RESUMO
BACKGROUND: Pharmacotherapy literacy (PTHL) is a specific ability to safely access, appraise and understand the available information concerning medication and to calculate and act accordingly. The concept of PTHL is mostly unknown for the majority of diabetes mellitus type 2 (DMT2) patients in Serbia. With diabetes being one of the major public health problems in Serbia with a prevalence of 9.1%, this two-study research aims at constructing performance-based instrument and estimating the prevalence of PTHL levels and identification of predictors of low PTHL scores in patients with DMT2. METHODS: Multistage study was performed to adapt the existing performance-based instrument (PTHL-SR) into specific questionnaire for DMT2 population (PTHL-DM instrument). PTHL levels were assessed through cross-sectional study categorising patients into groups of low, medium, and high PTHL levels. We considered 19 predictors for low PTHL scores, from sociodemographic characteristics, health behaviours and health characteristics, access to health-related information and empowerment-related indicators. Univariate and multivariate logistic regression analyses were used to determine independent predictors of low PTHL. RESULTS: The final 15-item PTHL-DM instrument proved to have satisfactory reliability (KR20 = 0.475) and internal reliability [ICC for the whole instrument was 0.97 with 95% confidence intervals (0.95-0.99)]. Positive correlation (rho = 0.69) between PTHL-DM score (15 questions) and the total PTHL-SR score (14 questions) was also observed. It was demonstrated that the majority of 350 patients had low PTHL (62%), and only 5% high PTHL level. Mean score on PTHL-DM was 7.8 ± 2.3. Probability of low PTHL increased among smokers, patients with low interest in health and those who estimated their health as bad. Patients who used pharmacists as sourse of information were less likely to be pharmacotherapy illiterate. Combined therapy with insulin and Oral Hypoglycemic Agents was associated with higher PTHL. CONCLUSIONS: Our data indicate that specific PTHL-DM tool is objective, valid, and reliable. It was found that low level of PTHL prevailed among DMT2 patients. Medication literacy is influenced by age, residence, education, and family status. Patients with better health literacy also reported better health behaviours. Different patient empowerment programs and approaches aimed at raising PTHL would be essential to improve self-management and control of this widespread chronic disease in Serbia.
Assuntos
Diabetes Mellitus Tipo 2 , Letramento em Saúde , Humanos , Sérvia , Estudos Transversais , Reprodutibilidade dos Testes , Diabetes Mellitus Tipo 2/tratamento farmacológicoRESUMO
The Schlafen 11 (SLFN11) protein has recently emerged as pivotal in DNA damage conditions, with predictive potential for tumor response to cytotoxic chemotherapies. Recent discoveries also showed that the programmed death ligand 1 (PD-L1) protein can be found on malignant cells, providing an immune evasion mechanism exploited by different tumors. Additionally, excessive generation of free radicals, redox imbalance, and consequential DNA damage can affect intestinal cell homeostasis and lead to neoplastic transformation. Therefore, our study aimed to investigate the significance of SLFN11 and PD-L1 proteins and redox status parameters as prognostic biomarkers in CRC patients. This study included a total of 155 CRC patients. SLFN11 and PD-L1 serum levels were measured with ELISA and evaluated based on redox status parameters, sociodemographic and clinical characteristics, and survival. The following redox status parameters were investigated: spectrophotometrically measured superoxide dismutase (SOD), sulfhydryl (SH) groups, advanced oxidation protein products (AOPP), malondialdehyde (MDA), pro-oxidant-antioxidant balance (PAB), and superoxide anion (O2â¢-). The prooxidative score, antioxidative score, and OXY-SCORE were also calculated. The results showed significantly shorter survival in patients with higher OXY-SCOREs and higher levels of serum SLFN11, while only histopathology-analysis-related factors showed significant prognostic value. OXY-SCORE and SLFN11 levels may harbor prognostic potential in CRC patients.
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Antígeno B7-H1 , Neoplasias Colorretais , Humanos , Antígeno B7-H1/metabolismo , Prognóstico , Oxirredução , Antioxidantes/metabolismo , Neoplasias Colorretais/patologia , Proteínas Nucleares/genéticaRESUMO
The aim of this multicentric study was to assess the impacts of oxidative stress, inflammation, and the presence of small, dense, low-density lipoproteins (sdLDL) on the antioxidative function of high-density lipoprotein (HDL) subclasses and the distribution of paraoxonase-1 (PON1) activity within HDL in patients with ST-segment elevation acute myocardial infarction (STEMI). In 69 STEMI patients and 67 healthy control subjects, the lipoproteins' subclasses were separated using polyacrylamide gradient (3-31%) gel electrophoresis. The relative proportion of sdLDL and each HDL subclass was evaluated by measuring the areas under the peaks of densitometric scans. The distribution of the relative proportion of PON1 activity within the HDL subclasses (pPON1 within HDL) was estimated using the zymogram method. The STEMI patients had significantly lower proportions of HDL2a and HDL3a subclasses (p = 0.001 and p < 0.001, respectively) and lower pPON1 within HDL3b (p = 0.006), as well as higher proportions of HDL3b and HDL3c subclasses (p = 0.013 and p < 0.001, respectively) and higher pPON1 within HDL2 than the controls. Independent positive associations between sdLDL and pPON1 within HDL3a and between malondialdehyde (MDA) and pPON1 within HDL2b were shown in the STEMI group. The increased oxidative stress and increased proportion of sdLDL in STEMI are closely related to the compromised antioxidative function of small HDL3 particles and the altered pPON1 within HDL.
Assuntos
Lipoproteínas HDL , Infarto do Miocárdio com Supradesnível do Segmento ST , Humanos , Arildialquilfosfatase , Lipoproteínas , Lipoproteínas LDLRESUMO
In the present study, we examined redox status parameters in arterial and venous blood samples, its potential to predict the prognosis of acute myocardial infarction (AMI) patients assessed through its impact on the comprehensive grading SYNTAX score, and its clinical accuracy. Potential connections between common blood biomarkers, biomarkers of redox status, leukocyte telomere length, and telomerase enzyme activity in the acute myocardial infarction burden were assessed using principal component analysis (PCA). This study included 92 patients with acute myocardial infarction. Significantly higher levels of advanced oxidation protein products (AOPP), superoxide anion (O2â¢-), ischemia-modified albumin (IMA), and significantly lower levels of total oxidant status (TOS) and total protein sulfhydryl (SH-) groups were found in arterial blood than in the peripheral venous blood samples, while biomarkers of the telomere-telomerase system did not show statistical significance in the two compared sample types (p = 0.834 and p = 0.419). To better understand the effect of the examined biomarkers in the AMI patients on SYNTAX score, those biomarkers were grouped using PCA, which merged them into the four the most contributing factors. The "cholesterol-protein factor" and "oxidative-telomere factor" were independent predictors of higher SYNTAX score (OR = 0.338, p = 0.008 and OR = 0.427, p = 0.035, respectively), while the ability to discriminate STEMI from non-STEMI patients had only the "oxidative-telomere factor" (AUC = 0.860, p = 0.008). The results show that traditional cardiovascular risk factors, i.e., high total cholesterol together with high total serum proteins and haemoglobin, are associated with severe disease progression in much the same way as a combination of redox biomarkers (pro-oxidant-antioxidant balance, total antioxidant status, IMA) and telomere length.
Assuntos
Infarto do Miocárdio , Telomerase , Humanos , Antioxidantes , Biomarcadores , Albumina Sérica , OxirreduçãoRESUMO
OBJECTIVES: Obstructive sleep apnea (OSA) is a common condition closely related to obesity, insulin resistance, dyslipidemia, and cardiovascular disease. The aim of this study was to explore the possible relationship between OSA and proprotein convertase subtilisin/kexin type 9 (PCSK9). METHODS: Full-night polysomnography was performed on 150 participants who were divided into three groups: controls, OSA patients on statin therapy, and OSA patients not on statin therapy. Biochemical markers, plasma low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subclasses, and PCSK9 were determined. RESULTS: PCSK9 was highest in OSA patients on statins compared to the control group and to OSA patients not on statins (p = 0.036 and p = 0.039, respectively), after adjustment for body mass index (BMI). LDL diameter was greater in OSA patients not on statins compared to OSA patients on statins (p = 0.032). PCSK9 was highest in the group of patients with all three risk factors (diagnosed OSA, statins, BMI ≥25 kg/m2) compared to groups with no, one, and two risk factors (p = 0.031, p = 0.001, and p = 0.029, respectively). Presence of OSA, statin therapy, and BMI ≥25 kg/m2 when combined were independently associated with higher levels of PCSK9 when adjusted for antihypertensive therapy, small dense LDL, and HDL 3c subclass (odds ratio = 2.849; interquartile range [1.026-7.912], p = 0.044). CONCLUSION: Statin therapy was closely related to PCSK9. OSA along with obesity and statin use induces elevation of PCSK9.
Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases , Obesidade , Pró-Proteína Convertase 9 , Apneia Obstrutiva do Sono , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Obesidade/complicações , Pró-Proteína Convertase 9/sangue , Apneia Obstrutiva do Sono/complicaçõesRESUMO
Heparin-binding EGF-like growth factor (HB-EGF) is involved in atherosclerosis progression. We investigated association between plasma HB-EGF levels and lipid, oxidative stress and inflammatory biomarkers in pediatric patients with type 1 diabetes mellitus (T1DM). Levels of HB-EGF, high-sensitive C-reactive protein (hsCRP), prooxidant-antioxidant balance (PAB), total antioxidant status (TAS), oxidized low-density lipoproteins (oxLDL), metabolic control and serum lipid parameters and paraoxonase 1 (PON1) activity were determined in 74 patients and 40 controls. In comparison to controls, patients had significantly higher levels (p < 0.01) of HB-EGF, hsCRP, PAB and oxLDL particles (p < 0.001), but lower levels of TAS and PON1 activity. In T1DM group, HB-EFG levels were positively associated with hsCRP, PAB and oxLDL levels. hsCRP and oxLDL levels were independent predictors of HB-EGF concentration. We demonstrated that oxidative modifications of LDL particles and low-grade inflammation are main determinants of increased plasma HB-EGF levels, which indicates an interactive role of oxidative stress, dyslipidemia and inflammation.
Assuntos
Diabetes Mellitus Tipo 1/sangue , Fator de Crescimento Semelhante a EGF de Ligação à Heparina/sangue , Adolescente , Arildialquilfosfatase/sangue , Biomarcadores/sangue , Proteína C-Reativa/análise , Criança , Diabetes Mellitus Tipo 1/metabolismo , Feminino , Humanos , Lipoproteínas LDL/sangue , Masculino , Estresse OxidativoRESUMO
Inflammatory biomarkers - pentraxin-3 (PTX3), cyclophilin A (CypA) and heparin-binding epidermal growth factor-like growth factor (HB-EGF) were examined in patients with ST-segment elevation myocardial infarction (STEMI) undergoing revascularization with primary percutaneous coronary intervention (pPCI) and stent implanting. Investigated parameters were compared between patients with and without obstructive coronary artery disease (CAD). In addition, their changes were tested in circulation before and immediately after pPCI. The study group consisted of 81 STEMI patients. Patients were classified in the STEMI-CAD group if they had significant obstructive CAD or in MINOCA group if they had no significant stenosis. In STEMI-CAD patients inflammatory parameters were determined prior to and after pPCI intervention. Immediately after pPCI, in STEMI-CAD patients levels of PTX3 were significantly lower (1.52 vs. 2.17 µg/L, p < .001), while the levels of HB-EGF (14.61 vs. 12.03 pg/L, p < .001) and CyPA (15.95 vs. 8.62 µg/L, p < .001) were significantly higher compared to levels before pPCI. STEMI-CAD patients had lower PTX3 values 2.17 µg/L (1.55-5.10 µg/L) than MINOCA patients 5.06 µg/L (2.77-6.7 µg/L), p = .046. Diagnostic accuracy of PTX3 for discrimination MINOCA from STEMI-CAD patients was low (area under receiver operating characteristic curve = 0.770). Evaluation of PTX3 values may be helpful in the understanding of MINOCA aetiology but they couldn't distinguish stenosis severity in STEMI patients. Inflammatory biomarkers significantly changed after pPCI but the possibility of clinical use of these biomarkers needs to be evaluated in a larger prospective study.
Assuntos
Biomarcadores/sangue , Proteína C-Reativa/análise , Ciclofilinas/sangue , Fator de Crescimento Semelhante a EGF de Ligação à Heparina/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Componente Amiloide P Sérico/análise , Idoso , Doença da Artéria Coronariana/sangue , Feminino , Humanos , Inflamação/sangue , Masculino , Pessoa de Meia-Idade , Miocardite/sangue , Curva ROC , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgiaRESUMO
Telomerase is RNA directed polymerase which acts as reverse transcriptase based on its own RNA component. It is considered to be involved in the pathology of many diseases and is recognized as a potential biomarker. The aims were to determine the sample storage conditions and the time frame for samples analysis, then to prove reliability of enzyme activity measurement with real-time telomeric repeat amplification protocol (TRAP) and to evaluate the suitable standard samples for telomerase activity measurements. Samples used for stability and freeze-thaw study were peripheral blood leukocytes, obtained from apparently healthy persons, patients with diagnosed cancer and cell lines. Telomerase activity was measured using TRAP method, while standard evaluation was done using nuclear magnetic resonance (NMR) technique. Storage at -20 °C preserved telomerase activity in samples from cancer patients for at least 14 days (21.46 ± 0.135 versus 21.84 ± 0.357, p = .756), while samples obtained from healthy persons should be stored at -80 °C. We observed significant decrease of telomerase activity at freeze thaw cycle 5 in cancer patients' samples (21.46 ± 0.135 versus 23.09 ± 0.316, p < .05), and in healthy persons' ones already at cycle 3 (22.74 ± 0.107 versus 24.85 ± 0.151, p < .05). Telomerase activity from cell lines samples showed overall greater stability regarding the storage period and freeze-thaw cycles and it was considered for standard sample, which was confirmed by NMR analysis. Telomerase enzyme had adequate stability while efficacy, linearity, and reproducibility of TRAP method were acceptable for bio-analytical methods. All this indicated that telomerase could be a reliable biomarker.
Assuntos
Reação em Cadeia da Polimerase/métodos , Sequências Repetitivas de Ácido Nucleico/genética , Telomerase/metabolismo , Linhagem Celular , Estabilidade Enzimática , Humanos , Espectroscopia de Prótons por Ressonância Magnética , Padrões de ReferênciaRESUMO
Carnitine is essential for energy metabolism and spermatozoa maturation. Combining L-carnitine and L-acetylcarnitine with micronutrients has been investigated as a treatment for infertility in men. We evaluated the effects of a therapeutic formulation, Proxeed Plus, on sperm parameters in oligoasthenozoospermic men. This prospective, randomised, double-blind, placebo-controlled clinical trial involved 175 males (19-44 years) with idiopathic oligoasthenozoospermia who failed to impregnate their partners (12 months). Males received Proxeed Plus or placebo for 3 and 6 months. Sperm volume, progressive motility and vitality significantly (p < 0.001) improved after 6 months compared to baseline. Sperm DNA fragmentation index significantly decreased compared to baseline (p < 0.001) and the 3-month therapy (p = 0.014) in treated men. Increased seminal carnitine and α-glucosidase concentration also positively correlated with improved progressive motility. Decreased DNA fragmentation index was the good predictor of progressive sperm motility >10%, and simultaneous measurement of changes in sperm vitality and DNA fragmentation index gave the highest probability of sperm motility 10% (AUC = 0.924; 95% CI = 0.852-0.996; p < 0.001). Logistic regression analyses revealed DNA fragmentation index decrease as the only independent predictor of sperm motility 10% (OR = 1.106; p = 0.034). We have demonstrated the beneficial effects of carnitine derivatives on progressive motility, vitality and sperm DNA fragmentation. Combining metabolic and micronutritive factors is beneficial for male infertility.
Assuntos
Acetilcarnitina/administração & dosagem , Carnitina/administração & dosagem , Micronutrientes/administração & dosagem , Oligospermia/tratamento farmacológico , Espermatozoides/efeitos dos fármacos , Adulto , Fragmentação do DNA/efeitos dos fármacos , Método Duplo-Cego , Combinação de Medicamentos , Humanos , Masculino , Placebos/administração & dosagem , Estudos Prospectivos , Contagem de Espermatozoides , Maturação do Esperma/efeitos dos fármacos , Motilidade dos Espermatozoides/efeitos dos fármacos , Resultado do TratamentoRESUMO
Background and objectives: Pharmaceutical literacy skills of parents are crucial for appropriate and safe medication use in pre-school children (ages 1â»7 years). A recent study on pharmacotherapy literacy from Serbia showed that one in five parents have difficulty understanding common information about the use of medicines. Because antipyretics are considered to be the most frequently used group of over-the-counter (OTC) medications during the pre-school period, we aimed to: (i) examine parental practice and expectations in antipyretic medication use, and (ii) analyze associations of parental practice and expectations related to socio-economic status and pharmacotherapy literacy. Materials and methods: A cross-sectional survey using a self- report validated specific instrument was conducted with the parents of pre-school children in kindergartens in Belgrade, Serbia. Pharmacotherapy literacy refers to the knowledge and personal skills needed to meet the complex demands of medicine use in both healthcare and non-healthcare settings. A comprehensive literature review, expert-focus group consultation, and pre-testing were employed in 4-item multiple-choice test development to explore practice and expectations related to the use of OTC pediatric antipyretic medicines. Results: The final analytical cohort was comprised of 813 participants, the majority (63.3%) chose a medicine based on a physician's suggestion and only 15.4% of parents reported they would follow the advice of a pharmacist. More than a half of parents (54.1%) would need advice about antipyretic medicine from a pharmacist, firstly in a simpler language. Parents satisfied with the information given by a pharmacist had higher pharmacotherapy literacy, compared to parents with lower levels (ORâ»0.718, 95%CI (0.597â»0.865), p < 0.001). Men had a higher expectation of pharmacists to explain medicine use in a simpler language (ORâ»1.630, 95%CI (1.063â»2.501), p = 0.025), as well as parents with three or more children (ORâ»2.527, 95%CI (1.43â»4.459), p = 0.001). Parents with higher knowledge about medicine use were less likely to ask for simpler information (ORâ»0,707; 95%CI (0,583â»0,856), p < 0,001). Conclusions: Our main finding is that practice in antipyretic OTC medicine use was associated with levels of parental pharmacotherapy literacy. The expectations of pharmacists were higher among parents with lower levels of pharmacotherapy literacy, who expected more information in a simpler and more precise language. This study highlighted the need for pharmacists to identify risks in parental practice and to provide information about medicines to parents of pre-school children in a simpler and more appropriate way.
Assuntos
Antipiréticos/efeitos adversos , Antipiréticos/uso terapêutico , Saúde da Criança , Conhecimentos, Atitudes e Prática em Saúde , Medicamentos sem Prescrição/efeitos adversos , Medicamentos sem Prescrição/uso terapêutico , Pais , Adolescente , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Feminino , Letramento em Saúde , Humanos , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pediatras , Farmacêuticos , Autorrelato/estatística & dados numéricos , Sérvia , Adulto JovemRESUMO
Background and objectives: Pharmacotherapy literacy (PHTL) is an individual's capacity to obtain, evaluate, calculate, and comprehend basic information about pharmacotherapy and pharmacy-related services necessary to make appropriate medication-related decisions, regardless of the mode of content delivery (e.g., written, oral, visual images and symbols). It is already proven that low PHTL of parents can cause serious problems in the treatment of a pediatric population. We aimed to identify the differences in parental PHTL levels, socio-demographic and health-related characteristics (chronic disease of a child, breastfeeding of a child, annual visits to a pediatrician, parental-self-estimation of health status) between rural and urban areas and to investigate the influence of living in rural areas on a low PHTL level. Materials and methods: Our study was cross-sectional with a validated 14-item instrument ("Parental pharmacotherapy literacy questionnaire-Serbian"), which assessed overall PHTL and its three domains of knowledge, understanding and numerical skills necessary for the safe use of medicines. We analyzed 250 parents of pre-school children (1-7 years old) in rural areas and 182 parents from urban areas in Serbia. Results: Every tenth parent from rural and every fourth parent from urban areas had the highest PHTL level or more than 85% correct answers. However, 51% and 28% of parents in rural and urban areas, respectively, had a low PHTL level (less than 65% correct answers), [Ð¥2(1, n = 432) = 33.2; p < 0.001]. Parents from different areas statistically differed in age, education level, employment, breastfeeding and annual visits to pediatrician rate. Those from rural areas had almost twice the probability of low PHTL levels (ORa = 2.033; p = 0.003) than their urban counterparts, independently of other examined parental characteristics. Conclusions: Parents from rural areas have more difficulties to obtain, evaluate, calculate and comprehend basic information related to pharmacotherapy than parents from urban areas.
Assuntos
Proteção da Criança , Conhecimentos, Atitudes e Prática em Saúde , Pais , Educação de Pacientes como Assunto , Adolescente , Adulto , Criança , Estudos Transversais , Tratamento Farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , População Rural , Sérvia , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana , Adulto JovemRESUMO
CONTEXT: Polyphenols and flavonoids in artichoke leaf tincture (ALT) protect cells against oxidative damage. OBJECTIVES: We examined ALT effects on deoxyribonucleic acid (DNA) damage and lipid profiles in rat plasma and gene expression in rat aorta [haemeoxygenase-1 (HO1), haemeoxygenase-2 (HO2), NADPH oxidase 4 (NOX-4), monocyte chemoattractant protein-1 (MCP-1) and nuclear factor (erythroid-derived 2)-like 2 (Nrf2)]. MATERIALS AND METHODS: Eighteen male Wistar albino rats were divided into three groups (n = 6/group): The control group (CG) was fed with standard pellet chow for 11 weeks; the AD group was fed for a similar period of time with pellet chow supplemented with 2% cholesterol, 3% sunflower oil and 1% sodium cholate. The ADA group was fed with pellet chow (for 1 week), the atherogenic diet (see above) for the following 4 weeks and then with ALT (0.1 mL/kg body weight) and atherogenic diet for 6 weeks. According to HPLC analysis, the isolated main compounds in ALT were chlorogenic acid, caffeic acid, isoquercitrin and rutin. RESULTS: Normalized HO-1 [0.11 (0.04-0.24)] and MCP-1 [0.29 (0.21-0.47)] mRNA levels and DNA scores [12.50 (4.50-36.50)] were significantly lower in the ADA group than in the AD group [0.84 (0.35-2.51)], p = 0.021 for HO-1 [0.85 (0.61-3.45)], p = 0.047 for MCP-1 and [176.5 (66.50-221.25)], p = 0.020 for DNA scores. HO-1 mRNA was lower in the ADA group than in the CG group [0.30 (0.21-0.71), p = 0.049]. CONCLUSIONS: Supplementation with ALT limited the effects of the atherogenic diet through reduced MCP-1 expression, thereby preventing oxidative damage.
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Aterosclerose/dietoterapia , Cynara scolymus , Dano ao DNA/efeitos dos fármacos , Dieta Aterogênica/efeitos adversos , Extratos Vegetais/uso terapêutico , Folhas de Planta , Animais , Aterosclerose/sangue , Aterosclerose/etiologia , Dano ao DNA/fisiologia , Masculino , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/farmacologia , Ratos , Ratos WistarRESUMO
- Premature infants are susceptible to oxidative stress that causes neonatal disease such as retinopathy of prematurity (ROP). Oxidative stress is an imbalance between the production of pro-oxidants and the ability of the body to detoxify their harmful effects by antioxidants. The proliferative phase 2 ROP occurs at around 33rd postmenstrual week (pmw). The purpose of our study was to evaluate the pro-oxidant/antioxidant status in preterm infants at 33rd pmw. The study included 59 premature infants. ROP was classified according to the International Classification of Retinopathy of Prematurity. Total oxidative status (TOS), total antioxidant status (TAS), malondialdehyde (MDA) and paraoxonase 1 (PON1) activity were determined spectrophotometrically. The values of the pro-oxidants TOS and MDA were significantly higher in infants with ROP as compared to infants without ROP (p<0.05 both). There were no significant differences in the values of TAS and PON1 between the infants with and without ROP. According to study results, TOS and MDA are good markers of oxidative stress, whereas TAS and PON1 activity are unreliable in assessing antioxidant protection.
Assuntos
Antioxidantes/metabolismo , Arildialquilfosfatase/sangue , Malondialdeído/sangue , Estresse Oxidativo , Retinopatia da Prematuridade/metabolismo , Biomarcadores/sangue , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Espécies Reativas de Oxigênio/metabolismo , Reprodutibilidade dos Testes , Espectrofotometria/métodosRESUMO
Emergency contraception (EC) in Serbia is available in two products: Levonorgestel, which has nonprescription status, and Ulipristal acetate, which is a prescription-only medicine. Considering their dispensing statuses, gynecologists and pharmacists are health care professionals (HCPs) with the widest impact on EC use. Yet little is known about their beliefs and practices regarding these medicines. We surveyed 166 gynecologists (during October 2012-October 2013) and 452 community pharmacists (during January-April 2014). Results showed significant differences between these two groups, suggesting that provision of EC to users may be inconsistent. Gynecologists were more convinced than pharmacists that EC would reduce the abortion rate (86% versus 53%, p < .001). However, they were more concerned than pharmacists that easy access to EC would cause less regular contraceptive use (66% versus 29%, p < .001) and risky sexual behaviors, including initiating sexual activity at a younger age (37% versus 19%, p < .001) and having more sexual partners (33% versus 12%, p < .001). Additionally, more pharmacists than gynecologists (12% versus 2%, p < .001) said they would not provide EC to anyone under any circumstance, even to victims of sexual assault. These results indicated a need for reevaluating and establishing official guidelines for dispensing practices.
Assuntos
Atitude do Pessoal de Saúde , Anticoncepção Pós-Coito , Ginecologia , Conhecimentos, Atitudes e Prática em Saúde , Farmacêuticos , Adulto , Feminino , Humanos , Gravidez , SérviaRESUMO
Preclinical Research Major depressive disorder (MDD) is a major psychiatric illness and it is predicted to be the second leading cause of disability by 2020 with a lifetime prevalence of about 13%. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used therapeutic class for MDD. However, response to SSRI treatment varies considerably between patients. Biomarkers of treatment response may enable clinicians to target the appropriate drug for each patient. Biomarkers need to have accuracy in real life, sensitivity, specificity, and relevance to depression. Introduction of MDD biomarkers into the health care system can increase the overall cost of clinical diagnosis of patients. Because of that, decisions to allocate health research funding must be based on drug effectiveness and cost-effectiveness. The assessment of MDD biomarkers should include reliable evidence of associated drug effectiveness, adverse events and consequences (reduced productivity and quality of life, disability) and effectiveness of alternative approaches, other drug classes or behavioral or alternative therapies. In addition, all the variables included in an economic model (probabilities, outcomes, and costs) should be based on reliable evidence gained from the literature-ideally meta-analyses-and the evidence should also be determined by informed and specific expert opinion. Early assessment can guide decisions about whether or not to continue test development, and ideally to optimize the process. Drug Dev Res 77 : 374-378, 2016. © 2016 Wiley Periodicals, Inc.
Assuntos
Antidepressivos/uso terapêutico , Biomarcadores/metabolismo , Transtorno Depressivo Maior/tratamento farmacológico , Antidepressivos/economia , Antidepressivos/farmacologia , Análise Custo-Benefício , Transtorno Depressivo Maior/economia , Transtorno Depressivo Maior/fisiopatologia , Humanos , Modelos Econômicos , Qualidade de Vida , Sensibilidade e Especificidade , Inibidores Seletivos de Recaptação de Serotonina/economia , Inibidores Seletivos de Recaptação de Serotonina/farmacologia , Inibidores Seletivos de Recaptação de Serotonina/uso terapêuticoRESUMO
We carried out a cross-sectional, web-based study to identify predictors (personal characteristics, knowledge, and attitudes) of Serbian pharmacists' decisions to decline emergency contraceptive pills (ECP) dispensing. In total, 452 questionnaires were completed and analyzed. Half of the surveyed pharmacists had poor knowledge of ECP. Almost the same number (42%) had either never undertaken training in these products or did not remember having training. The less knowledgeable respondents were more likely to decline ECP provision overall (OR 1.862) and in particular circumstances (nonintended user (OR 1.412) or >72 h after intercourse (OR 1.445)). To expand availability of these products, well-organized trainings are needed.
Assuntos
Atitude do Pessoal de Saúde , Anticoncepcionais Pós-Coito , Conhecimentos, Atitudes e Prática em Saúde , Farmacêuticos , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Sérvia , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: To examine Serbian gynaecologists' attitudes and practices related to contraception and abortion, as the principal alternative to contraception. METHODS: A self-reported questionnaire was administered to a convenience sample of gynaecologists attending educational meetings of a medical society from October 2012 to October 2013. The data gathered were assessed by means of univariate and multivariate analyses. RESULTS: Almost half of the respondents had ethical objections and would refuse to provide certain contraceptives to patients. Two thirds of the gynaecologists (63%) considered fertility awareness methods to be a poor option for most women. Twenty-three percent objected to abortion. Those who objected to contraceptives were less likely to object to abortions (OR: 0.422). This attitude was more prevalent in Southern and Eastern Serbia, where gynaecologists were more likely to object (OR: 4.892) and to refuse to prescribe contraceptives (OR: 4.161), but less likely to object to abortion (OR: 0.278) than in other regions. CONCLUSIONS: A large proportion of Serbian gynaecologists objected to some contraceptive methods and were more in favour of abortions, especially in the least developed regions.
Assuntos
Aborto Induzido/psicologia , Anticoncepção/psicologia , Ginecologia/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , SérviaRESUMO
BACKGROUND: Dyslipidemia is a common feature of chronic kidney disease (CKD). Although it has been observed that the pattern of lipid abnormalities can vary according to the stage of CKD, there is lack of data concerning the distribution of lipoprotein subclasses at various stages of the disease. In addition, association of proatherogenic small, dense low-density lipoprotein (sdLDL) subclasses with markers of inflammation, such is galectin-3, is not sufficiently explored. The aim of this study was to analyze concentrations and relative proportions of sdLDL-cholesterol (sdLDL-C) and galectin-3 in patients with CKD, with respect to the stage of the disease. Also, we sought possible independent associations of galectin-3 and sdLDL-C. METHODS: The study involved 100 hemodialysis (HD) and 50 pre-dialysis patients, together with 94 healthy individuals. SdLDL-C was measured by heparin-magnesium precipitation method. Galectin-3 was measured by ELISA technique. RESULTS: Galectin-3 levels were higher in pre-dialysis and HD patients than in the control group (p < 0.01). The concentration of sdLDL-C was highest in the pre-dialysis group and lowest in HD patients (p < 0.01). CKD patients with increased galectin-3 concentrations had significantly higher relative proportions of cholesterol in sdLDL (% sdLDL-C) than their counterparts with lower galectin-3 levels (p < 0.05). Relative proportion of sdLDL-C was shown to be an independent determinant of galectin-3 concentration. CONCLUSIONS: Our results demonstrated alterations in concentrations and proportions of sdLDL-C according to the stages of CKD. The observed independent associations of % sdLDL-C and galectin-3 provide further insight into their complex interaction during the progression of atherosclerosis in CKD.
Assuntos
LDL-Colesterol/sangue , Galectina 3/sangue , Insuficiência Renal Crônica/diagnóstico , Aterosclerose/sangue , Biomarcadores/sangue , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diálise Renal , Insuficiência Renal Crônica/sangueRESUMO
Background: The pre-analytical (PA) phase is the most vulnerable phase of the laboratory testing procedure, with critical procedures-collection, handling, sample transport, and time and temperature of sample storage. This study aimed to examine the stability of basic biochemical parameters depending on the samples' storage conditions and the number of freeze-thaw cycles (FTCs). In parallel, the presence of sample bacterial contamination during routine laboratory work was examined. Methods: Two plasma pools (ethylenediaminetetraacetic acid (EDTA), and sodium-fluoride/potassium oxalate plasma (NaF)) were stored at +4 ËC/-20 ËC. Total chole - sterol (TC), glucose, triglycerides (TG), urea, and albumin concentrations were measured using BioSystems reagents (cholesterol oxidase/peroxidase, glucose oxidase/per - oxidase, glycerol phosphate oxidase/peroxidase, urease/ salicylate, and bromcresol green method, respectively) on Ilab 300+. Sample bacterial contamination was determined by 16S rRNA sequence analysis. The expe - riment encompassed a 5 day-period: Day 1-fresh sample, Day 2-1st FTC, Day 3-2nd FTC, Day 4-3rd FTC, Day 5-4th FTC. The appearance of bacteria in two consecutive samples was the experiment's endpoint.
RESUMO
Fatty acids play a crucial role in obesity development and in the comorbidities of obesity in both adults and children. This study aimed to assess the impact of circulating fatty acids on biomarkers of metabolic health of adolescents living with obesity. Parameters such as blood lipids, redox status, and leukocyte telomere length (rLTL) were measured alongside the proportions of individual fatty acids. The Mann-Whitney U test revealed that individuals with obesity exhibited an unfavorable lipid and redox status compared to the control normal weight group. The group with obesity also had lower plasma n-3 polyunsaturated fatty acids (PUFAs) and a higher ratio of n-6 to n-3 PUFAs than the control group. They also had a shorter rLTL, indicating accelerated biological aging. There was an inverse association of rLTL and plasma n-6-to-n-3 PUFA ratio. Future studies should explore the impact of recommended nutrition plans and increased physical activity on these parameters to determine if these interventions can enhance the health and well-being of adolescents with obesity, knowing that early obesity can track into adulthood.