Safety, pitfalls, and misunderstandings about the use of ozone therapy as a regenerative medicine tool. A narrative review.

Despite various opinions and healthy controversy on Ozone Therapy (OT), the practices of this therapy have increased worldwide. Main areas of study with consistent scientific outcomes are the topical treatment of both disk herniation and periodontal disease. On the other hand, there is a net dissociation of the scientific resonance concerning systemic oxygen/ozone treatments. It is our intention to discuss in logical terms the numerous papers that commendably reported adverse reactions attributable to OT, focusing our attention mainly to the techniques of administration and not to the simple contact of ozone with biological material. The case reports on OT treatments safety concerns discussed on international journals, make it possible to state that most safety issues are secondary to infections or traumatic reactions due to malpractice. Commonly, the molecule of ozone itself is not responsible of severe reactions at the therapeutic modalities. The millions of patients treated so far from the thousands of physicians correctly practicing OT world widely in the last 40 years demonstrate the safety of this simple and cost-effective regenerative medicine tool. The promising therapeutic implications also for the current COVID-19 emergency are a further stimulus to the standardization of this therapeutic resource with multiple application specificities.

Radiolabelling of ascorbic acid: a new clue to clarify its action as an anticancer agent?

Vitamin C exists in two forms: the reduced (ascorbic acid--AA) and oxidized form (dehydroascorbic acid--DHA). This is a nutrient whose benefits are long known and widely publicized, being most of them related to its antioxidant action. As an antioxidant, the main role of vitamin C is to neutralize free radicals, reducing oxidative stress. However, some controversial studies suggest that this nutrient may have a preventive and therapeutic role in cancer disease due to their possible pro-oxidant activity, promoting the formation of reactive oxygen species that can induce cell death in cancer cells. This factor, coupled with the decrease of antioxidant enzymes and increase of decompartmentalized transition metals in tumor cells may result in the selective cytotoxicity of vitamin C and the subsequent revelation of its therapeutic potential. In this way the first purpose of this work was radioactively label the reduced form of vitamin C with Tc-99m, its quality control by HPLC and the time stability. The second purpose was to use the radioactive complex 99mTc-AA in in vitro and in vivo studies in order to evaluate its uptake by colorectal cancer cells and biodistribution in mices, respectively. The results suggest that the pharmaceutical formulation developed, which was reproducible and stable over time, was residually taken up by colorectal cancer cells. Future studies are needed to deepen our understanding about the radioactive complex 99mTc-AA and clarify the mechanisms of action of vitamin C in oncologic disease.

Resultados de la aplicación en atención primaria de un protocolo de valoración geriátrica integral en ancianos de riesgo / Outcomes of the application of a protocol of comprehensive geriatric assessment in elderly persons at risk in primary care

OBJETIVO: Analizar los resultados de la aplicación en atención primaria de un protocolo de valoración geriátrica integral en ancianos de riesgo. DISEÑO: Estudio transversal descriptivo realizado durante los meses de mayo y junio de 1998 en un centro de salud urbano. MÉTODO: Aplicación de un protocolo de valoración geriátrica integral a las personas con 65 o más años que cumplían al menos uno de los criterios de inclusión: a) todos los sujetos de 80 o más años, y b) el grupo de personas entre 65 y 79 años y que presentaran una o más de las condiciones siguientes: toma de tres o más fármacos al día, consumo de psicofármacos, comorbilidad generadora de dependencia funcional, caídas durante el último año, alta hospitalaria en los 6 meses previos, personas que viven solas o que han enviudado en el último año. En el protocolo de valoración geriátrica integral estaban incluidos una serie de instrumentos que permitían la realización de la valoración funcional (Lawton, Katz), del equilibrio (posición unipodal tándem y semitándem), afectiva (Geriatric Depression Scale reducido), mental (Pfeiffer) y nutricional (Mini Nutritional Assessment reducido). Adicionalmente, se realizaron acciones dirigidas a la detección de problemas sensoriales, del sueño y del ritmo deposicional, y se registró el nivel de actividad física. PACIENTES: Un total de 126 personas, de las 817 que acudieron de manera espontánea durante el período del estudio, cumplían los criterios de inclusión. MEDICIONES Y RESULTADOS PRINCIPALES: El 15,4 per cent (n = 126; 75 mujeres y 51 varones) cumplían criterios de anciano frágil. El 88,9 per cent tenían entre 65-79 años. El 76,2 per cent presentaban más de 2 motivos de inclusión. Tras la aplicación de la valoración geriátrica integral destacan los siguientes hallazgos: el 7,9 per cent eran dependientes para alguna de las actividades de la vida diaria instrumentales y el 16,7 per cent lo eran para alguna de las actividades de la vida diaria básicas. El 32,6 per cent presentaban alteración de la marcha y el 30,2 per cent del equilibrio. Se detectaron un total de 176 síndromes geriátricos, aproximadamente 1,4 por persona. El más frecuente para el total de la muestra fue la inestabilidad (36,5 per cent), seguido de los trastornos afectivos y depresivos (22,2 per cent). Casi un 16 per cent del total presentaron incontinencia urinaria. CONCLUSIONES: La aplicación de un protocolo de valoración geriátrica integral en atención primaria permite introducir el concepto de valoración geriátrica sistemática en ese ámbito y detectar problemas no conocidos en ancianos de riesgo. Resultados de la aplicación en atención primaria de un protocolo de valoración geriátrica integral en ancianos de riesgo (AU)

Environmental tobacco smoke interference in the assessment of the health impact of a municipal waste incinerator on children through urinary thioether assay.

The urinary elimination of thioethers urinary thioethers (UT) was studied in 83 schoolchildren living in two different areas of the city of Mataró, with special attention paid to the influence of a waste incinerator and of the smoking habits of their parents. The mean UT values were 8.79+/-3.23 and 7.52+/-3.23 mmol/mol creatinine in the area close to the incinerator (A1) and in the area far away from it (A2) respectively (statistically n.s.). Children exposed to environmental tobacco smoke (ETS) at home presented increased levels of UT (8.60+/-3.11 vs 5.93+/-3.22 mmol/mol creatinine; P=0.002). Considering the two exposures together (waste incinerator and ETS), no differences were found between the two areas studied (A1 and A2) in non-exposed (ETS) children, whereas slight differences were found when comparing highest ETS exposed children from the two areas (10. 18+/-2.70 vs 8.00+/-3.42 mmol/mol creatinine; P=0.04). Exposure to ETS could affect health more than pollutants from a waste incinerator and may interfere with non-selective assays such as urinary thioethers.