Health-related claims in food supplements endorsements: a content analysis from the perspective of EU regulation.

OBJECTIVES: Based on the legal framework regulating the advertisement of food supplements in the EU, the aim of this article is to analyse the relationship between the presence of endorsers, the different types of health-related claims (H-RCs) and product content information. STUDY DESIGN: We applied a quantitative approach based on the content analysis of all radio spots broadcast throughout 2017 on full-service radio stations in Spain. METHODS: A corpus of 10,556 radio spots was obtained of the three radio stations with the highest audience levels (165 without repetitions). We incorporated data on the accumulated broadcast frequencies to supplement the content analysis specific to each radio spot with its weight in relation to the overall advertising discourse. We developed a coding scheme to assess the type of endorser, the types of H-RCs, and the product content information. RESULTS: Results show that European directives are breached in different ways. Healthcare experts prevail in disease claims, although they are prohibited. Celebrities are the most widely used endorsers (25%) in the function and reduction of disease risk claims. In addition, although these types of claims require substantiation by authorised ingredient, 73% of H-RCs lack this information. CONCLUSIONS: The high presence of illicit H-RCs and endorsers, such as physicians, and the omission of compulsory product information suggest that public administrations must apply stricter monitoring and sanctioning mechanisms to dissuade advertisers from further breaches of the law and to protect consumers. Implications for public health policy are made.

Investigación Cualitativa en Atención Farmacéutica: Experiencia del Observatorio Farmacéutico Social, una propuesta en farmacia comunitaria con enfoque pedagógico y social / Qualitative Research in Pharmaceutical Care: Observatorio Farmacéutico Social experience, a proposal in community pharmacy with a pedagogical and social approach

Introducción: El Observatorio Farmacéutico Social (OFS) es una propuesta investigativa en farmacia comunitaria con enfoque pedagógico y social. Indaga sobre el uso cultural de medicamentos, plantas medicinales, educación para la salud, promoción de la salud y prevención de la enfermedad, especialmente, en poblaciones vulnerables. En Colombia la información sobre este tema es limitada. Objetivo: Documentar experiencias de vida y conocimientos relacionados con el uso de medicamentos y plantas medicinales en una población de adultos líderes comunitarios, de participación voluntaria, utilizando la propuesta de OFS. Método: Propuesta de corte cualitativo, basada en la metodología participativa de Investigación-Acción-Participación. Para el trabajo de campo se utilizaron algunas Metodologías interactivas de la investigación cualitativa. La lectura de los resultados se realizó desde la mirada crítico-reflexiva de los investigadores, acorde con recomendaciones técnicas y científicas relacionadas con el uso adecuado de medicamentos. Resultados: Se estructuró una propuesta de OFS, que permitió la participación de 46 mujeres. Los principales hallazgos se dieron sobre conocimientos y mitos asociados al uso de medicamentos, confianza en la atención médica, adherencia a los tratamientos y defensa por los saberes ancestrales relacionados con el uso de plantas medicinales. Conclusiones: Actualmente no se encuentra información que documente la disponibilidad de un observatorio con estas características; por ello, se considera necesario continuar la estructuración y funcionamiento del OFS como una propuesta de educación popular en el uso adecuado de medicamentos y plantas medicinales y, así, contribuir al logro de resultados positivos en la terapia farmacológica

Introduction: The Observatorio Farmacéutico Social (OFS) is a research proposal in community pharmacy with a pedagogical and social approach. The OFS seeks to investigate on cultural usage of drugs, medicinal plants, health education and disease prevention, particularly, in vulnerable populations. In Colombia, the information related to this issue is limited. Aim: To document life experiences and knowledge related to the usage of drugs and medicinal plants in a population of community leaders, among whom participation is voluntary, through the OFS proposal. Method: It was carried out a qualitative research proposal based on Participatory-Action-Research (PAR) methodology. For the fieldwork some Interactive Qualitative Research Methodologies were used. The results’ interpretation was made from the critical and reflexive researchers’ eye, following the technical and scientific recommendations about the appropriate usage of medications. Results: It was structured an OFS proposal that allowed the participation of 46 women. The main findings in the OFS experience were about the knowledge and myths associated with the usage of drugs, confidence in medical care, adherence to treatments and defense of medicinal plants’ usage. Conclusions: Currently there is no information documenting the availability of an observatory with these features. For this reason, is considered necessary to progress in the structure and operation of the OFS as a popular education proposal in the appropriate usage of drugs and medicinal plants and, thus, contribute to the achievement of positive and safe results in the pharmacological therapy

Clinical management guidelines for subarachnoid haemorrhage. Diagnosis and treatment.

OBJECTIVE: To update the Spanish Society of Neurology's guidelines for subarachnoid haemorrhage diagnosis and treatment. MATERIAL AND METHODS: A review and analysis of the existing literature. Recommendations are given based on the level of evidence for each study reviewed. RESULTS: The most common cause of spontaneous subarachnoid haemorrhage (SAH) is cerebral aneurysm rupture. Its estimated incidence in Spain is 9/100 000 inhabitants/year with a relative frequency of approximately 5% of all strokes. Hypertension and smoking are the main risk factors. Stroke patients require treatment in a specialised centre. Admission to a stroke unit should be considered for SAH patients whose initial clinical condition is good (Grades I or II on the Hunt and Hess scale). We recommend early exclusion of aneurysms from the circulation. The diagnostic study of choice for SAH is brain CT (computed tomography) without contrast. If the test is negative and SAH is still suspected, a lumbar puncture should then be performed. The diagnostic tests recommended in order to determine the source of the haemorrhage are MRI (magnetic resonance imaging) and angiography. Doppler ultrasonography studies are very useful for diagnosing and monitoring vasospasm. Nimodipine is recommended for preventing delayed cerebral ischaemia. Blood pressure treatment and neurovascular intervention may be considered in treating refractory vasospasm. CONCLUSIONS: SAH is a severe and complex disease which must be managed in specialised centres by professionals with ample experience in relevant diagnostic and therapeutic processes.

Clinical and cost effectiveness of sacral nerve stimulation for faecal incontinence.

BACKGROUND: Sacral nerve stimulation (SNS) has better results and safety than other surgical procedures for faecal incontinence. This prospective study assessed the clinical effectiveness and costs of SNS at a single centre. METHODS: Patients who had experienced one or more episodes of faecal incontinence were studied for up to 5 years by continence diary, anorectal manometry and quality of life questionnaires. Direct medical costs were calculated and the cost-effectiveness of the treatment was analysed. RESULTS: Fifty-seven percutaneous nerve evaluations were performed in 47 patients between June 1999 and February 2006; 29 patients underwent permanent implantation. After a median follow-up of 34.7 (range 2.3-81.2) months, 25 of the 29 patients had a significant reduction in incontinence episodes; 14 patients were in complete remission. At 3-year follow-up, the mean reduction in incontinence episodes was 89 per cent. No change was observed in anal manometric values. Patients reported a significant improvement in quality of life. The introduction of SNS has an incremental cost-effectiveness ratio, below the accepted Spanish threshold. CONCLUSION: The introduction of SNS to the management of faecal incontinence within the Spanish setting is both effective and efficient.

Supplementation with bypass fat in silvopastoral systems diminishes the ratio of milk saturated/unsaturated fatty acids.

This study was conducted to evaluate if supplementing bypass fat to cows under silvopastoral systems, increases the concentration of unsaturated fatty acids in milk, thus improving the saturated/ unsaturated ratio without a negative effect on total milk yield in fat or protein. Two concentrations of two different sources of bypass fat were evaluated for 40 days, each in a group of 24 multiparous Lucerna (Colombian breed) cows. A cross-over design of 8 Latin squares 3 x 3 was used. The variables submitted to analysis were body condition, daily milk production and milk composition. Body condition, milk yield and milk quality were not different but there was a significant decrease in the amount of saturated fatty acid in both experiments while the unsaturated fat increased significantly in experiment 1 and remained stable in experiment 2. Results, such as these have as far as we know, not been reported previously and they provide an approach for the improvement of milk as a "functional food".

Evolution of ecotoxicity upon Fenton's oxidation of phenol in water.

This work deals with the evolution of intermediates and ecotoxicity upon Fenton's oxidation of phenol in aqueous solution. The EC50 values of the intermediates identified in the oxidation pathway of phenol have been measured. Some of these compounds, mainly hydroquinone and p-benzoquinone, showed toxicity levels much higher than phenol itself. Depending on the operating conditions, these intermediates could be completely transformed into organic acids, mainly oxalic and formic. Ecotoxicity values substantially lower than those expected from the chemical composition were measured in the reaction samples. This is explained by a reduction of the concentration of aromatic intermediates when the pH was adjusted at 6-8 (according to what is required by the standard bioassay ISO 11348-3). Formation of complexes between hydroquinone and p-benzoquinone at increasing pH can remove from solution those highly toxic intermediates whose very low EC50 values give rise to a high ecotoxicity even at fairly low concentrations. This together with the enhanced decomposition of residual H202 at increasing pH represent important beneficial effects of the neutralization step following Fenton treatment which allow a complementary cleaning of the effluent.

[Consumption of licit and illicit drugs in Chile: results of the 1998 study and comparison with the 1994 and 1996 studies]. / Consumo de drogas lícitas e ilícitas en Chile: resultados del estudio de 1998 y comparación con los estudios de 1994 y 1996.

The principal results are presented here from the Third National Study of the Consumption of Drugs, which was carried out in Chile by the National Board for Narcotics Control between 1 September 1998 and 15 January 1999. The 1998 study used the same methodological design as the first and second studies, which were done in 1994 and 1996. The 1998 study expanded the sample to 31,665 individuals, who were representative of a population of 6,940,727 people from 12 to 64 years old, both sexes, and five socioeconomic levels and who were residents of urban areas in 62 commune administrative divisions of the 13 regions of the country. Results from the 1998 study are compared with those from 1996 and 1994. The 1998 study shows that 17.5% of Chileans have at some time in their life used one of the three illicit drugs most popular in the country: marijuana (16.8%), coca paste (2.3%), and cocaine hydrochloride (4.0%). The prevalence of use of any of the three drugs, mainly marijuana, during the preceding year was 5.3% and during the preceding month 2.2%. With respect to licit drugs, 28.4% of Chileans have at some time in their lives used antianxiety drugs, 84.4% of them have consumed alcohol, and 71.9% have used tobacco. Most of the people who once used illegal drugs have stopped doing so: 71.6% in the case of marijuana, 64.1% with coca paste, and 66.8% with cocaine hydrochloride. For legal drugs, the percentages were lower: 55.5% for anxiolytics, 16.0% for alcohol, and 34.5% for tobacco. The consumption of licit and illicit drugs was several times greater among men than among women, except for anxiolytics, whose use was three times greater among women. Drug use was more frequent among persons between 19 and 25 years old. Consumption of illegal drugs was more frequent at higher socioeconomic levels, and use of licit drugs was more common in the lower socioeconomic levels. The 50th percentile of the age of initiating drug use was 17 years for alcohol, 15 for tobacco, 30 for antianxiety agents, 17 for marijuana, 20 for coca paste, and 21 for cocaine hydrochloride. Comparing the results of the three studies shows that, after an increase in the use of licit drugs between 1994 and 1996, there was a stabilization in 1998. With illegal drugs there was a modest increase in consumption between 1996 and 1998, following a small reduction between 1994 and 1996.

[Effects of dehydroepiandrosterone on blood cells of the rat]. / Effectos de la dehidroepiandrosterona sobre las células sanguíneas de la rata.

The effects of dehydroepiandrosterone (DHEA) on haemoglobin, hematocrit and white cell counts values were studied in male and female rats, castrated rats and pregnant rats. After 5 continuous days of DHEA administrated subcutaneously (80 mg/kg/d; body w.) haemoglobin and hematocrit values were similar those values obtained before the treatment. White cell counts were reduced (40%) in female no castrated rats due to a significantly lymphopenia. The white cell counts were increased in castrated rats and with DHEA administration there were reduced to the initial values. Estradiol treatment had the same effect as DHEA on castrated rats. These data suggest that DHEA administrated to castrated or sexually active male and female rats affects the white cells without important effects on red blood cells.

Fatty acid binding protein is induced in neurons of the dorsal root ganglia after peripheral nerve injury.

Peripheral nerve trauma induces the expression of genes presumed to be involved in the process of nerve degeneration and repair. In the present study, an in vivo paradigm was employed to identify molecules which may have important roles in these processes. A cDNA library was constructed with RNA extracted from rat dorsal root ganglia (DRG) 3 days after a sciatic nerve crush. After differential hybridization to this library, several cDNAs were identified that encoded mRNAs that were upregulated in the DRG ipsilateral to the crush injury, as opposed to the contralateral or naive DRG. Approximately 0.15% of all the clones screened were found to be induced. This report presents the types of induced sequences identified and characterizes one of them, DA11. The 0.7 kb DA11 full length cDNA clone contains a 405 nucleotide open reading frame that encodes a putative protein of 15.2 kDa (135 amino acid residues) and is a member of the family of fatty acid binding proteins (FABP). The DA11 protein differs by one amino acid residue from the sequence of the C-FAPB protein and by eight residues from the sequence of mal1, proteins found in rat and mouse skin, respectively. Northern and Western blot analyses showed that the DA11 mRNA and protein were induced in the injured DRG. Furthermore, studies using antibodies generated against DA11 found that the DA11-like immunoreactivity was more pronounced in the nuclei of neurons located in the DRG ipsilateral to the sciatic cut than those located in the contralateral DRG. The induction of DA11 mRNA and protein in DRG neurons suggests, for the first time, the involvement of a neuronal FABP in the process of degeneration and repair in the nervous system.

[Symptomatic effect of epomediol in patients with cholestasis of pregnancy]. / Efecto sintomático del epomediol en pacientes con colestasis gravídica.

Epomediol is a terpenoid that prevents and reverses cholestasis induced by ethinylestradiol in the rat, apparently by improving liver cell membrane fluidity. Assuming that the pathogenesis of intrahepatic cholestasis of pregnancy (ICP) is related with increased estrogen levels, we studied the effects of epomediol in this disease. Patients hospitalized due to ICP received epomediol 900 mg/day (n = 7), or 1,200 mg/day (n = 4) orally, during 15 days. Biochemical parameters of liver dysfunction (serum bilirubin, bile salts, aminotransferase, alkaline phosphatases) were not modified during nor after epomediol administration. The severity of pruritus was significantly reduced in comparison to pretreatment status, with both doses of epomediol. A greater amelioration of pruritus was observed in patients treated with epomediol 1,200 mg/day than in patients who received 900 mg/day (to 20.7 +/- 6.2, as percent of pre-treatment severity score, versus 48.8 +/- 7.5 respectively; p < 0.05). After epomediol administration was stopped, pruritus relapsed in 6 patients; 3 of them had received the higher drug dose. After delivery, pruritus vanished and liver function tests returned to normal, in all patients. No adverse effects attributable to the drug were observed in the mothers or in their babies. The beneficial effect of epomediol on pruritus in patients with ICP appeared greater in this study than that observed recently in similar patients who received a placebo.

Effect of in vivo nitroglycerin therapy on endothelium-dependent and independent vascular relaxation and cyclic GMP accumulation in rat aorta.

Vascular relaxation by the organic (nitroglycerin) and inorganic (sodium nitroprusside) nitrovasodilators and the endothelium-dependent vasodilators (acetylcholine and histamine) has been associated with cyclic GMP accumulation. Tolerance to vasodilation by nitroglycerin commonly occurs following prolonged exposure to nitroglycerin. This study investigates the effects of in vivo nitroglycerin therapy on vascular relaxation and cyclic GMP accumulation induced by the nitrovasodilators and the endothelium-dependent vasodilators. Rats were injected with nitroglycerin or the propylene glycol diluent control for 4-7 days. Thoracic aortas from the nitroglycerin-treated rats were 750-fold less sensitive to the relaxant effects of nitroglycerin. In contrast, these aortas were only threefold less sensitive to the relaxant effects of sodium nitroprusside, while the maximum relaxation to acetylcholine and histamine was depressed by 50 and 41%, respectively. Desensitization to relaxation was associated with reduced cyclic GMP elevations to all the vasodilators. Relaxation to 8-bromo cyclic GMP, dibutyryl cyclic AMP, or diltiazem was unaffected by nitroglycerin therapy. Tolerance was also associated with an increased sensitivity to the contractile effects of low concentrations of norepinephrine. This increased sensitivity to norepinephrine was associated with a decrease in cyclic GMP levels. The present results suggest that: (1) desensitization to nitroglycerin, sodium nitroprusside, acetylcholine, and histamine by nitroglycerin therapy may be at the level of cyclic GMP accumulation; (2) cyclic GMP is the common mediator of relaxation induced by the nitro- and endothelium-dependent vasodilators; (3) the mechanisms involved in the activation of guanylate cyclase and relaxation by sodium nitroprusside, acetylcholine, and histamine are probably different than those of nitroglycerin; and (4) cyclic GMP may be acting as a physiological negative feedback signal in agonist-induced contraction.