The Effect of the Extra Virgin Olive Oil Minor Phenolic Compound 3',4'-Dihydroxyphenylglycol in Experimental Diabetic Kidney Disease.

The aim of this study was to analyze the possible nephroprotective effect of 3',4'-dihydroxyphenylglycol (DHPG), a polyphenolic compound of extra virgin olive oil (EVOO), on renal lesions in an experimental model of type 1 diabetes. Rats were distributed as follows: healthy normoglycemic rats (NDR), diabetic rats treated with saline (DR), and DR treated with 0.5 mg/kg/day or 1 mg/kg/day of DHPG. DR showed a significantly higher serum and renal oxidative and nitrosative stress profile than NDR, as well as reduced prostacyclin production and renal damage (defined as urinary protein excretion, reduced creatinine clearance, increased glomerular volume, and increased glomerulosclerosis index). DHPG reduced the oxidative and nitrosative stress and increased prostacyclin production (a 59.2% reduction in DR and 34.7-7.8% reduction in DHPG-treated rats), as well as 38-56% reduction in urinary protein excretion and 22-46% reduction in glomerular morphological parameters (after the treatment with 0.5 or 1 mg/kg/day, respectively). Conclusions: DHPG administration to type 1-like diabetic rats exerts a nephroprotective effect probably due to the sum of its antioxidant (Pearson's coefficient 0.68-0.74), antinitrosative (Pearson's coefficient 0.83), and prostacyclin production regulator (Pearson's coefficient 0.75) effects.

Neuroprotective Effect of 3',4'-Dihydroxyphenylglycol in Type-1-like Diabetic Rats-Influence of the Hydroxytyrosol/3',4'-dihydroxyphenylglycol Ratio.

The aim of this study was to assess the possible neuroprotective effect of 3',4'-dihydroxyphenylglycol (DHPG), a polyphenol from extra virgin olive oil (EVOO), in an experimental model of diabetes and whether this effect is modified by the presence of another EVOO polyphenol, hydroxytyrosol (HT). The neuroprotective effect was assessed in a hypoxia-reoxygenation model in brain slices and by quantifying retinal nerve cells. The animals were distributed as follows: (1) normoglycemic rats (NDR), (2) diabetic rats (DR), (3) DR treated with HT (5 mg/kg/day p.o.), (4) DR treated with DHPG (0.5 mg/kg/day), or (5) with 1 mg/kg/day, (6) DR treated with HT plus DHPG 0.5 mg/kg/day, or (7) HT plus 1 mg/kg/day p.o. DHPG. Diabetic animals presented higher levels of oxidative stress variables and lower numbers of neuronal cells in retinal tissue. The administration of DHPG or HT reduced most of the oxidative stress variables and brain lactate dehydrogenase efflux (LDH) as an indirect index of cellular death and also reduced the loss of retinal cells. The association of DHPG+HT in the same proportions, as found in EVOO, improved the neuroprotective and antioxidant effects of both polyphenols.

Synergistic Effect of 3',4'-Dihidroxifenilglicol and Hydroxytyrosol on Oxidative and Nitrosative Stress and Some Cardiovascular Biomarkers in an Experimental Model of Type 1 Diabetes Mellitus.

The objective of this study was to assess a possible synergistic effect of two extra-virgin olive oil polyphenols, 3,4,-dyhydroxyphenylglycol (DHPG) and hydroxytyrosol (HT), in an experimental model of type 1 diabetes. Seven groups of animals were studied: (1) Nondiabetic rats (NDR), (2) 2-month-old diabetic rats (DR), (3) DR treated with 5 mg/kg/day p.o. HT, (4) DR treated with 0.5 mg/kg/day p.o. DHPG, (5) DR treated with 1 mg/kg/day p.o. DHPG, (6) DR treated with HT + DHPG (0.5), (7) DR treated with HT + DHPG (1). Oxidative stress variables (lipid peroxidation, glutathione, total antioxidant activity, 8-isoprostanes, 8-hydroxy-2-deoxyguanosine, and oxidized LDL), nitrosative stress (3-nitrotyrosine), and some cardiovascular biomarkers (platelet aggregation, thromboxane B2, prostacyclin, myeloperoxidase, and vascular cell adhesion protein 1 (VCAM-1)) were analyzed. The diabetic animals showed an imbalance in all of the analyzed variables. HT exerted an antioxidant and downregulatory effect on prothrombotic biomarkers while reducing the fall of prostacyclin. DHPG presented a similar, but quantitatively lower, profile. HT plus DHPG showed a synergistic effect in the reduction of oxidative and nitrosative stress, platelet aggregation, production of prostacyclin, myeloperoxidase, and VCAM-1. This synergism could be important for the development of functional oils enriched in these two polyphenols in the proportion used in this study.

Nephroprotective Effect of the Virgin Olive Oil Polyphenol Hydroxytyrosol in Type 1-like Experimental Diabetes Mellitus: Relationships with Its Antioxidant Effect.

The aim of this study was to determine whether hydroxytyrosol administration prevented kidney damage in an experimental model of type 1 diabetes mellitus in rats. Hydroxytyrosol was administered to streptozotocin-diabetic rats: 1 and 5 mg/kg/day p.o. for two months. After hydroxytyrosol administration, proteinuria was significantly reduced (67-73%), calculated creatinine clearance was significantly increased (26-38%), and the glomerular volume and glomerulosclerosis index were decreased (20-30%). Hydroxytyrosol reduced oxidative and nitrosative stress variables and thromboxane metabolite production. Statistical correlations were found between biochemical and kidney function variables. Oral administration of 1 and 5 mg/kg/day of hydroxytyrosol produced an antioxidant and nephroprotective effect in an experimental model of type 1-like diabetes mellitus. The nephroprotective effect was significantly associated with the systemic and renal antioxidant action of hydroxytyrosol, which also influenced eicosanoid production.

Extra Virgin Oil Polyphenols Improve the Protective Effects of Hydroxytyrosol in an In Vitro Model of Hypoxia-Reoxygenation of Rat Brain.

Hydroxytyrosol (HT) is the component primarily responsible for the neuroprotective effect of extra virgin olive oil (EVOO). However, it is less effective on its own than the demonstrated neuroprotective effect of EVOO, and for this reason, it can be postulated that there is an interaction between several of the polyphenols of EVOO. The objective of the study was to assess the possible interaction of four EVOO polyphenols (HT, tyrosol, dihydroxyphenylglycol, and oleocanthal) in an experimental model of hypoxia-reoxygenation in rat brain slices. The lactate dehydrogenase (LDH) efflux, lipid peroxidation, and peroxynitrite production were determined as measures of cell death, oxidative stress, and nitrosative stress, respectively. First, the polyphenols were incubated with the brain slices in the same proportions that exist in EVOO, comparing their effects with those of HT. In all cases, the cytoprotective and antioxidant effects of the combination were greater than those of HT alone. Second, we calculated the concentration-effect curves for HT in the absence or presence of each polyphenol. Tyrosol did not significantly modify any of the variables inhibited by HT. Dihydroxyphenylglycol only increased the cytoprotective effect of HT at 10 µM, while it increased its antioxidant effect at 50 and 100 µM and its inhibitory effect on peroxynitrite formation at all the concentrations tested. Oleocanthal increased the cytoprotective and antioxidant effects of HT but did not modify its inhibitory effect on nitrosative stress. The results of this study show that the EVOO polyphenols DHPG and OLC increase the cytoprotective effect of HT in an experimental model of hypoxia-reoxygenation in rat brain slices, mainly due to a possibly synergistic effect on HT's antioxidant action. These results could explain the greater neuroprotective effect of EVOO than of the polyphenols alone.

Evaluation of Inappropriate Prescribing in Patients Older than 65 Years in Primary Health Care.

To asses inappropriate prescribing and its predisposing factors in polymedicated patients over the age of 65 in primary health care. DESIGN: cross-sectional study. SETTING: Primary care centres in the Costa del Sol Health District and Northern Health Area of Malaga in southern Spain. PARTICIPANTS: Patients older than 65 years who use multiple medications. Data collection was conducted during 1 year in a population of 425 individuals who comprised a stratified randomized sample of the population of health care users in the study area. The data were collected by interview on a structured data collection form. STUDY VARIABLES: Dependent variable: Potentially inappropriate prescribing (PIP) (STOPP/START criteria). Predictor variables: Sociodemographic characteristics, clinical characteristics and medication use. A descriptive analysis of the variables was performed. Statistical inference was based on bivariate analysis (Student's t or Mann-Whitney U test and chi-squared test) and multivariate analysis was used to control for confounding factors. 73.6% of participants met one or more STOPP/START criteria. According to information about prescribed treatments, 48.5% of participants met at least one STOPP criterion and 43.30% of them met at least one START criterion. The largest percentage of inappropriate prescriptions was associated with cardiovascular treatments. More than three-quarters of the participants had one or more inappropriate prescriptions for medicines in primary care, according to STOPP/START criteria. In addition, PIP was directly related to the number of prescribed medications, gender and specific pathologies (diabetes).

Prevalence and Related Factors of Ineffective Self-Health Management in Polymedicated Patients Over the Age of 65 Years.

PURPOSE: To determine the prevalence of Ineffective Self-Health Management (ISHM) (00078) and its related factors in polymedicated patients over the age of 65 years. METHODS: A cross-sectional, descriptive design was used. A home interview was conducted with each participant (N = 375) for data collection. FINDINGS: The prevalence of ISHM was 37.3%. The risk factors associated were social risk, depression, noncompliance, medication errors, and confusion with medications. CONCLUSIONS: Among polymedicated elderly patients, the prevalence of ISHM is high. The diagnosis is closely connected to the compliance and complexity of the treatment regimen, in addition to those relating strictly to social and emotional factors. IMPLICATIONS: Nursing methodology encompasses instruments that allow nurses in clinical practice to evaluate the issue of compliance.

Medication-related factors associated with health-related quality of life in patients older than 65 years with polypharmacy.

METHODS AND DESIGN: Objective: To describe the relationship between medication-related factors and the health-related quality of life in patients older than 65 years who use multiple medications (polypharmacy). Design: Cross-sectional descriptive study. Setting: Primary care. Participants: Patients older than 65 years who use multiple medications (n = 375). Measurements: The main outcome measure was health-related quality of life according to the EuroQol-5D instrument. Sociodemographic, clinical and medication-related variables were recorded during home interviews. RESULTS: Mean age was 74.72 ± 5.59 years, and 65.5% of our participants were women. The global level of health-related quality of life according to the EQ-5D visual analog scale was 59.25 ± 20.92. Of the five EuroQol dimensions, anxiety/depression and pain were the most frequently reported, while mobility and self-care were the dimensions with the greatest impact on self-reported quality of life. Multivariate analysis indicated that functional independence was the factor most strongly associated (ß = 14.27 p < 0.001) with better health-related quality of life, while illiteracy (ß = -13.58 p < 0.001), depression (ß = -10.13 p < 0.001), social risk (ß = -7.23 p = 0.004) and using more than 10 medicines (ß = -4.85 p = 0.009) were strongly associated with a poorer health-related quality of life. CONCLUSIONS: Factors inherent within the patient such as functional incapacity, cognitive impairment and social and emotional problems were the main constraints to quality of life in our study population. The number of medicines taken was negatively related with quality of life.

Adherencia al tratamiento en pacientes polimedicados mayores de 65 años con prescripción por principio activo / Adherence to treatment, by active ingredient, in patients over 65 years on multiple medication

OBJETIVO: Valorar el nivel de adherencia al tratamiento y los factores relacionados en polimedicados mayores de 65 con prescripción por principio activo. DISEÑO: Estudio observacional, descriptivo, transversal, sobre polimedicados mayores de 65 años adscritos a los centros de atención primaria del Distrito Sanitario Costa del Sol y del Área Sanitaria Norte de Málaga. Se ha realizado entre enero del 2011 y septiembre del 2012, sobre una población de 375 individuos obtenida mediante muestreo aleatorio simple a partir de las listas de pacientes proporcionadas por cada centro. Los datos se recogieron mediante entrevista, sobre hoja estructurada de recogida de datos y previa firma del consentimiento informado. Variables del estudio: Variable principal de resultado: adherencia al tratamiento (test de Morisky-Green). Variables predictoras: Prescripción por principio activo, variables sociodemográficas, clínicas y relacionadas con la medicación. Se efectuó un análisis descriptivo de las variables. La inferencia estadística se realizó mediante análisis bivariante (test de la t de Student o U de Mann Whitney y chi al cuadrado), controlándose los factores de confusión mediante análisis multivariante (regresión lineal y logística). RESULTADOS: El cumplimiento terapéutico se sitúa en el 51,7%, no apreciándose diferencias estadísticamente significativas con respecto al sexo o la edad. Encontramos relación con residir en zona de interior (p = 0,001), vivir acompañados (p < 0,05) y no presentar riesgo de ansiedad (p = 0,046). CONCLUSIONES: La adherencia es similar a los estudios realizados, independientemente de si la prescripción es por principio activo. El incumplimiento fue mayor en individuos que viven solos, en población costera y con riesgo de ansiedad

AIM: To assess the level of adherence, by active ingredient, to treatment and associated factors in polymedicated patients over 65 years-old. DESIGN: Observational, descriptive and cross-sectional study over polymedicated patients over 65 years of the Costa del Sol Health District and the North Malaga Health Area. The study was performed between January 2011 and September 2012 on 375 subjects obtained by simple random sampling from lists provided by each health centre. Data was collected by means of an interview with structured questions. Informed consent was given and signed by all patients before interview. Study variables: Main results variable adherence to treatment (Morisky-Green's test).Predictable variables: Prescription by active ingredient, socio-demographic variables, healthcare centre variables, and treatment associated variables. A descriptive analysis of variables was performed. Statistical inference was determined using univariate analysis (t test of Student or Mann-Whitney U, and Chi-squared), and controlling for confounding factors by multivariate analysis (linear and logistic regression). RESULTS: The result for therapeutic compliance was 51.7%. No statistically significant differences were observed as regards sex and age. A relationship was found in those who resided in rural areas (p = 0.001), lived with family (p < 0.05), and were not at risk of suffering from anxiety (p = 0.046). CONCLUSIONS: We found similar patient adherence to treatment despite the prescribing generic drugs. Failure to therapeutic compliance was greater in those patients who lived by themselves, in a city close to the coast, or in those patients who were at risk of suffering from anxiety

[Adherence to treatment, by active ingredient, in patients over 65 years on multiple medication]. / Adherencia al tratamiento en pacientes polimedicados mayores de 65 años con prescripción por principio activo.

AIM: To assess the level of adherence, by active ingredient, to treatment and associated factors in polymedicated patients over 65 years-old. DESIGN: Observational, descriptive and cross-sectional study over polymedicated patients over 65 years of the Costa del Sol Health District and the North Malaga Health Area. The study was performed between January 2011 and September 2012 on 375 subjects obtained by simple random sampling from lists provided by each health centre. Data was collected by means of an interview with structured questions. Informed consent was given and signed by all patients before interview. STUDY VARIABLES: Main results variable adherence to treatment (Morisky-Green's test). PREDICTABLE VARIABLES: Prescription by active ingredient, socio-demographic variables, health care centre variables, and treatment associated variables. A descriptive analysis of variables was performed. Statistical inference was determined using univariate analysis (t test of Student or Mann-Whitney U, and Chi-squared), and controlling for confounding factors by multivariate analysis (linear and logistic regression). RESULTS: The result for therapeutic compliance was 51.7%. No statistically significant differences were observed as regards sex and age. A relationship was found in those who resided in rural areas (P=.001), lived with family (P<.05), and were not at risk of suffering from anxiety (P=.046). CONCLUSIONS: We found similar patient adherence to treatment despite the prescribing generic drugs. Failure to therapeutic compliance was greater in those patients who lived by themselves, in a city close to the coast, or in those patients who were at risk of suffering from anxiety.