Menopausal hormone therapy in questions and answers : a manual for physicians of various specialties

This manual has been prepared by the Expert Team of the Polish Menopause and Andropause Society for physicians representing various medical specialties who see patients with menopausal symptoms in their daily practice. In order to make the manual as practical as possible, the current state of knowledge on menopausal hormone therapy (MHT) is presented in the form of questions and answers. They address issues which are essential for initiating and managing MHT based on the most up-to-date treatment algorithms and, at the same time, in line with the old maxim “primum non nocere”

Comparative efficacy and tolerability of drotaverine 80mg and ibuprofen 400mg in patients with primary dysmenorrhoea – Protocol DOROTA

Abstract Objective: To compare efficacy and tolerability of drotaverine 80mg and ibuprofen 400mg in patients with primary dysmenorrhoea. Materials and methods: Nine-month, multicenter (11 study centers in Poland), randomised, double-blind, phase III study, conducted in two parallel group, included 345 women between the ages of 18 and 35, suffering from primary dysmenorrhoea with presence of moderate to severe pain in each of the last 3 cycles. Patients had regular menstrual cycles and used an adequate barrier contraception method with a negative pregnancy test before randomization. Patients were given 80mg drotaverine or 400mg ibuprofen and asked to assess the pain intensity rated on a 4 point categorical scale (0 - none, 1 - mild, 2 - moderate, 3 - severe) at baseline and 0.5, 1, 2, 3, 4, 5 and 6 hours after the first intake and evaluate the efficacy (excellent, good, fair, poor) at the end of the treatment period. They were also asked to asses the tolerance of the medication (excellent, good, fair, poor). Results: The weighted sum of pain intensity differences over the 6-hour observation period (SPID-6) was calculated. The pain intensity before the first intake was comparable in the two groups. At the time-points, the decrease of pain was always greater in the ibuprofen 400mg group, than in the drotaverine 80mg group and was maximum at the 4th hour in the drotaverine 80mg group (-1.2+/-1.18) and at the 3rd hour in the ibuprofen 400mg group (-1.7+/-0.99). 41,8% patients treated with drotaverine and 68,6% patients treated with ibuprofen assessed drug efficacy as excellent or good. Although the patients' global assessment of tolerability was significantly better (p=0.02) with ibuprofen 400mg (excellent or good: 86.8%), than with drotaverine 80mg (excellent or good: 78.4%), no relevant difference between the both groups was observed for frequency, nature, intensity and causality of the reported adverse events. Conclusions: After analizing the data statistically and clinically, significant differences in favour of ibuprofen 400mg were evidenced for efficacy criteria. Ibuprofen was more efficient and the effect was faster, than drotaverine in relieving pain in dysmenorrhoea. Both drugs were well tolerated. The reported adverse events were typical drug reactions or expected events in patients suffering from dysmenorrhoea

Analysis of ultrasonic scans and karyotype of fetuses with holoprosencephaly diagnosed in The Department of Obstetrics & Gynecology of the Postgraduate Center of Medical Education between 1997 & 2005

Objectives: The aim of our study was to determine the risk of aneuploidy and associated malformations in fetuses with holoprosencephaly. We have also analyzed the gestational age during the first examination. Design: We have studied ultrasound reports of fetuses with holoprosencephaly. Materials and Methods: We analyzed 33 cases, diagnosed in the course of the last eight years in our center. All fetuses underwent a detailed ultrasound survey and, in most cases, antenatal karyotyping. In all cases the type of holoprosencephaly was assessed Results: In analyzed fetuses alobar holoprosencephaly was diagnosed in 24, semilobar in 7 and lobar holoprosencephaly in 2 cases. Associated anomalies were detected in 28 (mostly face defects) and chromosomal abnormalities in 12 cases. The median gestational age at the first examination was 25 weeks. No more than 14 examinations had been performed before 24 week. Conclusions: Our findings suggest that in case of fetuses with holoprosencephaly, a detailed ultrasound survey and karyotyping are essential to be performed in all cases. For that reason, patients with fetuses with holoprosencephaly should be diagnosed as early as possible in the referral center

Determination of physical parameters of the eclipsing binary V729 Cyg

We report new BVRI photometric observations of an eclipsing, massive binary V729 Cyg taken between 2008 and 2011. We performed light curve modeling of the new data and those available in the literature using the Wilson-Devinney code. The best fit was obtained for a contact configuration, similarly to results derived previously by other investigators. However, a huge temperature difference of about 10 000K - 12 000K was derived, inconsistent with theoretical calculations. Ruling out a possibility of V729 Cyg being a semi-detached system harbouring an accretion disk, we determined physical parameters of components

Intima-media thickness and ankle-brachial index are correlated with the extent of coronary artery disease measured by the SYNTAX score

Introduction: The extent of peripheral artery disease (PAD) measured by the ankle-brachial index (ABI) and intima-media thickness (IMT) is correlated with the complexity of coronary artery disease (CAD) in stable angina patients. However, data regarding patients with acute coronary syndromes are still lacking. Aim: To compare coronary complexity measured by the SYNTAX score in patients with and without PAD presenting with myocardial infarction (MI). Material and methods: Both ABI and IMT were measured in 101 consecutive patients who underwent primary diagnostic due to MI. Patients were divided into three tertile groups depending on the SYNTAX score (0–4; 5–11; 12 and more points). Results: Mean ABI in the general population was 0.9 ±0.26, mean IMT was 0.8 ±0.3 mm and mean SYNTAX score was 7.8 ±5.4 points. We found significant correlations between ABI and SYNTAX score (p = 0.01), IMT and SYNTAX score (p < 0.001), and IMT and ABI (p < 0.001). The highest mean values of IMT (p < 0.001) and lowest mean values of ABI (p = 0.015) were found in patients in the highest SYNTAX score group. When analyzing receiver operating characteristics (ROC) curves, IMT had greater specificity and sensitivity than ABI. Conclusions: Both IMT and ABI are correlated with SYNTAX score (positively for IMT and negatively for ABI values). In our study, IMT was a better predictor of SYNTAX score than ABI. Our study suggests that the higher rate of cardiovascular events in patients with PAD presenting with MI may be partially explained by greater coronary lesion complexity

Ten years of anti-HPV vaccinations : what do we know?

Human papillomavirus (HPV) is one of the most important carcinogens in humans. Vaccines against HPV are now considered the first anti-cancer vaccinations. Since 2007, in many developed countries, there have been recommendations present for preventive vaccines against HPV. At present, the degree of implementation of these recommendations depends on a number of country-specific factors such as the health care system organization or the ways of funding. HPV vaccines are primarily to prevent the development of cervical cancer and other genital cancers. Therefore, only their long-term effectiveness can be measured, when a correspondingly large cohort of vaccinated teenagers reaches the age of the greatest incidence of these cancers. However, great care should be taken in assessing the results of vaccinations due to the possibility of misinterpretation and possible erroneous data. Undoubtedly, teenagers are the target population of HPV vaccines. However, vaccinating young sexually active women is also justified from an individual point of view. A 9-valent vaccine has been registered in the USA and in Europe - including Poland - as one of the three preventive vaccines. It is recommended to vaccinate women between 13 and 26 and men between 13 and 21, previously unvaccinated. It is also recommended to vaccinate men aged 26 years or less who have sexual relations with other men and people with reduced immunity, including HIV-positive people who have not been vaccinated previously