Healthcare Professionals' Knowledge and Behaviors Regarding Drug-Dietary Supplement and Drug-Herbal Product Interactions.

Given the widespread use of dietary supplements (DS) and herbal products (HP), healthcare professionals (HCPs) will increasingly encounter patients who use these preparations with conventional drugs and who need their services to reduce the consequences of adverse therapeutic outcomes. The aim of our survey was to assess the knowledge and behaviors of HCPs regarding the risk of potential drug−dietary supplement (DDSIs) and drug−herbal product (DHPIs) interactions. This cross-sectional survey collected data via on paper-based questionnaire among general practitioners (GPs) (n = 105), specialty doctors (n = 87) and nurses (n = 154). The HCPs were mostly familiar with the interaction of doxycycline with magnesium (83%) and were least familiar with interaction of warfarin with glucosamine (14%). The results on DDSIs and DHPIs knowledge showed that GPs scored significantly higher than nurses (p < 0.001 and p = 0.003, respectively), while specialty doctors scored significantly higher than nurses only on DDSIs knowledge (p < 0.001). Only 28% of respondents reported that they often or always ask patients on drug therapy about the use of DS or HP, and 25% of respondents record such data in the medical documentation of patients. Our results showed that HCPs have sufficient knowledge about most major DDSIs and DHPIs, but insufficient knowledge about most moderate interactions. However, their overall knowledge and behavior regarding the risk of these interactions indicate the need for further continuing education and training.

Protective effects of celery juice in treatments with Doxorubicin.

The aim of this work was to investigate possible protective effect of celery juice in doxorubicin treatment. The following biochemical parameters were determined: content of reduced glutathione, activities of catalase, xanthine oxidase, glutathione peroxidase, peroxidase, and lipid peroxidation intensity in liver homogenate and blood hemolysate. We examined influence of diluted pure celery leaves and roots juices and their combinations with doxorubicine on analyzed biochemical parameters. Celery roots and leaves juices influenced the examined biochemical parameters and showed protective effects when applied with doxorubicine.

Effect of aroma and magnum hops extracts and paracetamol on antioxidant liver parameters in mice.

Hop varieties that are mainly grown in Serbia are Magnum (German variety) and Aroma, which is grown only in the Vojvodina region. About the use of hops extracts as an auxiliary remedy there are divergent opinions. Our findings indicate that extracts of Magnum and Aroma varieties, among the others, enhance and prolong the analgesic action of paracetamol. For this reason we undertook a study of the effects of these extracts alone and in combination with paracetamol, along with the action of paracetamol alone, on the activity of the antioxidant enzymes GSHPx, CAT, Px, XOD, GSHR, glutathione content, LPx intensity, as well as activities of AST and ALT. Paracetamol in the dose applied exerted no influence on the investigated parameters and neither did ethanolic extract of Magnum variety. On the other hand, ethanolic extract of Aroma hops caused a significant reduction of GSH content. In combination with paracetamol, extracts of both Magnum and Aroma varieties reduced significantly the LPx intensity, activities of CAT and GSHPx, as well as GSH content in the liver homogenate. A significant increase in the AST value with respect to control was also observed. These findings indicate the disturbance in the functioning of hepatocytes, probably by decelarating metabolism and elimination of paracetamol.

Disturbance of oxidative balance in the first trimester of spontaneous abortions.

Background/Aim: Pregnancy is defined as a condition of increased oxidative stress. The aim of this research was to determine the intensity of pro-oxidative processes and the content of GSH, as well as antioxidative enzymes: superoxide dismutase (SOD), catalase (CAT), gluthatione peroxidase (GSH-Px), and the total antioxidative status (TAS) in patients with spontaneous abortions. Methods: A total of 120 patients were involved in the research (70 spontaneous abortions and 50 healthy pregnancies). The patients were divided into groups: 35 patients with incomplete and complete spontaneous abortion (group S), 35 patients with missed abortion (group M) and a control group of 50 healthy pregnancies (group N), all of them being in the first trimester of pregnancy. The intensity of lipid proxidation (LPx) was determined with a modified thyobarbituric acid method. The GSH content in erythrocytes was determined by the method ba-sed on the amount of non-protein sulfhydryl residues using the Ellman's reagens. The following antioxidative parameters in the blood were measured: SOD ­ by the method with xanthine oxidase-using commercial RANSOD sets; CAT ­ by the method of Aebi (the enzyme activity was measured by monitoring the decomposition of H2O2 at 240 nm); GSH-Px was determined using hydrogen peroxide as a substrate. The TAS was determined using the ferric reducing autioxidant potential (FRAP) met-hod. Results: The highest average value of LPx was recorded in the spontaneous abortion group (48.03 pmoL/mg Hgb), and the lowest value was recorded in the control group (26.06 pmoL/mg Hgb). A statistically significant positive correlation between LPx and CAT in the group of patients with missed abortion was also noted (p < 0.05, r = 0.37). There was a statistically highly significant difference (p < 0.001) in SOD and in CAT activitices be-tween the examined patients (groups S and N) and the control group (Student's t-test and ANOVA). The highest average value of TAS was recorded in the group S (710.39 µmol/L), while the value in the group M was 277.66 µmol/L. The average value of TAS in the control group was 452.12 µmol/L. Student's t-test showed a statistically highly significant difference in the values of TAS between the examined patients (groups S and M) and the control group. Conclusion: Determination of the value of pro-oxidative and antioxidative parameters in patients with sponta-neous abortion can be the indicator of condition of fetoplacental unit and these analyses can be included in the protocol of the rutine perinatal diagnostics.

EFFECTS OF L-ASCORBIC ACID AND ALPHA-TOCOPHEROL ON BIOCHEMICAL PARAMETERS OF SWIMMING-INDUCED OXIDATIVE STRESS IN SERUM OF GUINEA PIGS.

BACKGROUND: The purpose of this study is to determine the effect of L-ascorbic acid and alpha-tocopherol as well as combination of these vitamins with or without exposure to physical exercise on intensity of lipid peroxidation, activity of xanthine oxidase, activity of total antioxidative system, concentration of glutathione, and activity of catalase in the serum of guinea pigs. MATERIALS AND METHODS: The experimental measurements of intensity of lipid peroxidation, activity of xanthine oxidase, activity of total antioxidative system, concentration of glutathione, and activity of catalase were done in the serum of guinea pigs. The animals were exposed to the test load to achieve exhaustion and the test was terminated when the animal for the third time to sink into the water. RESULTS: The results of this study demonstrated that endurance exercise of guinea pigs induced oxidative stress response in terms of increased lipid peroxidation and activity of xanthine oxidase in the serum of experimental animals. Our study investigated the antioxidant activity of L-ascorbic acid and alpha-tocopherol also measuring three protective markers in the serum: total antioxidant activity, content of glutathione and activity of catalase. The results obtained show that the vitamins influence the concentrations of above mentioned biochemical parameters, which points out their protective effect of swimming-induced oxidative stress. CONCLUSION: Single or combined administration of L-ascorbic acid and alpha-tocopherol caused significant inhibition of these markers indicating the important antioxidant activity of the vitamins. Results lead to conclude that the combined treatments with vitamins with or without exposure to physical exercise showed the clear synergistic effect..

The role of xanthine oxidase in hemodialysis-induced oxidative injury: relationship with nutritional status.

The role of xanthine oxidase (XOD) in patients undergoing chronic hemodialysis treatment (HD) is poorly understood. Geriatric nutritional risk index (GNRI) ≤ 90 could be linked with malnutrition-inflammation complex syndrome. This study measured XOD, myeloperoxidase (MPO), superoxide dismutase (SOD), lipid hydroperoxides, total free thiol groups, and advanced oxidation protein products (AOPP) in 50 HD patients before commencing (pre-HD) and immediately after completion of HD session (post-HD) and in 22 healthy controls. Pre-HD serum hydroperoxides, AOPP, XOD, and SOD were higher and total thiol groups were lower in patients than in controls (P < 0.05, resp.). Compared to baseline values, serum MPO activity was increased irrespective of GNRI status. Serum XOD activity was increasing during HD treatment in the group with GNRI ≤ 90 (P = 0.030) whilst decreasing in the group with GNRI > 90 (P = 0.002). In a multiple regression analysis, post-HD serum XOD activity was independently associated with GNRI ≤ 90 ( ß ± SE: 0.398 ± 0.151; P = 0.012) and HD vintage ( ß ± SE: -0.349 ± 0.139; P = 0.016). These results indicate that an upregulated XOD may be implicated in HD-induced oxidative injury contributing to accelerated protein damage in patients with GNRI ≤ 90.

Xanthine oxidase and lens oxidative stress markers in diabetic and senile cataract patients.

Xanthine oxidase (XOD) is a prooxidant enzyme possibly implicated in diabetic lens injury and genesis of senile cataract (SC). We evaluated the impact of diabetes on XOD activity and its relationships with lens oxidative stress markers in patients operated on for SC. Serum and lens XOD activities, lens malondialdehyde (MDA), conjugated dienes, superoxide dismutase (SOD), glutathione peroxidase (GPx) and reduced glutathione (GSH) levels were measured in 62 non-diabetic and 29 diabetic patients operated on for SC. Lens XOD, SOD, GPx and GSH levels were gradually declining, while MDA and serum XOD were increasing with patient's age. Lens XOD activity was positively correlated with conjugated dienes concentration (rho=0.316; p=0.003) while being inversely correlated with age (rho=-0.371; p<0.001), indicating that low ocular expression of XOD could be related to lower intensity of oxidative stress and delayed occurrence of SC. When samples were adjusted for confounding factors, serum XOD (p<0.001), lens XOD (p=0.003) and conjugated dienes (p=0.002) were significantly higher in diabetic than in non-diabetic group. Lens SOD and GPx were moderately increased while MDA and GSH were unchanged in diabetic, compared with non-diabetic SC group. Blood HbA1C concentration was positively correlated with lens XOD (rho=0.346; p<0.001) as well as serum XOD activity (rho=0.485; p<0.001). These results suggest that poor glycemic control may upregulate systemic and ocular XOD activities contributing to lens oxidative stress and possibly to earlier onset of cataract.

Oxidative stress and myeloperoxidase activity during bacterial meningitis: effects of febrile episodes and the BBB permeability.

OBJECTIVE: To investigate participation of extracellular myeloperoxidase (MPO) in oxidative stress during different courses of the bacterial meningitis (BM). MATERIALS AND METHODS: We sequentially assessed WBC count, blood-brain barrier (BBB) permeability, serum and cerebrospinal fluid (CSF) lipid peroxidation (LPO), MPO and antioxidative activity (AOA) in proven pediatric BM. RESULTS: BM patients exhibited increased systemic and local LPO and MPO, and reduced AOA, which was exaggerated in the febrile episodes. Serum MPO and LPO products were related to the BBB permeability at the baseline. CSF hydroperoxide level was influenced by the BBB permeability, CSF albumin concentration, and serum hydroperoxide (r=0.502; p<0.001, and r=0.611; p<0.001, and r=0.358; p<0.001, respectively). CSF hydroperoxide and MPO correlated in complicated cases during the study. CONCLUSIONS: These results suggest that CSF LPO and MPO were closely related in BM, had different courses if febrile episodes had occurred, but were partly influenced by the BBB permeability.