Comparative Effectiveness of Thai Herbal Formula (Thor-Ra-Nee-San-Tha-Kat) Versus Naproxen for Chronic Myofascial Pain: A Pilot Randomized-Controlled Trial.

Background: Myofascial pain syndrome (MPS) is a painful musculoskeletal condition. The prevalence of MPS ranges from 5.9% to 38.7% in the general population. "Thor-ra-nee-san-tha-kat" (TRK) is a traditional formula included in the Thailand National List of Essential Medicines for the treatment for muscle pain caused by abdominal rigidity and for severe constipation. Objectives: The authors employed a pilot single-blind, randomized-controlled trial to compare the effectiveness of TRK and naproxen for the treatment of chronic upper trapezius MPS. Materials and Methods: Seventy-six male and female subjects, ages 25-55 years, who met the inclusion criteria were equally randomized into two groups to receive either two 500 mg capsules of TRK once daily before bed or two 250 mg naproxen tablets twice a day after meals for 14 days. Subjects assessed their level of pain using the numerical rating scale. Cervical range of motion (CROM) was determined using a goniometer, and pressure pain threshold (PPT) was assessed using an algometer. Adverse drug reactions were recorded and all items were compared within and between groups, before and after treatment. Results: The results revealed that patient pain scores after 14 days of treatment were much improved with mean differences exceeding the reference minimum clinically important difference (MCID) in both groups. However, the changes in CROM and PPT values were small and did not surpass their respective reference MCIDs except for the right lateral bending CROM for naproxen treatment. The adverse drug reactions were mild, with watery stools reported by 47% of patients in the TRK-treated group and constipation reported by 24% of those in the naproxen group. Conclusion: The administration of TRK formula for 14 days was safe and as effective as naproxen at providing short-term relief of pain in patients with chronic upper trapezius pain.

Dietary sources of melatonin and benefits from production of high melatonin pasteurized milk.

Melatonin is a neurohormone that regulates circadian rhythms in the human body. It can also be taken to alleviate insomnia and sleep disorders. Pasteurized milk is a good source of nutrients and some bioactive compounds. Recently, the growing trend of healthy foods has resulted in higher competition with regard to milk products. Functional milk has been developed with higher bioactive compounds to respond to consumer demand. High melatonin pasteurized milk was developed using selected edible grains and mulberry leaves to fortify melatonin in pasteurized milk. Melatonin and free tryptophan of fourteen edible grains and mulberry leaves were determined using HPLC-FD. Highest melatonin concentrations were observed in white sesame, sunflower and soybean (75.24, 67.45 and 56.49 ng/g dry weight (dw), with highest concentrations of free tryptophan in soybean, red bean and mung bean (2617.83, 1527.23 and 845.27 ng/g dw, respectively), while melatonin and free tryptophan contents in fresh mulberry leaves were 51.57 ng/g and 210.53 ng/g dw, respectively. Soymilk powder and mulberry leaf tea were supplemented to prepare high melatonin pasteurized milk. Results showed that chemical compositions, melatonin and free tryptophan contents significantly increased (P < 0.05) with increasing amounts of soymilk powder and mulberry leaf tea. Sensory evaluation gave highest overall liking score for the treatment consisting of mulberry leaf tea (4.00%), soymilk powder (4.00%) and milk (89.80%). Findings indicated that mulberry leaves and soybean are both good sources of melatonin and free tryptophan and can be applied to prepare high melatonin pasteurized milk.

Optimization of pasteurized milk with soymilk powder and mulberry leaf tea based on melatonin, bioactive compounds and antioxidant activity using response surface methodology.

Melatonin is a natural hormone which regulates human circadian rhythms and is presented in milk at low concentrations. To improve melatonin concentration and amounts of bioactive compounds in pasteurized milk (PM), soymilk powder (SMP) and mulberry leaf tea (MLT) were added using mixture design response surface methodology (RSM) and levels of SMP, MLT and raw milk (RM) were optimized. PM containing 4.50% SMP, 4.50% MLT and 88.80% RM gave the highest chemical compositions, bioactive compounds and antioxidant activity. Mathematical models of chemical compositions, bioactive compounds and antioxidant activity showed significant differences, whereas sensory attributes were not significantly different in all modeled parameters. Optimum levels were 3.90% SMP, 4.50% MLT and 89.40% RM. Verification of optimum proportions showed that experimental values of chemical compositions, bioactive compounds and antioxidant activity agreed with model predictions. Optimum PM contained melatonin (1.49 ng/mL), free tryptophan (0.26 µg/mL), and total phenolic content (0.72 mg GAE/mL) with high antioxidant activity when assayed by DPPH, ABTS and FRAP. Results suggested that mixture design RSM has the potential to optimize SMP, MLT and RM levels to obtain PM with increased amounts of bioactive compounds and high melatonin content.

Validation of the Thai version of the family reported outcome measure (FROM-16)© to assess the impact of disease on the partner or family members of patients with cancer.

BACKGROUND: Cancer not only impairs a patient's physical and psychosocial functional behaviour, but also contributes to negative impact on family members' health related quality of life. Currently, there is an absence of a relevant tool in Thai with which to measure such impact. The aim of this study was to translate and validate the Family Reported Outcome Measure (FROM-16) in Thai cancer patients' family members. METHODS: Thai version of FROM-16 was generated by interactive forward-backward translation process following standard guidelines. This was tested for psychometric properties including reliability and validity, namely content validity, concurrent validity, known group validity, internal consistency, exploratory and confirmatory factor analysis. Construct validity was examined by comparing the Thai FROM-16 version with the WHOQOL-BREF-THAI. RESULTS: The internal consistency reliability was strong (Cronbach's alpha = 0.86). A Negative moderate correlation between the Thai FROM-16 and WHOQOL-BREF-THAI was observed (r = - 0.4545, p < 0.00), and known group validity was proved by a statistically significant higher score in family members with high burden of care and insufficient income. The factor analysis supported both 3-factor and 2-factor loading model with slight difference when compared with the original version. CONCLUSIONS: The Thai FROM-16 showed good reliability and validity in Thai family members of patients with cancer. A slight difference in factor analysis results compared to the original version could be due to cross-culture application.

Correlating the Dermatology Life Quality Index with psychiatric measures: A systematic review.

Skin conditions may have a major impact on the psychologic well-being of patients, ranging from depression to anxiety. The Dermatology Life Quality Index (DLQI) is the most commonly used quality of life tool in dermatology, though it has yet to be correlated with psychiatric measures used in clinical therapeutic trials. We conducted a systematic review to determine whether there is any correlation between the DLQI and psychiatric measure scores, potentially allowing the DLQI to be used as a surrogate measure for depression or psychiatric screening. Six databases were searched using the following keywords: "DLQI," "Dermatology Life Quality Index," "Psych*," "depression," "anxiety," "stress," and "trial*." All randomized trials where full DLQI and psychiatric scores were provided were included. PRISMA guidelines were followed. In all, 462 records were screened, but only seven met inclusion criteria. Hospital Anxiety and Depression Scale (HADS) was the most commonly used psychiatric measure; the "depression" component score changes correlated strongly with the DLQI (r = 0.715). There needs to be guidance on psychiatric measurement and reporting in clinical trials. Although the DLQI correlated well with the "depression" domain of the HADS scale, interviews and screening for depression are still vital for full assessment of patient psychologic well-being.

Transmucosal delivery of melatonin-encapsulated niosomes in a mucoadhesive gel.

AIM: A transmucosal niosome gel was developed to improve the pharmacokinetics of exogenous melatonin. MATERIALS & METHODS: The melatonin niosomes (MN) gel was characterized and melatonin levels were determined in healthy volunteers. RESULTS: Micron-sized MN in a gel, mean ex vivo residence time of more than 3 h with maximum adhesiveness at 25 and 37°C showed similar in vitro release but different in vitro permeation to melatonin gel. Oral transmucosal MN gels, at 2.5, 5 and 10 mg, topically applied in 14 healthy volunteers in a randomized double-blinded crossover design with 7-day washout, gave dose-proportional pharmacokinetics, with improved absorption and prolonged systemic circulation. CONCLUSION: The transmucosal MN gel provides a topical option for melatonin administration with substantial prolonged systemic delivery.

Beneficial Effects of Adjuvant Melatonin in Minimizing Oral Mucositis Complications in Head and Neck Cancer Patients Receiving Concurrent Chemoradiation.

OBJECTIVES: Oral mucositis is a major cause of pain and delayed cancer treatment leading to poor survival in head and neck cancer patients receiving concurrent chemoradiation. The study evaluated the effect of adjuvant melatonin on minimizing oral mucositis complications to reduce these treatment delays and interruptions. DESIGN: A randomized, double-blind, double dummy, placebo-controlled clinical trial. SETTING: Ubon Ratchathani Cancer Hospital, Thailand. PARTICIPANTS: Thirty-nine head and neck cancer patients receiving concurrent chemoradiation (5 days/week of radiation plus chemotherapy three or six cycles). METHODS: Patients were randomized to receive 20 mg melatonin gargle (or matched placebo) before each irradiation, and 20 mg melatonin capsules (or matched placebo) taken nightly during 7 weeks of concurrent chemoradiation. Endpoints were oral mucositis events (incidence and time to grade 3 mucositis or grade 2 xerostomia), pain medication consumption and quality of life (QOL). RESULTS: Melatonin group reported lower incidence of grade 3 oral mucositis (42% vs. 55%) and grade 2 xerostomia (20% vs. 21%); no statistical significance was detected. Melatonin regimen delayed onset of grade 3 mucositis (median 34 days vs. 50 days; p = 0.0318), allowing median time of 16 more patient visits before its onset and fewer interrupted treatments due to oral mucositis were reported (n = 1 vs. n = 5). There was no difference of grade 2 xerostomia (median 32 days vs. 50 days; p = 0.624). Morphine consumption was also reduced (median 57 mg vs. 0 mg; p = 0.0342), while QOL was comparable during the study period. CONCLUSION: Adjuvant melatonin delayed the onset of oral mucositis, which enables uninterrupted cancer treatment and reduced the amount of morphine used for pain treatment.

Intranasal melatonin nanoniosomes: pharmacokinetic, pharmacodynamics and toxicity studies.

AIM: Intranasal melatonin encapsulated in nanosized niosomes was preclinically evaluated. METHODOLOGY: A formula of melatonin niosomes (MN) was selected through physicochemical and cytotoxic data for pharmacokinetic, pharmacodynamics and toxicity studies in male Wistar rats. RESULTS: Intranasal MN was bioequivalent to intravenous injection of melatonin, providing therapeutic level doses. Acute and subchronic toxicity screening showed no abnormal signs, symptoms or hematological effects in any animals. Transient nasal irritations with no inflammation were observed with intranasal MN, leading it to be categorized as relatively harmless. CONCLUSION: The intranasal MN could deliver melatonin to the brain to induce sleep and provide delayed systemic circulation, relative to intravenous injection and also distribute to peripheral tissue.

The anti-oxidant effects of melatonin derivatives on human gingival fibroblasts.

OBJECTIVES: Aim of this in vitro study was to evaluate the anti-oxidant activity of indole ring modified melatonin derivatives as compared with melatonin in primary human gingival fibroblast (HGF) cells. METHODS: Anti-oxidant activity of melatonin (MLT), acetyl-melatonin (AMLT) and benzoyl-melatonin (BMLT) was evaluated by5 standard methods as follows: 2, 2-diphenyl-1-picrylhydrazyl (DPPH); ferric ion reducing antioxidant power (FRAP); superoxide anion scavenging; nitric oxide (NO) scavenging; and thiobarbituric acid reactive substances (TBARs).Evaluation of cellular antioxidant activity (CAA) and protectivity against H2O2 induced cellular damage was performed via MTT assay in HGF cells. RESULTS: According to the standard anti-oxidant assays, the antioxidant power of AMLT and BMLT were slightly less than MLT in FRAP and superoxide scavenging assays. In the NO scavenging and TBARs assays, BMLT and AMLT were more potent than MLT, whereas DPPH assays demonstrated that MLT was more potent than others. BMLT and AMLT had more potent anti-oxidant and protective activities against H2O2in HGF cells as compared with MLT. CONCLUSIONS: MLT derivatives demonstrated different anti-oxidant activities as compared with MLT, depending upon assays. These findings imply that N-indole substitution of MLT may help to improve hydrogen atom transfer to free radicals but electron transfer property is slightly decreased. Anti-oxidant and protective effects of melatonin derivatives (AMLT and BMLT) on human gingival fibroblasts imply the potential use of these molecules as alternative therapeutics for chronic inflammatory oral diseases.

Pineal calcification is associated with pediatric primary brain tumor.

AIM: Melatonin has been associated with various tumors, including brain tumor, and shown to inhibit growth of neuroblastoma cells and gliomas in animal models. Likewise, patients with glioblastoma receiving melatonin reported better survival than controls. Pineal calcification may lead to a decreased production of melatonin by calcified glands. This study assessed association between pineal calcification and primary brain tumor in pediatric/adolescent patients. METHODS: Medical chart review was conducted in 181 patients <15 years old who had undergone brain computed tomography (CT) during 2008-2012. Pineal calcification was identified using brain CT scan by an experienced neurosurgeon. Primary brain tumor was confirmed by CT scan and histology, and association with pineal calcification was estimated using multiple logistic regression, adjusted for age and gender. RESULTS: Primary brain tumor was detected in 51 patients (mean age 9.0, standard deviation 4.0 years), with medulloblastoma being the most common (11 patients). Pineal calcification was detected in 12 patients (23.5%) with primary brain tumor, while only 11 patients (8.5%) without tumor had pineal calcification. Adjusted for patients' ages and genders, pineal calcification was associated with an increase in primary brain tumor of 2.82-fold (odds ratio 2.82; 95% confidence interval 1.12-7.08, P = 0.027). CONCLUSION: Pineal calcification appears to be associated with primary brain tumor. Further studies to explore this link are discussed and warranted.

Melatonin in patients with cancer receiving chemotherapy: a randomized, double-blind, placebo-controlled trial.

BACKGROUND: The MIRCIT trial was a randomized, double-blind, placebo-controlled study of advanced Non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients were randomized to receive 10 mg or 20 mg of melatonin or placebo. Assessment of health-related quality of life (HRQoL) was completed at baseline, and at 2, 3 and 7 months. Survival and adverse events were collected. DNA damage marker 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) was measured during the first three months of chemotherapy. RESULTS: Patients in the melatonin-treated group had better adjusted HRQoL scores, with a slightly significantly better score (2.69 points, 95% confidence interval (CI)=0.01-5.38, p=0.049) being found in social well-being. Median survival was 7.3 months (95% CI=3.42-11.14) without significant difference. A great amont of DNA damage marker was observed in the placebo-treated group, and this was associated with lower survival (r(2)=-0.656, p=0.02), implying the protective effect of melatonin in healthy cells. CONCLUSION: Melatonin in combination with chemotherapy did not affect survival and adverse events of advanced patients with NSCLC, but there was a trend for better HRQoL.

Validation of the Thai Version of a Work-related Quality of Life Scale in the Nursing Profession.

BACKGROUND: Currently available questionnaires for evaluating the quality of worklife do not fully examine every factor related to worklife in all cultures. A tool in Thai is therefore needed for the direct evaluation of the quality of worklife. Our aim was to translate the Work-related Quality of Life Scale-2 (WRQLS-2) into Thai, to assess the validity and reliability of the Thai-translated version, and to examine the tool's accuracy vis-à-vis nursing in Thailand. METHODS: This was a descriptive correlation study. Forward and backward translations were performed to develop a Thai version of the WRQLS. Six nursing experts participated in assessing content validity and 374 registered nurses (RNs) participated in its testing. After a 2-week interval, 67 RNs were retested. Structural validity was examined using principal components analysis. The Cronbach's alpha values were calculated. The respective independent sample t test and intraclass correlation coefficient were used to analyze known-group validity and test-retest reliability. Multistate sampling was used to select 374 RNs from the In- and Outpatient Department of Srinagarind Hospital of the Khon Kaen University (Khon Kaen, Thailand). RESULTS: The content validity index of the scale was 0.97. Principal components analysis resulted in a seven-factor model, which explains 59% of the total variance. The overall Cronbach's alpha value was 0.925, whereas the subscales ranged between 0.67 and 0.82. In the assessment results, the known-group validity was established for the difference between civil servants and university employees [F (7.982, 0.005) and t (3.351; p < 0.05)]. Civil servants apparently had a better quality worklife, compared to university employees. Good test-retest reliability was observed (r = 0.892, p < 0.05). CONCLUSION: The Thai version of a WRQLS appears to be well validated and practicable for determining the quality of the work-life among nurses in Thailand.

Pineal calcification is a novel risk factor for symptomatic intracerebral hemorrhage.

BACKGROUND: Pineal calcification is associated with symptomatic cerebral infarction in humans. However, there are limited data on the association of pineal calcification and intracerebral hemorrhage. We evaluated this association of symptomatic intracerebral hemorrhage and pineal calcification by computed tomography of the brain. METHODS: We reviewed all computed tomographic (CT) scans of the brains of patients over 15 years of age during the year 2011 at a university teaching hospital. Symptomatic intracerebral hemorrhage was identified by having clinical syndrome of stroke and acute intracerebral hemorrhage from brain CT scans. Pineal calcification was also evidenced by brain CT scans. Other stroke risk factors were recorded. The association of various risk factors including pineal calcification and intracerebral hemorrhage was calculated using logistic regression analysis. RESULTS: There were 2140 CT scans of the brains during the study period. Of those, 1071 scans (50.05%) met the study criteria. Intracerebral hemorrhage and pineal calcification were found in 77 (7.2%) and 689 (64.3%) patients, respectively. Pineal calcification was a significant risk factor for intracerebral hemorrhage with an adjusted odds ratio of 2.36 (95% confidence interval of 1.22-4.54). Other significant factors were age>50 years, hypertension, and diabetes. CONCLUSION: Pineal calcification is associated with symptomatic intracerebral hemorrhage.

Pineal calcification is associated with symptomatic cerebral infarction.

BACKGROUND: Pineal calcification and low melatonin have been shown to be risk factors for stroke in animal studies; however, there are limited clinical data on the association of pineal calcification and stroke in humans. METHODS: All computed tomographic (CT) scans of the brains of patients >15 years of age during the year 2011 at a university teaching hospital were retrospectively reviewed. Patient medical charts were used to obtain the risk factors for stroke, including diabetes, hypertension, dyslipidemia, age, and sex. Cerebral infarction was identified by having clinical syndromes of stroke and a positive CT scan. Patients with embolic or hemorrhagic stroke were excluded. Pineal calcification was evidenced by the CT scans. The association of various stroke risk factors and cerebral infarction were calculated using logistic regression analysis. RESULTS: A total of 1614 patients were included, and symptomatic cerebral infarction was identified in 620 patients (38.4%). Regarding stroke risk factors in symptomatic cerebral infarction patients, the majority of patients were male (356 [57.4%]), >50 years of age (525 [84.7%]), and had hypertension (361 [58.2%]); some had diabetes (199 [32.1%]) and dyslipidemia (174 [28.1%]). Pineal calcification was found in 1081 patients (67.0%), with a male:female ratio of 1.5:1. Significant factors related to cerebral infarction by univariate logistic regression were age >50 years, hypertension, diabetes, dyslipidemia, and pineal calcification. Pineal calcification as a risk factor for cerebral infarction had an adjusted odds ratio of 1.35 (95% confidence interval 1.05-1.72). CONCLUSIONS: Pineal calcification may be a potential new contributor to cerebral infarction.

Melatonin inhibits cholangiocarcinoma and reduces liver injury in Opisthorchis viverrini-infected and N-nitrosodimethylamine-treated hamsters.

The human liver fluke Opisthorchis viverrini infection and N-nitrosodimethylamine (NDMA) administration induce cholangiocarcinoma (CCA) and liver injury in hamsters. Melatonin protects against liver injury and reduces the alteration of mitochondrial structure, mitochondrial membrane potential, and mitochondrial pro- and anti-apoptotic pathways in various cancer types. To investigate the chemopreventive effect of melatonin on CCA genesis and liver injury, hamsters were treated with a combination of O. viverrini infection and NDMA concurrently administered with melatonin (10 mg/kg and 50 mg/kg) for 120 days. Melatonin treatment at 50 mg/kg caused a significant reduction in liver/body weight ratios and decreased tumor volumes leading to an increase in the survival of animals. In the tumorous tissues, the high-dose melatonin reduced DNA fragmentation and mitochondrial apoptosis by inducing anti-apoptotic protein (Bcl-2) in the mitochondrial fraction and down-regulating cytochrome c, pro-apoptotic protein (Bax), and caspase-3 in tumor cytosol. Moreover, a high-dose melatonin treatment significantly increased mitochondrial antioxidant enzymes and prevented mitochondrial ultrastructure changes in the tumor. Overall, melatonin has potent chemopreventive effects in inhibiting CCA genesis and also reduces liver injury in hamster CCA, which, in part, might involve in the suppression of CCA by reducing tumor mitochondria alteration.

Preliminary psychometric properties of the chinese version of the work-related quality of life scale-2 in the nursing profession.

OBJECTIVES: As quality of work-life (QWL) among nurses affects both patient care and institutional standards, assessment regarding QWL for the profession is important. Work-related Quality of Life Scale (WRQOLS) is a reliable QWL assessment tool for the nursing profession. To develop a Chinese version of the WRQOLS-2 and to examine its psychometric properties as an instrument to assess QWL for the nursing profession in China. METHODS: Forward and back translating procedures were used to develop the Chinese version of WRQOLS-2. Six nursing experts participated in content validity evaluation and 352 registered nurses (RNs) participated in the tests. After a two-week interval, 70 of the RNs were retested. Structural validity was examined by principal components analysis and the Cronbach's alphas calculated. The respective independent sample t-test and intra-class correlation coefficient were used to analyze known-group validity and test-retest reliability. RESULTS: One item was rephrased for adaptation to Chinese organizational cultures. The content validity index of the scale was 0.98. Principal components analysis resulted in a seven-factor model, accounting for 62% of total variance, with Cronbach's alphas for subscales ranging from 0.71 to 0.88. Known-group validity was established in the assessment results of the participants in permanent employment vs. contract employment (t = 2.895, p < 0.01). Good test-retest reliability was observed (r = 0.88, p < 0.01). CONCLUSION: The translated Chinese version of the WRQOLS-2 has sufficient validity and reliability so that it can be used to evaluate the QWL among nurses in mainland China.

Serum melatonin levels and antioxidant capacities after consumption of pineapple, orange, or banana by healthy male volunteers.

Melatonin is a naturally occurring molecule biosynthesized by the pineal gland of vertebrates; it also has been identified in many plants. It is considered an important antioxidant and may retard the development of some neurodegenerative diseases and cancer. Previous studies in humans have measured melatonin metabolites in urine and have indicated that melatonin-containing foods may provide dietary melatonin. This study tested whether the consumption of fruits or fruit juice containing melatonin would influence the serum melatonin concentration and antioxidant status. In this crossover study, 12 healthy male volunteers took either juice extracted from one kilogram of orange or pineapple or two whole bananas, with a 1-wk washout period between the fruit or fruit juices. An enzyme-linked immunosorbent (ELISA) assay was used to determine the serum melatonin concentration. Serum antioxidant capacity was determined by ferric reducing antioxidant power (FRAP) assay and oxygen radical antioxidant capacity (ORAC) assay. The highest serum melatonin concentration was observed at 120 min after fruit consumption, and compared with before consumption levels, their values were significantly increased for pineapple (146 versus 48 pg/mL P = 0.002), orange (151 versus 40 pg/mL, P = 0.005), and banana (140 versus 32 pg/mL, P = 0.008), respectively. Serum antioxidant capacity following fruit consumption also significantly increased in both the FRAP (7-14% increase, P ≤ 0.004) and ORAC (6-9% increase, P = 0.002) assays. Both the serum FRAP and ORAC values strongly correlated with serum melatonin concentration for all three fruits. These findings suggest that tropical fruit consumption increases the serum melatonin concentrations and also raises the antioxidant capacity in the serum of healthy volunteers in proportion to serum melatonin levels.

Dietary intake of melatonin from tropical fruit altered urinary excretion of 6-sulfatoxymelatonin in healthy volunteers.

This study assessed the melatonin content of six tropical fruits and examined whether human consumption could contribute to dietary melatonin as measured by 6-sulfatoxymelatonin (aMT6-s, a marker of circulating melatonin in the body). Melatonin was extracted using methanol and analyzed by high-performance liquid chromatography. In a clinical crossover study, 30 healthy volunteers consumed selected fruits one at a time, with a 1week wash-out period between fruits, until completing all six fruits. Most fruits had moderate melatonin content. Significant increases in urine aMT6-s concentrations were seen after the consumption of pineapple (266%, p = 0.004), banana (180%, p = 0.001), and orange (47%, p = 0.007). The need to analyze melatonin both in fruit and as in vivo uptake was demonstrated. Further study is warranted regarding the clinical effect of fruit consumption in people with age-related melatonin reduction problems such as sleeplessness and illnesses involving oxidative damage.

Assessment of 8-isoprostane (8-isoPGF2α) in urine of non- small cell lung cancer (NSCLC) patients undergoing chemotherapy.

8-Isoprostane (8-isoPGF2α) is a reliable marker and considered a gold standard for lipid peroxidation. There are very few reports of 8-isoprostane levels in cancer patients, and in patients undergoing chemotherapy. Oxidative stress is however expected and has been observed in patients with cancer. This study measured 8-isoprostane levels in urine by ELISA of 25 patients undergoing chemotherapy for advanced non-small cell lung cancer, at cycles 1, 2, and 3 of treatment. It considers the creatinine clearance of the patients, and correction of 8-isoprostane levels by creatinine clearance, and overnight urine volume methods. The average 8-isoprostane levels in urine increased more than 6 to 12 fold on chemotherapy treatment, from 532±587 pg/mL at cycle 1, 6181±4334 at cycle 2, and 5511±2055 at cycle 3. Similar results were obtained if 8-isoprostane levels were corrected for overnight urine volume, giving averages of 285±244 µg at cycle 1, 4122±3349 at cycle 2, and 3266±1200 at cycle 3. No significant difference was seen in average total overnight urine volume or number of urinations between chemotherapy cycles except for a large variation in urine volume between cycle 2 and 3. Creatinine levels were significantly different only between cycles 1 and 2 (p=0.016). In conclusion, cisplatin therapy has been shown to induce high levels of lipid peroxidation in lung cancer patients and can be assessed from the 8-isoprostane marker in overnight urine, with or without urine volume correction.