Effectiveness Of Treatment Research Articles

Retinal microvascular phenotypes can track small vessel disease burden and CPAP treatment effectiveness in obstructive sleep apnoea.

Optical coherence tomography angiography (OCT-A) retinal imaging enables in vivo visualization of the retinal microvasculature that is developmentally related to the brain and can offer insight on cerebrovascular health. We investigated retinal phenotypes and neuroimaging markers of small vessel disease (SVD) in individuals with obstructive sleep apnoea (OSA). We enrolled 44 participants (mean age 50.1 ± SD 9.1 years) and performed OCT-A imaging before and after continuous positive airway pressure (CPAP) therapy. Pre-treatment analyses using a generalized estimating equations model adjusted for relevant covariates, revealed perivascular spaces (PVS) volume in basal ganglia associated with greater foveal vessel density (fVD) (p-value < 0.001), and smaller foveal avascular zone area (p-value = 0.01), whereas PVS count in centrum semiovale associated with lower retinal vessel radius (p-value = 0.02) and higher vessel tortuosity (p-value = 0.01). A reduction in retinal vessel radius was also observed with increased OSA severity (p-value = 0.05). Post-treatment analyses showed greater CPAP usage was associated with a decrease in fVD (p-value = 0.02), and increased retinal vessel radius (p-value = 0.01). The findings demonstrate for the first time the potential use of OCT-A to monitor CPAP treatment and its possible impact on both retinal and brain vascular health.

The influence of intervention fidelity on treatment effect estimates in clinical trials of complex interventions: A meta-epidemiological study

BackgroundRandomized clinical trials (RCT) provide the most reliable estimates of treatment effectiveness for therapeutic interventions. However, flaws in their design and conduct may bias treatment effect estimates, leading to over or underestimation of the true intervention effect. This is especially relevant for complex interventions, such as those in rehabilitation, which are multifaceted and tailored for individual patients or providers, leading to variations in delivery and treatment effects. ObjectiveTo assess whether poor intervention fidelity, the faithfulness of the intervention delivered in an RCT to what was intended in the trial protocol, influences (biases) estimates of treatment effects derived from meta-analysis of rehabilitation RCTs. MethodsIn this meta-epidemiological study of 19 meta-analyses and 204 RCTs published between 2010–2020, we evaluated the difference in intervention effects between RCTs in which intervention fidelity was monitored and those in which it was absent. We also conducted random-effects meta-regression to measure associations between intervention fidelity, risk of bias (ROB), study sample size, and treatment effect estimates. ResultsThere was a linear relationship between fidelity and treatment effect sizes across RCTs, even after adjusting for ROB and study sample size. Higher degrees of fidelity were associated with smaller but more precise treatment effect estimates (d= -0.23 95% CI: -0.38, -0.74). Lower or absent fidelity was associated with larger, less precise estimates. Adjusting for fidelity reduced pooled treatment effect estimates in 4 meta-analyses from moderate to small or from small to no negligible or no effect, highlighting how poor fidelity can bias meta-analyses’ results. ConclusionPoor or absent intervention fidelity in RCTs may lead to overestimation of observed treatment effects, skewing the conclusions from individuals studies and systematic reviews with meta-analyses when pooled. Caution is needed when interpreting the results of complex intervention RCTs when fidelity is not monitored or is monitored but not reported.

The effectiveness of surgical and conservative treatment of patients with endometriosis of the uterine scar after cesarean section

Target. To analyze the effectiveness of surgical and conservative treatment of patients with an incompetent uterine scar and endometriosis in the scar after cesarean section.Materials and methods of research. A retrospective analysis of 64 medical records of patients with a uterine scar and endometriosis in the scar for the period from 2021 to 2023 was carried out at the medical center, which is the clinical base of the Department of Obstetrics and Gynecology No. 2 of the Stavropol State Medical University.Results. The analysis showed the high effectiveness of surgical treatment of patients interested in subsequent pregnancies with an incompetent uterine scar and endometriosis in the scar. Conservative treatment given to patients not interested in subsequent pregnancies with an incompetent uterine scar and endometriosis in the scar has also demonstrated its effectiveness.

Predicting Early Treatment Effectiveness in Bell's Palsy Using Machine Learning: A Focus on Corticosteroids and Antivirals.

Facial nerve paralysis, particularly Bell's palsy, manifests as a rapid onset of unilateral facial weakness or paralysis. Despite most patients recovering within three to six months, a significant proportion experience poor recovery. This study utilized six machine learning models to investigate the effectiveness of early treatment in Bell's palsy. We applied data from 17hospitals in Scotland to predict treatment outcomes. Patients were randomized into four groups: Prednisolone (corticosteroids), Acyclovir (antivirals), both, and placebo. Outcomes, defined as full resolution of symptoms, were assessed using the House-Brackmann scale at 3 and 9 months post-treatment. We employed six different machine learning models to predict recovery outcomes and evaluated model performance using AUC, precision, recall, and F1-score. Among 493 patients, 72.6% recovered after three months and 89.5% after nine months. Logistic regression demonstrated the highest predictive performance for both 3-month (AUC = 0.751) and 9-month recovery (AUC = 0.720). Additionally, several models achieved Precision levels exceeding 0.9. We further employed the best-performing logistic regression for feature ranking, indicating that the patient's age and prednisolone administration are the most significant predictors of recovery. The results highlight the potential of machine learning models in predicting the effectiveness of early treatment. This study conducted a comprehensive comparison of six different machine learning models, with the logistic regression showing the highest predictive performance for both 3-month and 9-month recovery. Additionally, feature ranking using logistic regression supported the importance of Prednisolone in treatment. Notably, our findings revealed the significance of age in prognosis evaluation for the first time. This suggests that future research should further develop age-specific prognostic models, enabling clinicians to tailor individualized treatment strategies more effectively. This previously unrecognized discovery provides a foundation for prognostic analysis in Bell's palsy patients.

The impact of Charcot-Leyden Crystal protein on mesothelioma chemotherapy: targeting eosinophils for enhanced chemosensitivity

In mesothelioma (MPM), clinical evidence indicates that the absolute eosinophil count negatively correlates with overall survival and response to standard chemotherapy. Since eosinophils poorly infiltrate MPM tumours, we hypothesised that endocrine rather than paracrine pathways mediate the therapeutic response. We thus studied the effect of eosinophil-associated factors on response to chemotherapy in mesothelioma. The culture supernatant conditioned by primary human eosinophils was added to mesothelioma cells in presence of the standard chemotherapeutic regimen. The effectiveness of an anti-eosinophil treatment was evaluated in a preclinical model of C57BL/6 mice transplanted with mesothelioma tumour cells. Supernatant of eosinophils differentiated from EOL1 cells or directly isolated from peripheral blood inhibited apoptosis induced by cisplatin and pemetrexed in 2D cultures and in spheroids. Transcriptomic analysis indicated that the anti-apoptotic effect mediated by eosinophils involved molecular interactions with the Charcot-Leyden Crystal protein or Galectin-10 (CLC-P/Gal10). The functional relevance of CLC-P/Gal10 was demonstrated by antibody-mediated depletion. Recombinant human CLC-P/Gal10 mimicked the anti-apoptotic activity of eosinophil-derived supernatants. In the mouse model, eosinophilia did not significantly affect tumour growth but altered the response to chemotherapy. Finally, pretreatment of eosinophilia with the anti-Siglec-F antibody before chemotherapy restored the effectiveness of the treatment. This study provides a mechanistic rationale to clinical evidence correlating the poor outcome of patients with mesothelioma and with eosinophil-derived CLC-P/Gal10, opening new prospects for intervention in this fatal solid tumour. Belgian Foundation against Cancer, Fonds National de la Recherche Scientifique (FNRS), Télévie, Foundation Léon Fredericq, ULiège.

Benralizumab: Effectiveness in Patients with Uncontrolled Severe Eosinophilic Asthma at 6 and 12 Months at a Third-Level Care Hospital. Capacity for ICS-LABA Therapy Reduction.

Asthma is a health condition with worldwide relevance, evaluated based on the necessary treatment to control symptoms and exacerbations. Severe asthma is uncontrolled despite high doses of ICS-LABA and treatment for triggering factors. Severe eosinophilic asthma is characterized by an increase in eosinophils in the peripheral circulation, walls, and passages of the respiratory tract. Biologic treatments such as benralizumab have demonstrated effectiveness as aids in decreasing respiratory tract inflammation and improving the management of symptoms in patients living with asthma. To assess the efficacy and safety of benralizumab as an add-on therapy for patients with severe, uncontrolled asthma and elevated blood eosinophil counts. Observational, analytic and ambispective study in 21 patients diagnosed with severe eosinophilic asthma treated with benralizumab, to determine the treatment's effectiveness through the change in estimated respiratory function by spirometry through the forced expiratory volume in one second (FEV1) value, reduction in second controlling treatment, serum eosinophil reduction, change in the Asthma Control Test score and the Asthma Control Questionnaire test at 6 and 16 months of treatment. An average difference of 241.43 mL (±461.43) in FEV1 at 6 months was found, as well as an average FeNO reduction of 49.8 ppm and eosinophil reduction of 612.78 cells at 12 months of treatment, additionally, CSI requirements were reduced in 95% of patients. Benralizumab improved respiratory function as well as key biomarkers such as eosinophil count, exhaled nitric oxide fraction (FeNO), which reflected in a decreased requirement of inhaled corticosteroids and improved symptom control.

Personalized decision-making for vascular access creation in hemodialysis.

Selecting the appropriate kidney replacement therapy (KRT) is crucial in order to secure optimal care for chronic kidney disease (CKD) patients with end-stage renal disease (ESRD). Next to renal transplantation, the choice of dialysis modality directly affects patient well-being, treatment effectiveness, and long-term outcomes.1 Therefore, clinical decision-making must take into account a range of factors to tailor decisions to each patient's unique needs. Previously, when the dialysis population was less diverse and resources more limited, straight-forward algorithms could be effectively implemented both for selection of KRT as well as for hemodialysis (HD) vascular access (VA). Recently, the growing ESRD population with more elderly being considered for dialysis care together with improved treatment opportunities have resulted in more challenging decision-making where on-size-fits-all strategies are being replaced by more tailored and personalized strategies aimed to ensure "the right dialysis access - to the right patient - at the right time - for the right reason." In this review, recent trends enforcing a more personalized approach in the selection of VA for HD are summarized and discussed, where these concerns have become especially relevant.

Three-dimensional conformal radiation therapy with concurrent chemotherapy for stage III non-small cell lung cancer: protocol for a systematic review and meta-analysis

IntroductionLung cancer continues to be a common form of cancer worldwide and a primary contributor to cancer-related fatalities. Non-small cell lung cancer (NSCLC) is the most prevalent form, making up...

In Vitro Modeling of Idiopathic Pulmonary Fibrosis: Lung-on-a-Chip Systems and Other 3D Cultures.

Idiopathic pulmonary fibrosis (IPF) is a lethal disorder characterized by relentless progression of lung fibrosis that causes respiratory failure and early death. Currently, no curative treatments are available, and existing therapies include a limited selection of antifibrotic agents that only slow disease progression. The development of novel therapeutics has been hindered by a limited understanding of the disease's etiology and pathogenesis. A significant challenge in developing new treatments and understanding IPF is the lack of in vitro models that accurately replicate crucial microenvironments. In response, three-dimensional (3D) in vitro models have emerged as powerful tools for replicating organ-level microenvironments seen in vivo. This review summarizes the state of the art in advanced 3D lung models that mimic many physiological and pathological processes observed in IPF. We begin with a brief overview of conventional models, such as 2D cell cultures and animal models, and then explore more advanced 3D models, focusing on lung-on-a-chip systems. We discuss the current challenges and future research opportunities in this field, aiming to advance the understanding of the disease and the development of novel devices to assess the effectiveness of new IPF treatments.

Brief Report: Clinical Characteristics and Outcomes of Patients with Thoracic SMARCA4-Deficient Undifferentiated Tumors

IntroductionThoracic SMARCA4-deficient undifferentiated tumors (SMARCA4-UTs) are a recently-defined group of aggressive cancers in which the effectiveness of standard treatments for lung cancer is unknown. MethodsWe collected clinical, pathological, and demographic variables from 5 institutions for patients whose tumors met criteria for SMARCA4-UTs (undifferentiated morphology and loss of SMARCA4/BRG1 by immunohistochemistry). ResultsWe identified 92 patients with SMARCA4-UTs; 58 (63%) had stage IV disease at diagnosis, and 16 (17%) developed recurrent/metastatic disease after initial diagnosis. Median overall survival (OS) from metastatic diagnosis was 7.3 (95% CI: 4.6-12.8) months. Of patients with metastatic disease, 58 (78%) received first-line systemic treatment. Most commonly, patients received chemo/immunotherapy combination (41%), chemotherapy alone (33%), or immunotherapy alone (16%). Median progression-free survival (PFS) from start of systemic therapy was 1.9 (95%CI: 1.4-14.5) months for chemo/immunotherapy, 1.6 (95%CI: 1.1-5.8) months for chemotherapy, and 3.3 (95%CI: 1.2-undefined) months for immunotherapy alone. Five patients had durable responses (≥ 2 years); all received immunotherapy as part of first-line regimens. Nine (16%) of 55 tumor samples tested had PD-L1 expression ≥50%, with 24 (44%) negative samples. Tumor mutational burden was available in 48 cases (52%), median was 10.5 (range 2-48) mutations/megabase. ConclusionsThis multi-institution retrospective cohort analysis revealed a population of patients with short PFS to standard therapies and poor OS. A few patients demonstrated remarkable response to regimens including immunotherapy. Prospective clinical studies are urgently needed to identify better therapeutic approaches to treat this aggressive malignancy and this analysis may serve as a benchmark for future clinical trial design.

Real-World, Observational, Retrospective Study to Evaluate the Effectiveness and Safety of Treatment with Sorafenib in Patients with Advanced Hepatocellular Carcinoma

Background: Hepatocellular carcinoma (HCC) accounts for approximately 90% of liver cancer cases. Sorafenib, the first drug to demonstrate survival benefits for advanced HCC, was validated through the SHARP randomized clinical trial (RCT). While RCTs are essential for assessing new therapies, real-world studies provide additional insights into their effectiveness in routine clinical practice. This study aimed to evaluate sorafenib’s real-world effectiveness by analyzing overall survival (OS) and the time to radiological and symptomatic progression. Methods: Data from 368 patients treated with sorafenib at a Brazilian Cancer Center between 2009 and 2020 were retrospectively reviewed. Results: The median OS was 9.6 months, and the time to radiological progression was 5.3 months, similar to the SHARP trial. However, the time to symptomatic progression was shorter (2.3 months) than the SHARP study (4.1 months). In terms of safety, 27.4% of patients presented clinically relevant toxicities, and 24.5% needed to discontinue treatment due to toxicity. Conclusions: Overall, sorafenib demonstrated effectiveness in the studied population, with OS and radiological progression times comparable to SHARP study results. The difference in symptomatic progression may be due to the study’s retrospective nature and limitations.

Digital Models and 3D Biomechanics Analysis in Orthodontics. Part 1: Vector Calculations

Biomechanics is essential for optimizing orthodontic appliances and controlling dental movement. Charles J. Burstone pioneered a three-dimensional (3D) approach in orthodontics, advocating for a shift beyond appliance-focused methods. Initially, biomechanics studies were constrained to two-dimensional (2D) analysis due to the complexities of 3D evaluation. Despite progress in computational tools and digital modeling, orthodontic biomechanics has largely maintained a 2D orientation. This paper advances orthodontic biomechanics into 3D, re-evaluating concepts previously limited to 2D frameworks. A dedicated software, DDP-Ortho (Ortolab, Poland), is introduced to enable orthodontists to analyze and resolve biomechanical challenges in 3D, facilitating appliance designs with precise 3D force systems. The representation and calculation of force vectors and moments in 3D are detailed, emphasizing the inherent complexity absent computational support. Key processes such as vector subtraction and addition, fundamental for assessing and refining orthodontic force systems, are explained. Additionally, the vector split (couple replacement) method, previously described in 2D, is extended to 3D, addressing the unique constraints and challenges of this approach. These tools promise to refine the accuracy and effectiveness of orthodontic treatments, setting the stage to examine the interactions between 3D force systems and dental movement, which will be addressed in a subsequent paper, to broaden the potential of contemporary orthodontic therapy.

A Retrospective Comparison Between Home and in-Office NB-UVB Efficacy for Patients With Mycosis Fungoides.

This study addresses the gap in research comparing the effectiveness between home and in-office narrowband ultraviolet B (NB-UVB) phototherapy for the treatment of mycosis fungoides (MF). Elderly and disabled patients with this condition disproportionally lack access to home units due to insurance denial. A retrospective review included patients diagnosed with MF or Sezary syndrome who underwent either in-office or home UVB between 2016 and 2023. Eighty-four patients used home NB-UVB, while 75 used in-office. Clinical characteristics, treatment response, and access were evaluated. Overall, there was no significant difference in response rates between home and in-office NB-UVB phototherapy. Subgroup analysis based on adjuvant treatment revealed a significant difference in clinical response rates for patients using NB-UVB with topicals (p = 0.008) and NB-UVB with multiple systemic therapies (p = 0.04). Financial and time constraints were the most common cause of treatment discontinuation for in-office patients (28%). The effectiveness of home NB-UVB treatment is comparable, if not superior, to in-office treatment, likely attributed to treatment ease in access and compliance. Medicare and other health insurance companies should expand coverage to include home-based phototherapy for patients with MF, a potentially fatal cancer with a relative paucity of effective alternate therapies.

MASSIVE GASTROINTESTINAL STROMAL TUMOR OF THE STOMACH. CLINICAL CASE

Gastrointestinal stromal tumors (GIST) are rare overall but the most common malignant mesenchymal tumors in the gastrointestinal tract. The decisive factor for the diagnosis in addition to objective symptoms is the expres­sion of the proto-oncogene KIT (CD117) receptor. The most common treatment is surgical resection, preceded by neoadjuvant therapy. In this clinical case we present a 55 year old patient’s who is diagnosed with a giant gastric GIST, effectiveness of systemic treatment.

Effectiveness of 8-week TReatment with vortioxetine on depressive symptoms in major depressive disorder patients with comorbid generalized anxiety disorder in UAE (TRUE)

BackgroundMajor Depressive Disorder (MDD) is a leading cause of disability and results in excessive utilization of healthcare resources worldwide. The Middle East and North Africa (MENA) region shows a high prevalence of depressive disorders. Generalized Anxiety Disorder (GAD) and MDD have the highest rate of comorbidity of all mood and anxiety disorders, ranging from 40 to 98% in drug studies. Comorbid GAD results in more significant impairment in MDD and increases the severity of symptoms. Although several clinical trials supported the safety and effectiveness of vortioxetine, no data regarding these aspects has been revealed in the MENA region. This study aimed to assess the safety and efficacy of vortioxetine in patients with comorbid GAD in the United Arab Emirates (UAE).MethodIn a multicenter observational study, 118 patients with confirmed anxiety and depressive disorders were evaluated over four visits (baseline visit, two weeks, four weeks, and eight weeks) using MADRS and HAM-A scales to assess depression and anxiety severity, respectively by calculating mean change and the percent using Kendall’s W test.ResultsA significant mean difference in MADRS score was observed, with a gradual decrease of mean MADRS total scores over the assessment weeks (p < 0.001) as well as in HAM-A scores, from severe to moderate-severe anxiety through the four visits (p < 0.001). Furthermore, only one case was reported as a serious side effect. Nausea and insomnia were the most predominant side effects reported among the studied population.ConclusionVortioxetine was found effective and safe among patients with MDD and comorbid GAD.

Construction and evaluation of transdermal delivery system of terbinafine-loaded plant exosomes for the treatment of cutaneous fungal infections

Local transdermal of antifungal agents is a problem that limits the effectiveness of clinical treatment of dermatomycosis. In this study, cucumber-derived plant extracellular vesicles (PEV) were extracted and loaded with the antifungal drug terbinafine (TBF) to form TBF-PEV, which was applied locally to the site of skin fungal infection to improve the transdermal transport capacity of TBF and the antifungal effect in vitro and in vivo. Chemical enhancer and physical enhancer methods were replaced by low immunogenicity and non-irritating PEV. TBF-PEV caused obvious curling and wrinkling in the skin, induced changes in the distribution of skin lipids, and changed the structure and content of skin lipids and proteins, thereby increasing the transdermal efficiency of TBF. The local drug concentration was increased, and the antifungal effect was improved in vitro and in vivo. It was first found that PEV inhibited the growth of Candida albicans with high efflux pump expression. In general, this paper has certain significance in local transdermal treatment of fungal skin infections and reversal of fungal resistance.

Enhanced steam-sanitizer strategies for eliminating Listeria biofilms on food-contact surfaces

Food processing equipment contaminated with Listeria monocytogenes is a major cause of listeriosis outbreaks implicated in various fresh produce, highlighting the need for effective surface sanitization strategies to eliminate this pathogen from food-contact surfaces. This study evaluated the effectiveness of steam treatments at temperatures ranging from 100 - 142 °C, with or without chemical sanitizers, against L. innocua (a surrogate for L. monocytogenes) biofilms on stainless steel (SS), polyester (PET), and rubber surfaces. Seven-day-old L. innocua biofilms on these surfaces were subjected to short-time steam treatments at 100, 125, and 142 °C, either alone or in combination with 10 ppm peroxyacetic acid (PAA) or quaternary ammonium compound (QAC). Culturable L. innocua cells were then detached and enumerated. Results showed that steam treatments exhibited quick killing efficacy during the come-up time (CUT, 8-12 s), regardless of steam temperatures or surface materials. For example, steam CUT at 100 - 142 °C led to reductions of culturable L. innocua of 3.0 - 4.2 log10 CFU/coupon on SS, 2.5 - 2.9 log10 CFU/coupon on PET, and 2.4 - 2.8 log10 CFU/coupon on rubber, respectively. However, killing rates decreased beyond CUT and at extended steam exposure, with more pronounced survival tails on PET and rubber compared to SS. To enhance the eradication of L. innocua biofilms, PAA or QAC at 10 ppm was applied for 1 min, followed by a short (CUT + 6 s) steam treatment at 125 °C, which resulted in ≥ 4.9 log10 CFU/coupon reductions of culturable L. innocua on all surfaces. Rubber surfaces showed the greatest resistance to these hurdle treatments compared to SS and PET. The findings from this study provide effective surface sanitization strategies for the food industry to control L. monocytogenes in processing facilities.

The insights into the activity of the extracts from Polygonum aviculare L. and Pseudomonas fluorescens for enhancing and modeling seed germination and seedling growth of Melilotus officinalis L. Lam

The empirical evidence indicated that chemicals in plants and selected microorganisms can promote the germination process and determine the growth, viability, survival and yield potential of industrial crop plants. The main objective of this study was exploring the phytochemical and microbiological synergistic activity between plant extracts from Polygonum aviculare L. and beneficial bacteria Pseudomonas fluorescens to enhance germination of Melilotus officinalis seeds and improve morphological characteristics of seedlings. The derived plant preparations were analyzed qualitatively, which showed that the aqueous extracts of P. aviculare were characterized by a higher content of phenolic compounds, micro- and macroelements and carbohydrates compared to the macerates, and that no phytohormones were detected in both the infusions and macerates. Pure macerates (MAC), infusions (IF), bacterial cultures (PF) and their mixtures (MAC+PF; INF+PF) were used for seed treatment of test plants. In the control group, lower values of M. officinalis seed germination and seedling growth rates were observed in relation to the applied treatments. The most effective germination rates were obtained after the application of pure infusions (IF) and their mixture with P. fluorescens (IF+PF), while the highest growth rates (including an almost twofold increase in the length of the nostril shoots compared to the control) were obtained after the application of P. fluorescens inoculum (PF) and the mixture of the infusion and these bacteria (IF+PF).The use of modeling, as a tool for predicting germination efficiency, has been shown to provide screening opportunities for identifying the effectiveness of biostimulant treatments. Thereby, this indicates the need to develop such an approach under field conditions.

Development of medicinal and cosmetic cream based on flavonoids

The article discusses the results of the development of a cream based on Populus balsamifera L. bud flavonoids, which have anti-inflammatory, skin-regenerating effects.A cream's anti-inflammatory and wound-healing activity based on a flavonoid substance has been studied. In an experiment on a model of an incised skin wound, it was determined that a cream based on the sum of flavonoids from balsam poplar buds, containing pinostrobin, pinocembrin, tectochrysin, exhibits anti-inflammatory and wound-healing activities. Considering that the effectiveness of local wound treatment mainly depends on the rational treatment of the first phase of the wound process, we have developed a 1 % flavonoid cream and its production technology.The technology for the production of flavonoid cream includes extraction and isolation of the sum of flavonoids from the raw material of Populus balsamifera L. buds, preparation of flavonoid substance and excipients, preparation of the cream base and cream, packaging and labelling of cream. Based on the results of our experiments, a pilot industrial regulation for the production of a new cream based on the sum of flavonoids of Populus balsamifera L. buds has been developed, and pilot production of an original medicinal and cosmetic cream was organised.

Evaluation of the effectiveness and safety of treatments used in patients suffering from chronic obstructive pulmonary disease

Evaluation of the effectiveness and safety of treatments used in patients suffering from chronic obstructive pulmonary disease