[Clinical and neurophysiological manifestations of sluggish cognitive tempo in children]

OBJECTIVE

To study the clinical and neurophysiological features of children with low cognitive tempo (NCT), as well as the effectiveness of the drug Pantogam in the treatment of this pathology.

MATERIAL AND METHODS

A total of 90 children aged 8 to 10 years were examined. Of these, the main study group consisted of 30 children with NCT, the comparison group consisted of 30 children with a combined type of attention deficit hyperactivity disorder ADHD (ADHD-K), the control group consisted of 30 children without neuropsychiatric disorders. The study used clinical, neurophysiological (electroencephalography (EEG)) and parametric methods. The CMAS scale of apparent anxiety (The Children's Form of Manifest Anxiety Scale), the SNAP-IY scale (assessment of the degree of inattention, hyperactivity and impulsivity), the TOVA computer test (the Test of Variables of Attention), the scale «SCT» (Sluggish Cognitive Tempo) for assessing manifestations of low cognitive tempo, the «RAM» technique for quantifying working memory. Pantogam was used to treat patients at a dose of 750 mg per day for 8 weeks.

RESULTS

Patients with NCT are characterized by more pronounced attention disorders compared with healthy peers and with children with ADHD-K, and they have a decrease in mainly not selective attention, but the overall level of functional activity. Also, the group of children with NCT has an increased level of anxiety compared to the group of children with ADHD. A comparative analysis of the level of impulsivity showed that children with NCT are less characterized by a deficit in inhibition processes. According to the quantitative analysis of the EEG, specific changes in functional activity in the frontal and central regions of the cerebral cortex were revealed (a statistically significant increase in the ratio of absolute theta rhythm to beta1 rhythm, compared with other groups), reflecting insufficient cortical arousal and less focused neural states. When re-evaluating the condition of children with NCT after a course of therapy with Pantogam, an improvement in the form of a decrease in the degree of inattention, the severity of memory impairment and a decrease in reaction time was recorded in 60% of cases. According to quantitative EEG analysis, there was a significant decrease in the ratio of absolute theta rhythm to beta1 rhythm in the central leads of both hemispheres and in the parietal-temporal leads of the left hemisphere, indicating an increase in the level of overall activation of the cerebral cortex after a course of treatment.

CONCLUSION

Clinical and neurophysiological differences were revealed in patients with NCT and with combined ADHD. It has been shown that the use of Pantogam for the treatment of children with NCT leads not only to a decrease in the main manifestations of this disorder, but also to an improvement in the functional state of the brain.

Dexpanthenol ameliorates doxorubicin-induced lung injury by regulating endoplasmic reticulum stress and apoptosis

Doxorubicin (DOX), which is used as a chemotherapeutic agent in the treatment of tumors, has limited use due to its toxicity in various organs and tissues. One of the organs where DOX has a toxic effect is the lung. DOX shows this effect by increasing oxidative stress, inflammation, and apoptosis. Dexpanthenol (DEX), a homologue of pantothenic acid, has anti-inflammatory, antioxidant, and anti-apoptotic properties. Therefore, the purpose of our investigation was to explore how DEX could counteract the harmful effects of DOX on the lungs. Thirty-two rats were used in the study, and 4 groups were formed (control, DOX, DOX + DEX, and DEX). In these groups, parameters of inflammation, ER stress, apoptosis, and oxidative stress were evaluated by immunohistochemistry, RT-qPCR, and spectrophotometric methods. In addition, lung tissue was evaluated histopathologically in the groups. While CHOP/GADD153, caspase-12, caspase-9, and Bax gene expressions increased in the DOX group, Bcl-2 gene expression levels significantly decreased. In addition, changes in Bax and Bcl-2 were supported immunohistochemically. There was a significant increase in oxidative stress parameters and a significant decrease in antioxidant levels. In addition, an increase in inflammatory marker (TNF-α and IL-10) levels was determined. There was a decrease in CHOP/GADD153, caspase-12, caspase-9, and Bax gene expressions and an increase in Bcl-2 gene expression in the DEX-treated group. In addition, it was determined that there was a decrease in oxidative stress levels and inflammatory findings. The curative effect of DEX was supported by histopathological findings. As a result, it was experimentally determined that DEX has a healing effect on oxidative stress, ER stress, inflammation, and apoptosis in lung damage caused by DOX toxicity.

[Use of dexpanthenol in corneal damage]

Issues of regeneration of the cornea, which is the most vulnerable structure of the eyeball, suffering from various diseases and injuries, burns, when wearing contact lenses and glaucoma, are highly relevant for ophthalmologists. It is also necessary to minimize damage and stimulate corneal epithelization during and after the use of steroidal and non-steroidal anti-inflammatory drugs, antibacterial drugs and antiseptics, which have a cytotoxic effect and often inhibit regeneration processes, potentially even leading to the development of corneal epithelial defects. This review analyzes the effectiveness of a promising drug 5% dexpanthenol in terms of improving the reparative processes and the function of epithelial cells.

Non-clinical safety profile and pharmacodynamics of two formulations of the anti-sepsis drug candidate Rejuveinix (RJX)

Here, we demonstrate that the two distinct formulations of our anti-sepsis drug candidate Rejuveinix (RJX), have a very favorable safety profile in Wistar Albino rats at dose levels comparable to the projected clinical dose levels. 14-day treatment with RJX-P (RJX PPP.18.1051) or RJX-B (RJX-B200702-CLN) similarly elevated the day 15 tissue levels of the antioxidant enzyme superoxide dismutase (SOD) as well as ascorbic acid in both the lungs and liver in a dose-dependent fashion. The activity of SOD and ascorbic acid levels were significantly higher in tissues of RJX-P or RJX-B treated rats than vehicle-treated control rats (p < 0.0001). There was no statistically significant difference between tissue SOD activity or ascorbic acid levels of rats treated with RJX-P vs. rats treated with RJX-B (p > 0.05). The observed elevations of the SOD and ascorbic acid levels were transient and were no longer detectable on day 28 following a 14-day recovery period. These results demonstrate that RJX-P and RJX-B are bioequivalent relative to their pharmacodynamic effects on tissue SOD and ascorbic acid levels. Furthermore, both formulations showed profound protective activity in a mouse model of sepsis. In agreement with the PD evaluations in rats and their proposed mechanism of action, both RJX-P and RJX-B exhibited near-identical potent and dose-dependent anti-oxidant and anti-inflammatory activity in the LPS-GalN model of ARDS and multi-organ failure in mice.

The Effectiveness of Galactomyces Ferment Filtrate, Dexpanthenol, and Centella Asiatica Combination Serum in the Treatment of Post-Acne Hyperpigmentation in Subjects with Skin of Color

Post-acne hyperpigmentation (PAH) occurs secondary to acne vulgaris and may cause significant adverse effects. Although may occur in any skin types, PAH has been found to be more common and severe in people with colored skin. This study aimed to assess the effectiveness of combination serum containing galactomyces ferment filtrate (GFF), dexpanthenol, and Centella asiatica for treating PAH. This randomized controlled clinical trial involved Fitzpatrick skin type (FST) IV and V patients with PAH. Subjects were equally divided into treatment group, who received three drops of combination serum twice daily for 8 weeks, and placebo group. The melanin index (MI) and Lightness (L*) score were assessed every 2 weeks. Out of 51 subjects, the L* score of the treatment group in subjects with FST V was significantly higher on the 4th and 6th week compared to the placebo group (P ˂ 0.05). The MI of subjects with FST IV was significantly lower compared to the placebo group after 8 weeks (P ˂ 0.05). The treatment group showed consistent increasing and decreasing trend in L* score and MI, respectively (r ˃ 0.9, P ˂ 0.05). Combination serum containing GFF, dexpanthenol, and C. asiatica may be effective in treating PAH in subjects with colored skin by accelerating lessening of PAH.

HISTOLOGICAL EVALUATION OF THERAPEUTIC EFFECTS OF DEXPANTHENOL COMPOSITION WITH CERAMIDES IN RATS WITH SKIN BURN INJURY

The objective of our research was histological evaluation of therapeutic effects in case of burn injury in rats. Experiment was conducted on 84 test rats with burn injury of III-A stage. Therapeutical effect of studied medicines was evaluated using histological methods. Results achived gave evidence that on 18-th day of treatment with ceremids cream and dexpanthenol with ceramids cream the level granulation tissue maturing increased by 1,4 and 1,7 times and intensity of burn injury epithelization rose by 1,5 and 1,9 times in comparison with non-treated animals. Therapeutic effect of dexpanthenol with ceramids cream significantly overcome action of «Bepanten» cream. Thus, experiment done proved efficiency of ceramids use in cream composition with dexpanthenol as one of the therapeutic methods aimed at increase of skin burn injury healing activation.

Fosmetpantotenate (RE-024), a phosphopantothenate replacement therapy for pantothenate kinase-associated neurodegeneration: Mechanism of action and efficacy in nonclinical models

In cells, phosphorylation of pantothenic acid to generate phosphopantothenic acid by the pantothenate kinase enzymes is the first step in coenzyme A synthesis. Pantothenate kinase 2, the isoform localized in neuronal cell mitochondria, is dysfunctional in patients with pantothenate kinase-associated neurodegeneration. Fosmetpantotenate is a phosphopantothenic acid prodrug in clinical development for treatment of pantothenate kinase-associated neurodegeneration, which aims to replenish phosphopantothenic acid in patients. Fosmetpantotenate restored coenzyme A in short-hairpin RNA pantothenate kinase 2 gene-silenced neuroblastoma cells and was permeable in a blood-brain barrier model. The rate of fosmetpantotenate metabolism in blood is species-dependent. Following up to 700 mg/kg orally, blood exposure to fosmetpantotenate was negligible in rat and mouse, but measurable in monkey. Consistent with the difference in whole blood half-life, fosmetpantotenate dosed orally was found in the brains of the monkey (striatal dialysate) but was absent in mice. Following administration of isotopically labeled-fosmetpantotenate to mice, ~40% of liver coenzyme A (after 500 mg/kg orally) and ~50% of brain coenzyme A (after 125 μg intrastriatally) originated from isotopically labeled-fosmetpantotenate. Additionally, 10-day dosing of isotopically labeled-fosmetpantotenate, 12.5 μg, intracerebroventricularly in mice led to ~30% of brain coenzyme A containing the stable isotopic labels. This work supports the hypothesis that fosmetpantotenate acts to replace reduced phosphopantothenic acid in pantothenate kinase 2-deficient tissues.

Vitamin B5 Reduces Bacterial Growth via Regulating Innate Immunity and Adaptive Immunity in Mice Infected with Mycobacterium tuberculosis

The mechanisms by which vitamins regulate immunity and their effect as an adjuvant treatment for tuberculosis have gradually become very important research topics. Studies have found that vitamin B5 (VB5) can promote epithelial cells to express inflammatory cytokines. We aimed to examine the proinflammatory and antibacterial effect of VB5 in macrophages infected with Mycobacterium tuberculosis (MTB) strain H37Rv and the therapeutic potential of VB5 in vivo with tuberculosis. We investigated the activation of inflammatory signal molecules (NF-κB, AKT, JNK, ERK, and p38), the expression of two primary inflammatory cytokines (tumor necrosis factor and interleukin-6) and the bacterial burdens in H37Rv-infected macrophages stimulated with VB5 to explore the effect of VB5 on the inflammatory and antibacterial responses of macrophages. We further treated the H37Rv-infected mice with VB5 to explore VB5's promotion of the clearance of H37Rv in the lungs and the effect of VB5 on regulating the percentage of inflammatory cells. Our data showed that VB5 enhanced the phagocytosis and inflammatory response in macrophages infected with H37Rv. Oral administration of VB5 decreased the number of colony-forming units of H37Rv in lungs of mice at 1, 2, and 4 weeks after infection. In addition, VB5 regulated the percentage of macrophages and promoted CD4+ T cells to express interferon-γ and interleukin-17; however, it had no effect on the percentage of polymorphonuclear neutrophils, CD4+ and CD8+ T cells. In conclusion, VB5 significantly inhibits the growth of MTB by regulating innate immunity and adaptive immunity.

Development of the composition of intramammary combined preparation based on silver citrate for veterinary use

The goal of the present study was to develop a new intramammary combination preparation for veterinary use based on silver citrate, arginine and dexpanthenol for the treatment and prophylaxis of subclinical mastitis in cattle. When creating combined medicines for veterinary use, attention must be paid to the factors that influence their stability in a combined presence, and the composition of drugs, as well as the technology for their preparation should be determined. In the current study, a qualitative and quantitative control of model mixtures of active ingredients, as well as of a silver citrate-based combined preparation was carried out. The following parameters that define intramammary drug stability were studied: clarity, pH, and the quantitative content of the active ingredient. Based on the experimental studies, optimal pH limits for a new preparation were determined ranging from 6.4 to 6.7. Considering the instability of solutions based on silver citrate, studies on the stabilization of the preparation were conducted at the obtained pH values. As the result, we used povidone, which possessed the stabilizing properties. The amount of arginine that provides the optimum pH level for the selected combination of active ingredients was also determined. In conclusion, the optimal composition of an intramammary preparation for veterinary medicine in 10 ml ampoules with a shelf life of 6 months was developed.Key words: silver citrate arginine dexpanthenol intramammary dosage form stability.

Combination therapy with hydrogen peroxide (4%), salicylic acid (0.5%) and D-panthenol (4%): efficacy and skyn tolerability in common acne vulgaris during sun exposure period

OBJECTIVE

Acne vulgaris is a disease of the sebaceous follicle which affects up to 90% of adolescent patients. Topical retinoids, benzoyl peroxide and antibiotics are the main treatments for mild to moderate acne vulgaris. The use of such topical treatments is often associated with local irritation and dryness making the skin more sensitive to the sun. The aim of our study was to assess the efficacy and skin tolerability of a fixed-dose combination therapy with hydrogen peroxide (4%), Salicylic acid (0.5%) and D-panthenol (4%) (HSD) gel, in mild-moderate acne vulgaris, during the period of sun exposure.

PATIENTS AND METHODS

We retrospectively observed 30 patients of Central Italy with mild to moderate acne between April and September 2012. All the patients selected underwent only therapy with HSD gel once a day in the evening for 60 days, while in the morning they just applied SPF 50 sunscreen. We evaluate the efficacy at 30 and 60 days with the "Global Evaluation Scale" (GES) and the tolerability with a 0-3 qualitative scale.

RESULTS

The mean GES value showed a statistically significant reduction: 2.03 (SD 0.81) at baseline, 1.63 (SD 0.81) and 0.90 (SD 0.71) respectively at 30 and 60 days (p < 0.01). 21 (70%) and 27 patients (90%) did show good or very good tolerability at 30 and 60 days respectively.

CONCLUSIONS

Topical treatments with retinoids, antibiotics and antiseptics may increase skin irritation reducing patient adherence to the treatment. HSD gel has shown a good skin tolerability and efficacy in reducing acne lesions, even during the sun exposure period in which traditional treatments should be cautiously used.

Safety, efficacy, and tolerability of differential treatment to prevent and treat vaginal dryness and vulvovaginitis in diabetic women

BACKGROUND

Problems affecting the vaginal tract in diabetic women are very often neglected. The efficacy and safety of three gynecological treatments in diabetic women have been assessed.

MATERIALS AND METHODS

A single-blind randomized progressive trial on 48 diabetic women affected by vaginal dryness, dyspareunia, and recurrent Candida infections was carried out. The ICIQ Vaginal Symptoms (ICIQ-VS) questionnaire was administered.

RESULTS

The analysis of the parameters of ICIQ-VS questionnaire among the three groups showed significant difference only for "dragging pain" (p = 0.0 19) and "soreness" (p = 0.028). In all groups and for all parameters of the questionnaire, improvement of symptoms was observed. In particular, in Group 1 for all symptoms a highly significant difference was observed, to support the already known benefits of the products and of the proposed combination. Significant improvement was also observed in Group 2.

CONCLUSIONS

The proposed treatment with DermoXEN® Ultracalming Special for diabetics and DermoXEN® Vitexyl vaginal gel exert effective moisturizing and soothing action. Indeed, the aforementioned products have been proven effective for the main gynecological problems of diabetic women.

[ABOUT CO-OCCURRENCE OF CRHONIC PANCREATITIS WITH GASTRODUODENAL DISEASES]

The article summarizes clinical features of the course when chronic pancreatitis goes in combination with diseases of gastroduodenal and hepatobiliary systems and features of functional and morphological changes. The article also represents justification of need to include the combined medicine Doktovit (combination of Dexpanthenol and S-methylmethionine) into complex treatment of the pathology, describes mechanism of its gastro protective and reparative action.

Protective effect of vitamin B5 (dexpanthenol) on cardiovascular damage induced by streptozocin in rats

OBJECTIVES

This study investigated whether Dexpanthenol (DEX) improves diabetic cardiovascular function and cardiac performance by regulating total oxidant and antioxidant status.

METHODS

Diabetes was induced by a single intraperitoneal injection of Streptozocin (50 mg/kg in 1 ml of saline) and treatment groups received DEX (300 mg/kg/day) for 6 weeks. Endothelium (in)dependent relaxation responses were assessed in thoracic aortic rings and coronary vasculature together with alpha receptor and voltage dependant contractile responses of aorta. Myocardial contractility has been recorded by an intra ventricular latex balloon. Total oxidant and antioxidant status were measured from the serum samples.

RESULTS

Induction of diabetes resulted in an apparent body weight loss, high blood glucose, endothelial dysfunction and increased serum oxidant status. DEX supplementation restored the endothelial dysfunction, antioxidant status and body weight whereas decreasing blood glucose level.

CONCLUSION

Along with the standard therapy of diabetes, DEX can be used as a safe and economical way of adjuvant therapy to diminish the burden of the disease (Tab. 3, Fig. 3, Ref. 30).

Novel preoperative pharmacologic methods of preventing postoperative sore throat due to tracheal intubation

Postoperative sore throat (POST) is usually self-limiting but was rated by patients as one of the top 10 most undesirable anesthetic outcomes. Pharmacologic interventions that have been suggested to decrease the incidence of POST include application of local anesthetics and corticosteroids to the cuff of the endotracheal tube. These interventions often require extra steps during induction of general anesthesia. We sought evidence for using nonsteroidal, nonlocal anesthetic, topical pharmacologic interventions conveniently implemented preoperatively to decrease the incidence of POST. One hundred seventeen potential evidence sources were located, with 11 randomized controlled trials meeting inclusion criteria. The evidence examined ketamine, aspirin, and azulene gargle; benzydamine gargle or oral spray; dexpanthenol pastilles; and lozenges containing amyl-m-cresol or magnesium. Although there were methodologic concerns with the studies, the evidence suggested that all the treatment medications decreased the incidence of POST at early and late intervals. The severity of POST was also typically reduced. Preoperative ketamine and aspirin gargle are probably the most promising for providers practicing in the United States. However, before these agents are recommended for general use, large multicenter trials should be done exploring not only efficacy but also dose-response relationships and side effects.

[Clinical and neurophysiological objectification and evaluation of treatment efficacy in children with perinatal hypoxic-ischemic injury of the CNS]

OBJECTIVE

To objectify indications for treatment with pantogam in premature infants with perinatal hypoxic-ischemic injury of the CNS.

MATERIAL AND METHODS

We studied 71 children, with GA (gestation age) 24-36 weeks (32,9±2,9 weeks), with perinatal hypoxic-ischemic injury of the CNS, I-II grades, and hyperexitability syndrome. The main group (33 patients) received pantogam in dose 50 mg/kg/day at the adjusted age (AA) 36-40 weeks from the conception. The comparison group included 38 patients. EEG day sleep monitoring was performed before and at the end of treatment.

RESULTS

Shortening of sleep cycle was observed in 78,8% children of the main group and in 78,9% of the comparison group. Duration of transitional sleep over 1 min was 78,79% and 81,58%. At AA 44-46 weeks, the frequency of sleep disorders decreased to 45,45% (p=0,012) and 52,63% (p=0,05). Duration of transitional sleep over 1 min was 45,45% and 65,79%. Duration of the latent period of the 2nd stage of slow wave sleep was 6,4±2,57 and 12,5±7,18 min (p=0,0004).

CONCLUSION

The treatment reduced sleep disorders, changed the duration of transitional sleep stage and latent period of the 2nd stage of slow wave sleep.

Prevention of tungiasis and tungiasis-associated morbidity using the plant-based repellent Zanzarin: a randomized, controlled field study in rural Madagascar

Background

Tungiasis, a parasitic skin disease caused by the female sand flea Tunga penetrans, is a prevalent condition in impoverished communities in the tropics. In this setting, the ectoparasitosis is associated with important morbidity. It causes disfigurement and mutilation of the feet. Feasible and effective treatment is not available. So far prevention is the only means to control tungiasis-associated morbidity.

Methodology

In two villages in Central Madagascar, we assessed the efficacy of the availability of closed shoes and the twice-daily application of a plant-based repellent active against sand fleas (Zanzarin) in comparison to a control group without intervention. The study population was randomized into three groups: shoe group, repellent group and control group and monitored for ten weeks. The intensity of infestation, the attack rate and the severity of tungiasis-associated morbidity were assessed every two weeks.

Findings

In the repellent group, the median attack rate became zero already after two weeks. The intensity of the infestation decreased constantly during the observation period and tungiasis-associated morbidity was lowered to an insignificant level. In the shoe group, only a marginal decrease in the intensity of infestation and in the attack rate was observed. At week 10, the intensity of infestation, the attack rate and the severity score for acute tungiasis remained significantly higher in the shoe group than in the repellent group. Per protocol analysis showed that the protective effect of shoes was closely related to the regularity with which shoes were worn.

Conclusions

Although shoes were requested by the villagers and wearing shoes was encouraged by the investigators at the beginning of the study, the availability of shoes only marginally influenced the attack rate of female sand fleas. The twice-daily application of a plant-based repellent active against sand fleas reduced the attack to zero and lowered tungiasis-associated morbidity to an insignificant level.

Tungiasis (sand flea disease) is a parasitic skin disease present in many resource-poor communities in South America, the Caribbean and sub-Saharan Africa. In this setting tungiasis is associated with important morbidity. Hitherto, the only effective treatment is the surgical extraction of embedded sand fleas. In the endemic areas this is done using inappropriate sharp instruments and causes more harm than good. The prevention of the infestation is the only option to control morbidity. In this study we show that the twice daily application of a herbal repellent based on coconut-oil (Zanzarin), is highly effective in preventing sand flea disease in a heavily affected community in Madagascar. The attack rate became zero immediately after starting the application of the repellent. The degree of tungiasis associated morbidity approached zero within 10 weeks. In contrast, the availability of closed solid shoes had only a marginal protective effect; although shoes were requested by the villagers and wearing shoes was encouraged by the investigators at the beginning of the study. In a control group from the same village the attack rate, the intensity of infestation and of tungiasis-associated morbidity remained unchanged. Our study in rural Madagascar shows that effective und sustainable morbidity control is possible using a repellent derived from coconut oil.

[Management of cognitive impairment in children and adolescents with cerebral palsy treated with pantocalcin]

A randomized study on the efficacy and safety of the hopantenic acid preparation (pantocalcin) and its effect on cognitive functions in children with cerebral palsy (CCP) has been carried out. The positive effect of pantocalcin on the visual memory and attention concentration, activity and fatigability has been shown. At the same time, there was a decrease of anxiety in children and adolescents with CCP. No evidence for the effect of the drug on visual-motor skills has been found. The results of the study have demonstrated the high safety profile of pantocalcin when used in pediatric practice.

[Correction of early cognitive disorders in school-age children operated under total intravenous anaesthesia]

The aim of the study was to assess the possibility and effectiveness of hopaten acid use for early postoperative cognitive dysfunction correction in children of school age.

MATERIALS AND METHODS

In compliance with inclusion and exclusion criteria, totally 40 children of school age (7-16 years old, ASA status I-II) with surgical pathology: (varicocele, cryptorchidism, inguinal hernia) were included A comperative assessment of neuropsychic status during pre - and postoperative are period in children, operated under propofol-fentanyl total intravenous anesthesia (TIVA) was conducted All patients were randomized to the control (without cepebroprotection 1st group, 20 children) and experimental (using cepebroprotection with hopaten acid within 1 month after the operation, 2nd group, 20 children) groups. Dimension of the study: Harvard standard monitoring, respiratory gas composition, neuropsychic tests (Bourdon test, "10 words test", etc.).

RESULTS

For full compatibility groups (age, ASA status and anthropometric data, equal operation duration and the equipotential drug dosage adjustment is revealed, that in group of propofol-fentanyl TIVA in the early postoperative period in school age children postoperative cognitive dysfunction (POCD) is developing, which in case of absence of the corresponding correction is maintained after 1 month after operation (at least) in 80% of cases. In the application of hopaten acid cerebroprotection (40 mg/kg per day) severity of POCD reliably is reduced or compensated by the time of discharge from the hospital (3-7-th day when non-traumatic interventions), and 1 month after the operation in 30% of patients experienced improvement of cognitive functions, which proves the effectiveness of hopaten acid for POCD treatment.

CONCLUSION

In case of propofol-fentanyl TIVA anesthesia in children of school age is indicated preventive prescription of multimodal cerebroprotectors without age limitations (for example hopaten acid (40 mg/kg per day) for POCD treatment.

Comparative trial of 5% dexpanthenol in water-in-oil formulation with 1% hydrocortisone ointment in the treatment of childhood atopic dermatitis: a pilot study

BACKGROUND

Atopic dermatitis (AD) is a common chronic relapsing disease particularly affecting children. The emollient used for protection of skin barrier function is the standard treatment for patients with AD. Currently, there is a growing interest in the use of nonsteroidal anti-inflammatory agents such as dexpanthenol (vitamin B5) as an alternative treatment.

OBJECTIVE

To compare the effectiveness of 5% dexpanthenol (DT) ointment with 1% hydrocortisone (HC) ointment in childhood AD therapy.

METHOD

Patients were treated topically with 5% DT ointment on the right side of the body and 1% HC ointment on the other side twice daily for 4 weeks. The clinical responses were evaluated by SCORAD (Scoring Atopic Dermatitis index) with statistical analysis using paired t-test.

RESULT

Of the 30 children enrolled, 26 completed the protocol; mean age was 7.19 years. The average baseline SCORAD score of the DT-treated side and the HC-treated side was 30.95 and 30.54, respectively. There was no statistically significant difference in SCORAD score reduction between the 2 agents. The edematous score of the HC-treated side exhibited faster resolution than that of the DT-treated side, with a statistically significant difference at week 1 and without a statistically significant difference at weeks 2 to 4. The lichenification response rate of HC treatment was more rapid than that of DT treatment; however, there was no statistical group difference. No adverse events were observed with either agent.

CONCLUSION

The effectiveness of 5% DT ointment is equal to that of 1% HC ointment. DT ointment may be used as alternative treatment in mild to moderate childhood AD therapy.

A pilot study of the effect of pantothenic acid in the treatment of post-operative ileus: results from an orthopedic surgical department

OBJECTIVES

Post-operative ileus can also occur in other types of surgery not strictly related to abdomen. The objective of this study was to investigate the efficacy of pantothenic acid administration to stimulate intestinal peristalsis in case of post-operative ileus and estimate the most effective dose. This vitamin can be used for the treatment of chronic atonic intestine or for chronic constipation, but therapeutic indications are not precise in these conditions.

PATIENTS AND METHODS

This pilot study has used patients divided in groups treated in post-operative period with physiological solution for patients in control group (Placebo) and Dexpantenolo, which is a derivative in alcohol of pantothenic acid, for all the actively treated patients. The treatments were administered intravenously during the second and third post-operative day, according to the treatment schedule.

RESULTS

60 patients were recruited and they were allocated to five treatment groups or one control group. For males, the median time of the first bowel evacuation was 90 hours while for females the median time was 84 hours (p=0.891). For patients who received a spinal anesthetic, the median time was 72 hours, while for those who received a peridural anesthetic the median time was 96 hours (p=0.571). Between six treatment groups, instead, there is a significant difference between the median times from the operation to the first bowel evacuation (p<0.001). Linear regression model obtained using as outcome evacuation hours after surgery show that only variable which significantly affects time between operation and the first bowel evacuation is treatment dose (Beta = -0.868, p<0.001).

DISCUSSION

This study would seem to indicate that pantothenic acid is effective for treatment of post-operative intestinal ileus; there is a dose response relationship between pantothenic acid and the decreasing time from surgical operation to first bowel evacuation. However, this study is preliminary; further studies are necessary, preferably randomized and with a larger number of patients.

[Preventive and cessation therapy of mental disorders in patients with the acute coronary syndrome]

An open prospective trial of 93 inpatients divided into two main groups (61 patients) - with mental disorders (31) and without mental disorders (30) and a comparison group (32 patients) was carried out. All patients survived the acute coronary syndrome (myocardial infarction, unstable angina). The efficacy and safety of both preventive and cessation therapy with pantogam active in mean doses 1.8 and 1.2 g /daily, respectively, was demonstrated in respect of heterogeneous depressive, anxiety and somatoform disorders of the neurotic level.

[Efficacy and tolerability of pantogam activ in patients with partial epilepsy]

Randomized double-blind, placebo-controlled study to determine efficacy and tolerability of pantogam activ as an add-on drug in patients with partial epilepsy was conducted. 20 patients received pantogam activ, 20 patients - placebo. Good tolerability and no advers event were detected in the dose of 1800 mg/d. The reduction in the frequency of epileptic seizures was achieved in 72,1% in the group receiving pantogam activ and in 16,7% in the group placebo. Significant improvement in long-term memory and manifestations of anxiety were found in patients using pantogam activ. Quality of life in scale QOLIE-31 improved after taking pantogam and did not change after placebo.

[Efficacy of pantogam in the treatment of hyperkinetic disorders in children]

We have analyzed the efficacy of nootropic drug pantogam in the treatment of hyperkinetic disorders in children aged 6-12 years. The results of the randomized placebo-controlled trial demonstrated the decrease of major symptoms of hyperkinetic disorders (inattention, hyperactivity, impulsivity), comorbid mental and behavior disorders, the improvement of cognitive functions in the group of children treated with pantogam during 6 weeks and the absence of significant changes in the placebo group. It has been concluded that pantogam is effective in the treatment of hyperkinetic disorders in children.