Radioprotective effect of the Barbados Cherry (Malpighia glabra L.) against radiopharmaceutical iodine-131 in Wistar rats in vivo.

BACKGROUND: The increasing consumption of fruits and vegetables has contributed to the improvement of populational health, due in part, to the abundance of antioxidants in these foods. Antioxidants reduce the level of oxidative damage to DNA caused by free radicals and ionizing radiation, including the radioisotope iodine-131 (131I). This isotope is used for the diagnosis and treatment of thyroid injuries, such as hyperthyroidism and cancer. METHODS: This study aimed to evaluate the radioprotective and cytotoxic activity of acute and subchronic treatments with Barbados Cherry (BC) (Malpighia glabra L.) fruit juice (5 mg), which is rich in potent antioxidants such as vitamin C, phenols, carotenoids, anthocyanins and yellow flavonoids and its activity against the mutagenic activity of the therapeutic dose of 25 µCi of radioiodine for hyperthyroidism. The test system used was the bone marrow cells of Wistar rats (Rattus norvegicus) that were treated in vivo by gavage. RESULTS: BC showed radioprotective activity in acute treatments, which is most likely due to the joint action of its antioxidant components. In subchronic treatments, the continuous treatment presented an effective radioprotective activity, which was significantly different from treatment with the radiopharmaceutical only. Treatment with BC prior to (PRE) and simultaneous with (SIM) ionizing radiation decreased the number of induced chromosomal alterations, while post-treatment produced no protective effect. In addition, BC exhibited no cytotoxic activity. CONCLUSIONS: These data serve as evidence that BC can be used as a preventive health measure to improve public health quality by countering the action of inevitable exposure to mutagens, such as 131I.

Cost of noninfectious comorbidities in patients with HIV.

OBJECTIVES: We hypothesized that the increased prevalence of noninfectious comorbidities (NICMs) observed among HIV-infected patients may result in increased direct costs of medical care compared to the general population. Our objective was to provide estimates of and describe factors contributing to direct costs for medical care among HIV-infected patients, focusing on NICM care expenditure. METHODS: A case-control study analyzing direct medical care costs in 2009. Antiretroviral therapy (ART)-experienced HIV-infected patients (cases) were compared to age, sex, and race-matched adults from the general population, included in the CINECA ARNO database (controls). NICMs evaluated included cardiovascular disease, hypertension, diabetes mellitus, bone fractures, and renal failure. Medical care cost information evaluated included pharmacy, outpatient, and inpatient hospital expenditures. Linear regression models were constructed to evaluate predictors of total care cost for the controls and cases. RESULTS: There were 2854 cases and 8562 controls. Mean age was 46 years and 37% were women. We analyzed data from 29,275 drug prescription records. Positive predictors of health care cost in the overall population: HIV infection (ß = 2878; confidence interval (CI) = 2001-3755); polypathology (ß = 8911; CI = 8356-9466); age (ß = 62; CI = 45-79); and ART exposure (ß = 18,773; CI = 17,873-19,672). Predictors of health care cost among cases: Center for Disease Control group C (ß = 1548; CI = 330-2766); polypathology (ß = 11,081; CI = 9447-12,716); age < 50 years (ß = 1903; CI = 542-3264); protease inhibitor exposure (per month of use; ß = 69; CI = 53-85); CD4 count < 200 cells/mm(3) (ß = 5438; CI = 3082-7795); and ART drug change (per change; ß = 911; CI = 716-1106). CONCLUSION: Total cost of medical care is higher in cases than controls. Lower medical costs associated with higher CD4 strata are offset by increases in the care costs needed for advancing age, particularly for NICMs.

Cytotoxicity and mutagenicity of cola and grape flavored soft drinks in bone marrow cells of rodents / Citotoxicidade e mutagenicidade de refrigerantes sabor cola e uva, em células de medula óssea de roedor

Due to the large consumption of soft drinks in Brazil and worldwide in recent years and considering that some of the components presentin their composition pose potential risks to human health, the aim of this study was to evaluate the cytotoxic and mutagenic potential ofspecific cola and grape-flavored soft drink brands. Bone marrow cells of Wistar rats were initially treated by gavage with one single dose of Cola or Grape soft drink, which was next offered ad libitum (instead of water) for 24 hours. A negative control treatment was performed by administering one single dose of water and a positive control administering cyclophosphamide intraperitoneally. Statistical analysis showedthat the Cola and Grape soft drinks studied were not cytotoxic. However, the Cola soft drink proved mutagenic in this experiment treatmenttime. Therefore, this study serves as a warning about the consumption of Cola-flavored soft drink and for the need for further subchronicand chronic studies on soft drinks in order to evaluate the long term mutagenic and cytotoxic effects of these substances.

Devido ao grande consumo de refrigerantes no Brasil e no mundo nos últimos anos, e tendo em vista que alguns dos componentes presentes na composição destes possuem potenciais danosos para os organismos, em especial o humano, o objetivo deste trabalho foi avaliar o potencial citotóxico e mutagênico de uma marca de refrigerante sabor Cola e uma de sabor Uva. Foram utilizadas como sistema-teste as células demedula óssea de ratos Wistar, tratados via gavagem com dose única do refrigerante sabor Cola ou Uva e, em seguida, fornecidos ad libitum(no lugar da água), por 24 horas. Foi feito um controle negativo, administrando água, em dose única, e um controle positivo administrando ciclofosfamida, via intraperitoneal. A análise estatística mostrou que os refrigerantes sabor Cola e Uva não foram citotóxicos. Entretanto, o refrigerante sabor Cola foi mutagênico neste sistema-teste e tempo de tratamento. Desta forma, este estudo serve de alerta para o consumo de refrigerantes sabor Cola e indica que estudos subcrônicos e crônicos com os refrigerantes devem ser realizados, a fim avaliar os efeitos mutagênicos e citotóxicos dessas substâncias a longo prazo.

Premature age-related comorbidities among HIV-infected persons compared with the general population.

BACKGROUND: Human immunodeficiency virus (HIV)-infected patients may have a greater risk of noninfectious comorbidities (NICMs) compared with the general population. We assessed the prevalence and risk factors for NICMs in a large cohort of HIV-infected adults and compared these findings with data from matched control subjects. METHODS: We performed a case-control study involving antiretroviral therapy (ART)-experienced HIV-infected patients treated at Modena University, Italy, from 2002 through 2009. These patients were compared with age-, sex-, and race-matched adults (control subjects) from the general population included in the CINECA ARNO database. NICMs included cardiovascular disease, hypertension, diabetes mellitus, bone fractures, and renal failure. Polypathology (Pp) was defined as the concurrent presence of ≥2 NICMs. Logistic regression models were constructed to evaluate associated predictors of NICMs and Pp. RESULTS: There were 2854 patients and 8562 control subjects. The mean age was 46 years, and 37% were women. Individual NICM and Pp prevalences in each age stratum were higher among patients than among controls (all P <.001). Pp prevalence among patients aged 41-50 years was similar to that among controls aged 51-60 years (P value was not statistically significant); diabetes mellitus, cardiovascular disease, bone fractures, and renal failure were statistically independent after adjustment for sex, age, and hypertension. Logistic regression models showed that independent predictors of Pp in the overall cohort were (all P < .001) age (odds ratio [OR], 1.11), male sex (OR, 1.77), nadir CD4 cell count <200 cells/µL (OR, 4.46), and ART exposure (OR, 1.01). CONCLUSIONS: Specific age-related NICMs and Pp were more common among HIV-infected patients than in the general population. The prevalence of Pp in HIV-infected persons anticipated Pp prevalence observed in the general population among persons who were 10 years older, and HIV-specific cofactors (lower nadir CD4 cell count and more prolonged ART exposure) were identified as risk factors. These data support the need for earlier screening for NICMs in HIV-infected patients.

Mutagenicity of diagnostic and therapeutical doses of radiopharmaceutical iodine-131 in Wistar rats.

Iodine-131 ((131)I) is a radioisotope used for the diagnosis and treatment of thyroidal disorders such as hyperthyroidism and cancer. During its decay, (131)I emits beta particles and gamma rays; its physical half-life is 8 days, and it is accumulated preferentially in the thyroid tissue. This study aimed to evaluate the cytotoxicity and mutagenicity of diagnostic and therapeutic doses of (131)I using bone marrow cells of rats treated in vivo in a test system with a single dose by gavage. Concentrations of 5, 25, 50 and 250 µCi in 1 ml of water were used, and after 24 h, the animals were killed. Also, a concentration of 25 µCi/ml of water was used, and the animals were killed after 5 days. The results showed that no concentration of (131)I was cytotoxic and that all concentrations were mutagenic. As a result, there was no statistically significant difference detected by the χ(2) test in the induction of chromosomal aberrations between the different doses. Thus, the present study demonstrated a significant increase in chromosomal aberration in bone marrow cells exposed to (131)I regardless of the dose or the treatment time.

Antidepressant drug prescription and risk of abnormal bleeding: a case-control study.

This study assessed the risk of any bleeding abnormalities, including the risk of gastrointestinal bleeding, associated with antidepressant exposure. We used a case-control methodology. Case patients were individuals admitted with a diagnosis of abnormal bleeding. Control subjects were individuals admitted on the same date without evidence of abnormal bleeding. During the study period, 11,025 case patients were admitted for bleeding abnormalities (matched with 21,846 eligible control subjects), and 1008 were admitted for gastrointestinal bleeding (matched with 1990 eligible control subjects). With respect to any bleeding abnormalities, antidepressants as a group were not associated with an increased risk (adjusted odds ratio [OR], 0.99; 95% confidence interval [CI], 0.90-1.08). Similarly, selective serotonin reuptake inhibitors as a group, the group of tricyclic and related antidepressants, and the group of other antidepressants were not associated with an increased risk of bleeding. With respect to gastrointestinal bleeding abnormalities, antidepressants as a group were associated with a modestly increased risk (adjusted OR, 1.34; 95% CI, 1.01-1.80). Whereas the group of tricyclic and related antidepressants was not associated with an increased risk of bleeding, the group of selective serotonin reuptake inhibitors was associated with a nonsignificant trend toward an increased risk of bleeding (adjusted OR, 1.31; 95% CI, 0.91-1.88) and the group of other antidepressants with a statistically significant increase in the risk of bleeding (adjusted OR, 1.74; 95% CI, 1.04-2.93). In a population with a low baseline risk of bleeding, we detected a significant increase in the risk of gastrointestinal bleeding only.

Drug utilisation profile in the Italian paediatric population.

OBJECTIVE: In order to evaluate the prescribing pattern in the Italian paediatric population, prescriptions involving 923,353 children under 14 years old and dispensed during 2006 by the retail pharmacies of 22 Italian local health units were analysed. MATERIALS AND METHODS: A total of 561,237 children (61%) received at least one drug prescription. The prescription prevalence rate was highest in children 3 years of age (78%), decreased with increasing age and was higher in boys than in girls (chi(2)=655; p<<0.001). Each treated child received an average of 3.2 prescriptions and 4.8 boxes. RESULTS: Antibiotics and anti-asthmatics were the more prescribed therapeutic classes and represented 80% of prescriptions. Amoxicillin+clavulanic acid was the most prescribed drug (24% of the overall population; 17% of all boxes), followed by inhaled beclometasone and amoxicillin. A total of 620 different drugs were prescribed and the ten leading drugs represented 64% of the prescribed boxes. Six of the ten most prescribed drugs were the same in all age groups. Wide differences were found in the prevalence rate between the different local health units; these ranged between 50.1 and 68.4% (p<<0.001). The prescription prevalence increased in the 2000-2002 period (from 62.2 to 68.3%) and slightly decreased afterwards. CONCLUSION: Despite some limitations, the systematic monitoring of prescriptions is a valuable tool for evaluating the appropriateness of the care.

Inappropriate use of anti-asthmatic drugs in the Italian paediatric population.

OBJECTIVE: To evaluate anti-asthmatic drug prescriptions in a large Italian paediatric population. METHODS: Prescriptions involving 417,559 children younger than 14 years old dispensed during 2000 by the retail pharmacies of 17 Italian local health units participating in the ARNO project were analysed. RESULTS: In the study, 92,890 children (22.2%) received at least one anti-asthmatic drug prescription. The prevalence of prescriptions was higher in children less than 1 year old, significantly decreased with increasing age, and was higher in boys than in girls. Of children treated with anti-asthmatic drugs, 71.5% received prescriptions of less than three boxes. Beclomethasone, salbutamol, flunisolide and fluticasone were the most prescribed drugs. Beclomethasone and flunisolide were prescribed mostly as nebulised suspension. CONCLUSIONS: The data suggest that anti-asthmatic drugs are often prescribed for diseases different from asthma and that many children are exposed to treatments for which there is no evidence of efficacy.