR in the both groups did not change. A comparable decrease in fasting glycemia was found after 24 weeks in the both groups. Conclusion. The revealed lipid-lowering and pleiotropic effects confirm the necessity of using atorvastatin 80 mg. The absence of changes in the level of transaminases, CPK, serious adverse effects indicates the safety of the use of high-dose statin therapy in STEMI patients for the secondary prevention of cardiovascular events.

Assessment of the Impact of a Sports Kit on Physical Activity in Children 8 to 11 Years of Age

Objective: Fewer than 10% of French children meet the WHO recommendations for physical activity (PA). As engaging in play activities is a key way to promote PA in children, we evaluated the effect of a sports kit called “Le Sport Ca Me Dit” (“Sport is fun”) that provides a recreational way to engage in sports. Design: This was an open longitudinal controlled study. The children were divided into two groups for the first 7 weeks (Period 1): an Action group that used the kit for two recreational sessions per week (comprising six different activities) and a Control group that was not provided use of the kit. For the next 7 weeks (Period 2), neither group was provided use of the kit. Setting: Six towns in northern France. Subjects: 213 children aged 8-11 were recruited: 122 for the Control group and 91 for the Action group. Each child received a 3D accelerometer wristband to measure their level of PA during the 14 weeks of the study. In parallel, the children completed a questionnaire, 3 times (before (T0), during (T1) and at the end of the study (T2)), regarding their PA habits, screen time, and sleep habits. Results: A significant increase in the steps number was observed when the sports kit was used (p=0.025); although this effect was lost over time (p=0.672). Subpopulation analysis revealed a significant increase in the steps number and light PA in overweight children in the Action group for both periods (p=0.018 and p=0.012). Conclusion: The use of the sports kit increased the PA level of the children, and particularly in overweight children. Although these results require further investigation, they provide novel insights in regard to overweight children.

Monitorización intraoperatoria del bloqueo neuromuscular y la presión arterial con un solo dispositivo (TOF-Cuff): estudio comparativo con la mecanomiografía y la presión arterial invasiva

ObjectiveThe overall objective of the study is to determine the ability of TOF-Cuff device (blood-pressure modified cuff, including stimulation electrodes) to monitor with the same device the non-invasive blood pressure (NIBP) and the depth of a neuromuscular blockade (NMB) induced pharmacologically, by stimulation of the brachial plexus at the humeral level and recording evoked changes in arterial pressure. Material and methodClinical, single-centre, open-controlled study with 32 adult patients ASA I-III for scheduled elective surgery under general anaesthesia in supine position, for the validation of neuromuscular monitoring, comparing the values obtained from neuromuscular relaxation TOF-Cuff with those obtained by mechanomyography (MMG) (control method) during the recovery phase of NMB, when a TOF ratio>0.7 and>0.9 (primary endpoint) were reached respectively. And an additional consecutive study of 17 patients for validation of NIBP monitoring with TOF-Cuff device vs invasive blood pressure measured by an intra-arterial catheter. All data were analyzed using the Bland-Altman method. ResultsRecovery from NMB measured with the TOF-Cuff was earlier compared to MMG. Comparing TOF-ratio>0.9 measured with TOF-Cuff vs TOF-ratio>0.7 with MMG, a specificity of 91% and a positive predictive value of 84% were obtained.In NIBP measurement, the mean error and standard deviation of both systolic blood pressure (1.6±7mmHg) and diastolic blood pressure (−3.4±6.3) were within the European accuracy requirements for medical devices. ConclusionsThe TOF-Cuff device has been shown to be valid and safe in the monitoring of NMB and in the measurement of NIBP, with no patient presenting any adverse events, skin-level lesions or residual pain. It is not interchangeable with MMG, having a TOF-ratio>0.9 quantified by the TOF-Cuff device, a good correlation with a TOF-ratio>0.7 on MMG.

EFFECT OF LISINOPRIL ON 24-HOUR BLOOD PRESSURE AND ARTERIAL STIFFNESS IN PATIENTS WITH ARTERIAL HYPERTENSION AND RHEUMATOID ARTHRITIS

Aim. To study effect of 24-week treatment with lisinopril on blood pressure (BP) and arterial stiffness in patients with arterial hypertension (HT) and rheumatoid arthritis (RA). Material and methods. Twenty patients with essential HT grade 1-2 and RA (mean age 60.2±7.9 years) were treated with lisinoprilin 24 weeks in open controlled study. Office blood pressure (BP) was 147.2±9.4/87.5±8.6 mm Hg; 24-h mean BP – 141.8±9.3/82.2±9.6 mm Hg; HT duration was 14.5±9.4 years, and RA duration – 12.3±2.6 years. A high incidence of traditional cardiovascular risk factors was identified: 95% of patients had dyslipidaemia, 45% – obesity, 35% – impaired glucose tolerance. Atherosclerosis of carotid arteries with stenosis less than 25% was diagnosed in 65% of patients. Most patients had a positive rheumatoid factor and cyclic citrullinated peptide antibodies, as well as moderate RA activity and III-IV radiologic stage of RA. All patients received methotrexate as the basic anti-inflammatory drug, 12 (60%) patients – selective cyclooxygenase-2 inhibitors, 6 (30%) patients took corticosteroids equivalent to prednisolone 7.5±5.5 mg per day. Mean dose of lisinopril was 12.2±9.8 mg/day. Office BP measurements, 24-hour ambulatory BP monitoring (ABPM), and arterial stiffness evaluation were performed initially and at the end of the study. Arterial stiffness was assessed by cardio-ankle vascular index on the right (R-CAVI) and on the left (L-CAVI). Results. After 24-week therapy with lisinopril office systolic and diastolic BP significantly decreased by 16.0±7.2/11.6±9.1 mm Hg (p<0.0001) and 11.6±9.1 mm Hg (p<0.0001), respectively. The target BP was achieved in 16 (83%) patients. According to the ABPM 24-week therapy with lisino pril led to a significant (p<0.002) decrease in BP for all referable periods: by 12.4±9.1/7.6±3.9 mm Hg within 24 hours; by 13.4±10.1/8.0±6.1 mm Hg for daytime; by 10.1±9.3/7.3±6.3 mm Hg for night-time. After lisinopril treatment, R-CAVI decreased from 8.9±1.7 to 8.4±1.6 relative units (p=0.011), L-CAVI decreased from 8.9±1.6 to 8.4±1.5 relative units (p=0.003). Conclusion. In patients with combination of HT and RA, 24-week therapy with lisinopril had a significant antihypertensive effect and improved the elastic properties of the vessels.

Blended internet care for patients with severe mental illnesses: An open label prospective controlled cohort pilot study

IntroductionThis paper reports first experiences while providing blended (combined face-to-face and internet-based) flexible assertive community treatment (FACT) to outpatients with severe mental illnesses (SMI). The aim was to compare treatment satisfaction, clinical outcome and quality of life in the short term (3months) of patients receiving blended FACT with those receiving conventional FACT. MethodThis pilot study was designed as an open label prospective controlled cohort study. 47 SMI patients were found eligible and non-randomly allocated to Blended FACT (n=25) or to conventional FACT (n=22). Data were collected at baseline and at a 3-month follow-up. Measures included were the Dutch Mental Health Care Thermometer, Health of the Nation Outcome Scales (HONOS), Manchester Short Assessment of Quality of Life (MANSA), EuroQoL 5 dimensional (EQ5D) and the Mental Health Confidence Scale (MHCS). ResultsAt a three months follow-up, patients reported slightly improved quality of life (EuroQoL 5 dimensional, Wald χ2(1)=6.80, p=0.01; MANSA, Wald χ2(1)=4.02, p=0.05) and self-efficacy beliefs regarding their mental health problems (MHCS, Wald χ2(1)=3.71, p=0.05). HONOS scores did not change over time, Wald χ2(1)=2.34, p=0.13. Satisfaction scores were on average between satisfactory – good (BI: M=7.50, SD=1.54; CAU: M=7.53 SD=0.96; on a 1–10 scale). These results did not differ between the two study groups. ConclusionIt appears acceptable to patients to provide blended FACT with SMI, with outcomes comparable to face-to-face FACT. A future high quality trial is warranted to establish (cost-)effectiveness of blended FACT.

Effectiveness of Short-Term Dynamic Group Psychotherapy in Primary Care for Patients with Depressive Symptoms.

An open prospective controlled study was designed to compare the efficacy of short‐term dynamic group psychotherapy with the standard treatment in patients with depressive symptoms attended in the primary care setting. A total of 115 patients with depressive symptoms were assigned to receive psychotherapy (75 min) over 9 months (37 to 39 sessions) (n = 70) or the standard care (n = 45). Outcome measures were the differences between baseline and post‐treatment in the 17‐item Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM‐A) and the Short‐Form Health Survey (SF‐12) questionnaire in the two study groups. At the end of dynamic group psychotherapy, statistically significant improvements in the mean scores of all questionnaires were observed, whereas in control patients, significant improvements were only observed in the HDRS‐17 scale and in the Mental Component Summary score of the SF‐12. The mean changes after treatment were also higher in the psychotherapy group than in controls in all outcome measures, with statistically significant differences in the mean differences in favour of the psychotherapy group. In summary, implementation of short‐term dynamic group psychotherapy run by experienced psychotherapists for patients with depressive symptoms attended in routine primary care centres is feasible and effective. © 2016 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.Key Practitioner Message Short‐term dynamic group psychotherapy was delivered as a non‐pharmacological intervention to improve depressive symptoms.Statistically significant differences as compared with a control group were observed in 17‐item Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM‐A) and the Short‐Form Health Survey (SF‐12) questionnaire.Implementation of short‐term dynamic group psychotherapy run by experienced psychotherapists for patients with depressive symptoms attended in routine primary care centres is feasible and effective.

The possibility of perindopril in angioprotective in patients with metabolic syndrome after combination therapy with a thiazide diuretic

Aim. To assess the possibility of monotherapy with perindopril after transferring from combination therapy with losartan and hydrochlorothiazide with respect to correction of the anthropometric, metabolic parameters, premature vascular aging and vascular elasticity in patients with metabolic syndrome. Material and methods. Held open prospective controlled study of 50 patients with metabolic syndrome (IDF, 2005), which reached BP

Возможности периндоприла в ангиопротекции у пациентов с метаболическим синдромом после терапии тиазидсодержащей комбинацией

Aim. To assess the possibility of monotherapy with perindopril after transferring from combination therapy with losartan and hydrochlorothiazide with respect to correction of the anthropometric, metabolic parameters, premature vascular aging and vascular elasticity in patients with metabolic syndrome. Material and methods. Held open prospective controlled study of 50 patients with metabolic syndrome (IDF, 2005), which reached BP<140/90 mm Hg during three months of therapy with losartan (50 mg) + hydrochlorothiazide (12.5 mg) with conversion to monotherapy with perindopril 10 mg for 12 weeks. Patients were evaluated anthropometric and metabolic parameters, levels of adipokines, and indices of vascular elasticity and age was estimated on the date of the transfer with casinadirosa combination monotherapy with perindopril and after 12 weeks thereafter.Results. The results of the study demonstrated the possibility of a transfer with combination antihypertensive therapy monotherapy perindopril patients with metabolic syndrome that contributes to slow vascular aging, improve the elasticity of blood vessels, reduces inflammation and has a beneficial impact on adipokines.Conclusion. When achieved BP<140/90 mm Hg on combination with a thiazide diureticpossible in patients with MS monotherapy perindopril with consequent improvement in elasticity of blood vessels and of adipokines.

Working Memory Training in Children with Neurodevelopmental Disorders

In a naturalistic open label non-randomized controlled intervention study, Cogmed© working memory (WM) training effects were compared between different groups of children (n = 99; 65 boys, 34 girls), aged between 7 and 17 years with neurodevelopmental problems, i.e. ADHD (n = 45), learning disorders (LD, n = 34) or learning problems (n = 20). Training efficacy after 25 sessions was measured by WM capacity improvement, ADHD DSM-IV rating scale and the BRIEF. It was hypothesized that training effects may lie on a continuum with those of the LD group at the lower end and those of the learning problems group at the upper end. Results partly confirmed the hypothesis in that all groups improved significantly with ADHD-children or children with learning problems showing the best results.

Acute rhinosinusitis: basic misconceptions and the possibilities of standardized phitotherapy

The article tells about the effects of herbal medicines in the treatment of acute rhinosinusitis. Pharmacological advantages of myrtol standardized are demonstrated which, besides exhibiting mucoactive action, also provides an anti-inflammatory, antioxidant and antibacterial effect. Results of an open controlled study of the efficacy and tolerability of GeloMyrtol® Forte in the course of treatment of acute and exacerbated chronic rhinosinusitis are demonstrated, which provide evidence that GeloMyrtol® Forte is recommended as monotherapy for acute mild rhinosinusitis.

Evaluación clínica de dos preparados bifásicos y un trifásico a base de norgestrel/etinilestradiol

458 mujeres fueron evaluadas durante 3585 ciclos en un estudio controlado randomizado y abierto, diseñado para comparar dos preparados bifásicos y un trifásico a base de Norgestrel/Etilnilestradiol. Los tres preparados son anticonceptivos efectivos y no se registraron gestaciones. El control del ciclo fue bueno con los tres, pero la incidencia de sangrado intermensual fue ayor con el trifásico. Con este preparado la ingesta hormonal total está bien por debajo de la dosis fija más baja de Norgestrel/Etinilestradiol como preparación combinada (300 mcg. Norgestrel más 30 mcg. EE) en la proporción original 10:1. Se concluye que el tambaleo de dosis hormonales abre la posibilidad de anticoncepción con menor ingesta hormonal de lo que es posible cuando se utiliza un regimen a dosis fija.

Оценка эффективности и безопасности применения имихимода в лечении субклинических и клинических проявлений персистирующей папилломавирусной инфекции шейки матки у пациенток раннего репродуктивного возраста

Objectives. HPV infection is a major risk factor for cervix cancer. This study evaluated cervical application of imiquimodfortreatment of subclinical (flat condyloma) and clinical (CIN I, LSIL) manifestations of human papillomavirus infection. Methods. An open controlled study (n=28) efficacy and safety of imiquimod (5% cream Aldara) in 1-2 months. Results. All patients treated had complete clinical responses. Clinical efficacy of treatment at 1 month was 96,4%, in 2 months - 100%. Microbiological efficacy (full HPV-clearance) achieved in 60,7% of cases, in other cases there was a decrease in viral load. Elimination of the 16 types of virus was achieved in 80% of cases. Immunocytochemical study showed higher levels of expression of Toll-like receptor 4 and 9 type in the endo - and ectocervix after treatment. Undesirable effects were not grounds for termination of treatment.Conclusions. The trial does support the feasibility and acceptability of the use of imiquimod on the cervix in treatment of manifestations of human papillomavirus infection.

The Effects of Life Line Facial Cream/Periobitum Serum and Micro-Needling of Photodamaged Skin: A Split-Face Randomized Study

Background: Human growth factors serve as secretomes that regulate skin cell proliferation/differentiation and production of extracellular elements of the matrix and treat photo-aging. Microneedling of skin can also improve aging skin by facilitating normal wound healing of the temporary dermal conduits for therapeutic and cosmetic benefits. Objectives: This open, randomized split-face and single-center controlled study evaluated the safety and efficacy of the application of a cosmeceutical formulation, which incorporated growth factors derived from cultured pluripotential stem cells of unfertilized human ovum, in the treatment of photo-damaged facial skin. The use of micro-needling to stem cell-treated skin was evaluated for additional benefit. Material and Methods: Ten subjects in Group 1 with mild-to-moderate photo-damaged skin received the growth factor emulsion to one side of the face and serum to the eyelids/periorbitum and placebo on the contralateral side for twelve (12) weeks. Ten subjects in a separate Group 2 with similar photo-damaged skin received the same growth factor emulsions and serum to both sides of the face and eyelids/periorbitum, but only one side was treated with four micro-needling procedures four weeks apart. Subjects in Group 1 were assessed at baseline, 6 weeks and 12 weeks with the Canfield VISIA Investigator System and standardized 2D photography. Subjects in Group 2 were similarly assessed with the addition of the DermaLab Cortex System. Data analysis compared the p-values with the alpha level for statistical difference. Results: Group 1 subjects demonstrated a beneficial effect by VISIA Analysis on reduction of pigmented spots, UV-light damage with more effective effacement of wrinkles and textural changes after three months compared with that observed on the placebo side. Group 2 subjects demonstrated more improvement by VISIA Analysis in reduction of pigmentations, UV-light damage, porphyrin spots, and wrinkles with more textural smoothness with combined treatments than with cosmeceutical application alone. Cortex Analysis of skin, receiving combined treatments, demonstrated marked improvements in skin elasticity and hydration observed after cosmeceutical application alone. Conclusions: The used growth factor-containing creams and serum have a salutary effect on photodamaged skin whose effects may be further enhanced with the addition of micro-needling without introduction of side-effects or complications. Further investigations with a larger cohort of subjects for longer treatment periods will be needed to confirm and extend these initial findings.

Rational Choice of Treatment for Initial Stages of Gonarthrosis in Patients with Systemic Osteoporosis

Results of open controlled study of 60 outpatients aged 45-70 years, with systemic osteoporosis (postmenopausal and idiopathic) and I-II stages of gonarthrosis by Kellgren - Lawrence classification are presented. All patients were divided into 2 groups: study group (n=30) and control group (n=30). Additional treatment for gonarthrosis (Artra drug for 3 months) was prescribed only to patients from the study group. It was shown that study drug decreased significantly (p