Combined cytotoxicity of ZnO nanoparticles and chlorpyrifos in the rainbow trout, Oncorhynchus mikyss, gonadal cell line RTG-2.

The toxicity of ZnO nanoparticles (ZnO NPs) in aquatic organisms has been extensively studied, but little information is available on the effects associated with their interaction with other contaminants. In this context, the in vitro effects of co-exposure of chlorpyrifos (CPF) and ZnO NPs on fish-derived cells were investigated. A selection of concentrations was tested in single and binary exposures: CPF (0.312 - 75 mg/L) and ZnO NPs (10 - 100 mg/L). Cytotoxicity was measured using commonly used cellular endpoints: Alamar Blue/CFDA-AM for viability and plasma membrane integrity, NRU for lysosomal disruption and MTT for mitochondrial function. In addition, specific mechanisms of toxicity for CPF and ZnO NPs were tested: acetylcholinesterase (AChE) activity and ROS generation, respectively. AChE was by far the most sensitive assay for single exposure to CPF. There was no concentration-response relationship for ROS after single exposure to ZnO NPs, but 10 mg/L produced significant effects only for this cellular endpoint. Co-exposure of CPF with 10 m/L of ZnO NPs produced significant effects in almost all endpoints tested, which were enhanced by co-exposure with 100 mg/L of ZnO NPs. AChE testing of additional co-exposures with bulk ZnO, together with the application of the Independent Action (IA) prediction model, which allowed us to draw more in-depth conclusions on the toxicological behavior of the mixture. Synergism was observed at 0.625 mg/L CPF concentration and antagonism at 5 mg/L CPF in mixtures containing 100 mg/L of both ZnO NPs and bulk ZnO. However, more cases of synergism between CPF and ZnO NPs occurred at intermediate CPF concentrations, demonstrating that nano-sized particles have a more toxic interaction with CPF than bulk ZnO. Therefore it can be argued that in vitro assays allow the identification of interaction profiles of NP-containing mixtures by achieving multiple endpoints with a large number of concentration combinations.

Complementary medicine use in cancer patients receiving intravenous antineoplastic treatment.

OBJECTIVE: Complementary and alternative medicine (CAM) use has grown considerably, although there is little research on the topic in Spain. The aim of this study was to determine the prevalence of complementary medicine use in adult cancer patients at the same time as they were receiving conventional treatment in a Spanish referral cancer centre. METHOD: An observational, descriptive, cross-sectional study was conducted in the Ambulatory Treatment Unit during 2 consecutive weeks in March 2015. Adult patients who were receiving intravenous chemotherapy were included. Study variables were obtained from a questionnaire and medical records. RESULTS: 316 patients were included. 32.3% of the patients reported complementary medicine use during this period and 89% were ingesting products by mouth, herbs and natural products being the most commonly used. 81% of patients started to use complementary medicine after diagnosis, and family/friends were the main source of information. 65% of the patients reported improvements, especially in their physical and psychological well-being. Significant predictors of CAM use were female gender (P=0.028), younger age (P<0.001), and secondary education (P=0.009). CONCLUSIONS: A large proportion of cancer patients receiving intravenous chemotherapy also use complementary medicine, which they mainly take by mouth. Due to the risk of chemotherapy-CAM interactions, it is important for health-professionals to keep abreast of research on this issue, in order to provide advice on its potential benefit and risks.

Objetivo: La popularidad de la medicina alternativa y complementaria entre los pacientes oncológicos ha incrementado, pero aún se dispone de poca información acerca de su empleo en España. El objetivo principal de este estudio fue determinar la prevalencia del uso de medicina complementaria en pacientes oncológicos adultos que reciben tratamiento en un centro autonómico español de referencia.Método: Estudio observacional, descriptivo y transversal llevado a cabo en un Hospital de Día de oncología durante 2 semanas de marzo de 2015. Se incluyeron pacientes adultos que recibían tratamiento con quimioterapia intravenosa. Las variables del estudio se obtuvieron a través de un cuestionario y de la historia clínica.Resultados: Fueron incluidos 316 pacientes; el 32,3% estaba usando algún tipo de medicina complementaria en ese momento, y el 89% de ellos lo hacía a base de una ingesta oral de sustancias, principalmente hierbas y productos naturales. El 81% de los pacientes inició la medicina complementaria tras el diagnóstico, siendo la fuente de información principal familiares/amigos. El 65% refirió sentir mejoría, principalmente bienestar físico y psíquico. Los predictores significativos de uso de MAC fueron: ser mujer (p=0,028), edad joven (p<0,001) y un nivel educativo medio (p=0,009).Conclusiones: Una proporción importante de los pacientes oncológicos que reciben quimioterapia intravenosa usan simultáneamente medicina complementaria, y esta consiste principalmente en una ingesta oral de preparados. Debido al riesgo de interacción con el tratamiento, es importante la formación de los profesionales sanitarios en este ámbito, con el fin de poder aconsejar a los pacientes acerca de sus potenciales beneficios y riesgos.