Irrational Use of Medications among Adults with Insomnia: An Observational Study at a Sleep Clinic in Mexico.

BACKGROUND: To determine the patterns of irrational use of medications among a sample of adult patients with insomnia. METHODS: We included 89 adult patients diagnosed with chronic insomnia who had consumed medications for this disorder during the 12 months prior to admission to a specialized Sleep Disorders Clinic (SDC) in Mexico City. With a 13-item survey, information was gathered on patterns of medication use and irrational use, considering therapeutic indications, dose, route of administration, and duration of treatment. RESULTS: The participants had taken hypnotics (65%), antidepressants (21%), anticonvulsants (8%), and antipsychotics (6%), and 92% had irrational use of their medication. Irrational use was greatest with benzodiazepines and antipsychotics. There were two main types of irrational use: (1) 47% of participants had consumed a drug unsuitable for their condition, although it was almost always prescribed by a doctor, and (2) 43% had consumed a drug for longer than the maximum time recommended. CONCLUSION: It is worrisome to find that the irrational use of medications to treat insomnia, especially benzodiazepines and antipsychotics is widespread. Although most participants had acquired their medication by prescription, for many the drug was inappropriate to treat their condition. It should be mandatory that patients with insomnia receive specialized medical attention in primary clinical care.

Desafíos en el empleo de los medicamentos huérfanos

Las enfermedades raras son aquellas que tienen baja prevalencia y que, por lo tanto, el desarrollo de medicamentos para tratarlas no es rentable para las empresas farmacéuticas debido a la baja demanda. A pesar de que ya se cuenta con diferentes políticas públicas alrededor del mundo para incentivar a las industrias farmacéuticas a investigar estos medicamentos, conocidos como medicamentos huérfanos, su desarrollo conlleva muchas dificultades en las evaluaciones clínicas y el precio final para el público es muy elevado. Si bien en años recientes se ha planteado el uso de tecnología de impresión en 3D para producir estos medicamentos o incluso recurrir a otros medicamentos previamente aprobados para tratar enfermedades raras, existe un historial de mal uso de las legislaciones por parte de las empresas con el fin de generar beneficios comerciales, por lo que estas políticas deben reforzarse para que cumplan su propósito; ayudar a una población muy vulnerable. El objetivo del presente texto es exponer los resultados de una revisión documental sobre el panorama científico y sociopolítico en el que se encuentra el problema de las enfermedades raras y los medicamentos huérfanos, así como las posibles soluciones que se están desplegando para abordarlo. Deriva de un estudio que se desarrolla en el momento actual en la Universidad Autónoma Metropolitana, de Ciudad de México.

The strange illnesses are those that have low prevalence and that, therefore, the development of medications to treat them is not profitable for the pharmaceutical companies due to the drop demands. Although it is already counted with different political public around the world to motivate to the pharmaceutical industries to investigate these medications, well-known as orphan medications, their development bears many difficulties in the clinical evaluations and the final price for the public it is very high. Although in recent years he/she has thought about the use of impression technology in 3D to produce these medications or even to appeal to other medications previously approved to treat strange illnesses, a record of wrong use of the legislations exists on the part of the companies with the purpose of generating commercial benefits, for what these politicians should be reinforced so that they complete its purpose; to help a very vulnerable population. The objective of the present text is to expose the results of a documental revision on the scientific and sociopolitical panorama in which is the problem of the strange illnesses and the orphan medications, as well as the possible solutions that they are spreading to approach it. It derives of a study that is developed in the current moment in the Metropolitan Autonomous University, of Mexico City.

Flavonoides como suplementos para mejorar el rendimiento físico deportivo / Flavonoids as Supplements to Improve Sports Physical Performance

Introducción: El ejercicio físico puede generar especies reactivas de oxígeno que dañan componentes celulares esenciales, como la fatiga. Los flavonoides, debido a su baja toxicidad y actividad antioxidante, se han estudiado como potenciales suplementos alimenticios para mejorar el rendimiento deportivo. Objetivo: Describir la evidencia científica que se ha obtenido sobre la eficacia del uso de flavonoides como suplementos para mejorar el rendimiento físico deportivo. Métodos: Se realizó una búsqueda sobre la eficacia del uso de flavonoides como suplementos para el rendimiento físico y deportivo en las bases de datos PubMed y Google Scholar. Se utilizaron las palabras clave: flavonoid, supplementation, sport, exercise, fatigue, muscle, fats, physical activity, y se tomaron en cuenta los artículos publicados entre los años 2018 y 2022, en idioma inglés que cumplieron con los criterios de selección. Resultados: Los flavonoides son capaces de disminuir la fatiga debido al esfuerzo físico en un contexto deportivo, principalmente debido a su capacidad de regular la actividad de agentes antioxidantes endógenos como las enzimas superóxido dismutasa, catalasa y glutatión peroxidasa, que se encargan de la neutralización de las especies reactivas de oxígeno. Además, son capaces de favorecer la neutralización de metabolitos tóxicos que se generan durante el ejercicio y de aumentar las reservas energéticas (glicógeno en el hígado y músculos) y la resistencia muscular. Conclusiones: Existe evidencia científica de que los flavonoides son capaces de mejorar el rendimiento físico deportivo principalmente al disminuir la fatiga e incrementar la resistencia muscular(AU)

Introduction: Physical exercise can generate reactive oxygen species that damage essential cellular components, such as fatigue. Flavonoids, due to their low toxicity and antioxidant activity, have been studied as potential dietary supplements to improve sports performance. Objective: To describe the scientific evidence that has been obtained on the efficacy of the use of flavonoids as supplements to improve sports physical performance. Methods: A search was carried out, in PubMed and Google Scholar databases, on the efficacy of the use of flavonoids as supplements for physical and sports performance. The keywords were used flavonoid, supplementation, sport, exercise, fatigue, muscle, fats, physical activity. Articles published from 2018 to 2022, in English, that met the selection criteria were taken into account. Results: Flavonoids are capable of reducing fatigue due to physical exertion in a sports context, mainly due to their ability to regulate the activity of endogenous antioxidant agents such as superoxide dismutase, catalase and glutathione peroxidase enzymes, which are responsible for the neutralization of reactive oxygen species. In addition, they are capable of favoring the neutralization of toxic metabolites that are generated during exercise and of increasing energy reserves (glycogen in the liver and muscles) and muscular resistance. Conclusions: There is scientific evidence that flavonoids are capable of improving sports physical performance, mainly by reducing fatigue and increasing muscular resistance(AU)

Economic Cost of the Waste of Anti-inflammatory and Analgesic Drugs in Mexico City.

Anti-inflammatory and analgesic medications (AAMs) are widely used in Mexico and the rest of the world. Their excessive acquisition can lead to waste, representing an unnecessary expense for families and the public health system. The aim of this study was to estimate the economic cost of the waste of unused AAMs collected by the National System for the Collection of Residues of Containers and Medications (SINGREM, the acronym in Spanish) in Mexico City during 2019. Data from SINGREM on discarded AAMs in Mexico City were classified by the type and quantity of drug, pharmaceutical dosage form, origin, dose, and the complete or incomplete condition of the package. The unitary cost for each medication was based on public tenders of the Mexican Social Security Institute (IMSS) for the public sector and the prices in large drug store franchises for the private sector. A decision-making model was constructed to appraise the total cost of discarded AAMs. The economic cost of the 48924 units of discarded AAMs in SINGREM containers in Mexico City during 2019 was approx. USD$143500, of which over USD$127000 corresponded to the private health sector. The current findings evidence an enormous accumulation of unneeded or expired AAMs in Mexico City. According to the present data, the cost of such waste is substantial. The estimated cost was 8-fold higher for discarded medications originating from the private versus the public healthcare sector. It is important to implement measures to prevent this waste and increase awareness of the consequences of inadequate drug disposal.

Brief review of pathophysiological disorders as consequence of psychological stress / Breve revisión de los trastornos fisiopatológicos como consecuencia del estrés psicológico

Background: Psychological stress is a reaction to an unexpected situation that favours adaptation and response to the event. However, when psychological stress is chronic or very intense, it can induce changes in various systems and tissues, causing diseases or aggravating existing ones. Objective: To briefly analyse the pathophysiological conditions caused by psychological stress. Method: A narrative review of the scientific literature on pathophysiological conditions as a consequence of psychological stress was performed. Results: Psychological stress can induce various conditions at the gastrointestinal, immune and cardiovascular levels. This is mainly due to the neurobiological and endocrine response because when faced with a stressful stimulus, a deregulated release of glucocorticoids and catecholamines is generated, altering the normal physiology of the organism. Gastrointestinal disorders are mainly due to goblet cell dysfunction, resulting in intestinal hyperpermeability, inflammation and infection. Changes at the immune level lead to an increase in inflammatory responses but a decrease in the protective activities of the immune system. Finally, cardiovascular conditions include atherosclerosis, increased blood pressure and stroke. Conclusion: Psychological stress can induce real physiological pathologies and, in some cases, fatal ones. Some of the molecular mechanisms involved in these pathologies have already been studied and identified. Knowledge of these molecular mechanisms can help clinicians and therapists to improve the treatment and therapy of patients.

Introducción: El estrés psicológico es una respuesta a una situación inesperada que favorece la adaptación y la respuesta ante dicho evento. Sin embargo, cuando el estrés psicológico es crónico o muy intenso, se pueden desencadenar afecciones en diversos sistemas y tejidos, generando enfermedades o empeorando las ya existentes. Objetivo: Analizar brevemente las afecciones fisiopatológicas causadas por el estrés psicológico. Método: Se realizó una revisión narrativa con la literatura científica sobre las afecciones fisiopatológicas debidas al estrés psicológico. Resultados: El estrés psicológico puede desencadenar diversas afecciones a nivel gastrointestinal, inmunitario y cardiovascular. Esto se debe principalmente a la respuesta neurobiológica y endócrina, ya que ante estímulos estresores, se genera una liberación desregulada de glucocorticoides y catecolaminas que alteran la fisiología normal del organismo. Las afecciones a nivel gastrointestinal se deben principalmente a la disfunción de las células caliciformes, dando como consecuencia hiperpermeabilidad intestinal, inflamación e infecciones. Las alteraciones a nivel inmunitario generan un aumento en las respuestas inflamatorias pero una reducción en las actividades protectoras del sistema inmune. Por último, las afecciones cardiovasculares incluyen ateroesclerosis, aumento de la presión arterial y derrames cerebrales, entre otros. Conclusión: El estrés psicológico puede causar patologías fisiológicas reales y, en algunos casos, mortales. Algunos de los mecanismos moleculares implicados en estas patologías ya han sido estudiados y establecidos. Conocer estos mecanismos moleculares puede ayudar a los médicos y terapeutas a mejorar el tratamiento y la terapia del paciente.

Recovery of Naringin-Rich Flavonoid Extracts from Agroresidues with Anxiolytic- and Antidepressant-like Effects in Mice.

Citrus paradisi species belong to the Rutaceae family, and it is commonly known as grapefruit. Grapefruit consumption involves a large amount of waste that goes to landfills and produces significant pollution affecting the human health. To examine this phenomenon, we designed an efficient chemical method that recovers naringin-rich flavonoid extracts from the fresh waste of grapefruits, by using the solvent impregnation resin method (SIR) with XAD-4 amberlite and either methanol or water as elution systems. Additionally, we focused on evaluating these extracts' anxiolytic- and antidepressant-like effects in behavioral predictive paradigms in mice. According to direct Principal Component Analysis (PCA) by NMR, and Direct Injection Electrospray Ionization-Mass Spectrometry (DIESI-MS), methanol extracts obtained after resin treatment were free of coumarin compounds and evinced had a high content of naringin. Poncirin, phenylalanine, chrysin 5,7-dimethyl ether, 5,7-dimethoxy-4'-hydroxyflavanone, 2,3-dihydro-2-(4-hydroxyphenyl)-5,6,7,8-tetramethoxy-4H-1-benzopyran-4-one, tetrahydrocurcumin, corchoionoside C, 6'-coumaroyl-1'-O-[2-(3,4-dihydroxyphenyl) ethyl]-ß-D-glucopyranoside were also detected. Naringin-rich methanol extract caused a clear anxiolytic-like effect in the Elevated Plus Maze (EPM) and the Hole-Board (HBT) Tests, increasing oral doses of this extract did not produce a sedative effect. A single oral dose caused an antidepressant-like effect in the Tail Suspension Test (TST), while repeated administrations of the methanol extract elicited a robust antidepressant effect in the Forced Swimming Test (FST) in mice. Our evidence highlights the importance of bioprospecting studies of organic waste with therapeutic potentials, such as anxiety and depression disorders.

Synthesis and Biological Activities of Dehydrodiisoeugenol: A Review.

Dehydrodiisoeugenol (DHIE) is a neolignan found in more than 17 plant species, including herbs, fruit, and root. DHIE was, for the first time, isolated from Myristica fragrans bark in 1973. Since then, many methodologies have been used for the obtention of DHIE, including classical chemistry synthesis using metal catalysts and biocatalytic synthesis; employing horseradish peroxidase; peroxidase from Cocos nucifera; laccase; culture cells of plants; and microorganisms. Increasing evidence has indicated that DHIE has a wide range of biological activities: anti-inflammatory, anti-oxidant, anti-cancerogenic, and anti-microbial properties. However, evidence in vivo and in human beings is still lacking to support the usefulness potential of DHIE as a therapeutic agent. This study's review was created by searching for relevant DHIE material on websites such as Google Scholar, PubMed, SciFinder, Scholar, Science Direct, and others. This reviews the current state of knowledge regarding the different synthetical routes and biological applications of DHIE.