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Jindal S, Kant R, Saluja D, Aggarwal KK. Identification of thrombin inhibiting antithrombin-III like protein from Punica granatum using in silico approach and in vitro validation of thrombin inhibition activity in crude protein. Nat Prod Res 2023; 37:4131-4143. [PMID: 36705311 DOI: 10.1080/14786419.2023.2169919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/13/2023] [Indexed: 01/28/2023]
Abstract
Thrombosis is characterized by the formation of clots in the blood vessels. Antithrombin-III deficiency in the blood causes thrombus formation. Supplementing antithrombin-III may serve as anticoagulant therapy. In the present studies, an antithrombin like Protein from Punica granatum has been identified and characterized using in silico approach. Based on sequence homology, an ALPP was selected depending upon its highest binding affinity of -41.28 kcal/mol with thrombin. Thrombin structure complexed with ALPP was docked with TAME using AutoDock Vina. No binding was observed for TAME at Ser195 of thrombin. MD simulation (50 ns) was performed to evaluate the flexibility and stability of docked complexes. In vitro assays with crude protein showed 78% thrombin inhibition at 5 µg and calculated IC50 value was 0.188 µg. The presence of thrombin inhibitors in crude protein was also confirmed by reverse zymography. Thus, it is very likely that the protein identified from P. granatum may act as thrombin inhibitor.
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Affiliation(s)
- Shanky Jindal
- University School of Biotechnology, Guru Gobind Singh Indraprastha University, New Delhi, India
| | - Ravi Kant
- Dr. B.R. Ambedkar Centre for Biomedical Research (ACBR), University of Delhi, New Delhi, India
| | - Daman Saluja
- Dr. B.R. Ambedkar Centre for Biomedical Research (ACBR), University of Delhi, New Delhi, India
| | - Kamal Krishan Aggarwal
- University School of Biotechnology, Guru Gobind Singh Indraprastha University, New Delhi, India
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2
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Debes AM, Koenig A, Strobach D, Schinkoethe T, Forster M, Harbeck N, Wuerstlein R. Biologically Based Complementary and Alternative Medicine Use in Breast Cancer Patients and Possible Drug-Drug Interactions. Breast Care (Basel) 2023; 18:327-335. [PMID: 37901050 PMCID: PMC10601661 DOI: 10.1159/000531346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/24/2023] [Indexed: 10/31/2023] Open
Abstract
Purpose Biologically based complementary and alternative medicine (BB-CAM) is gaining importance. Cancer patients in particular are at risk of interactions between the prescribed medications (intravenous or oral anticancer therapy, concomitant medication, medication for pre-existing illnesses) and BB-CAM. This investigation aims to identify potentially clinically relevant interactions between both BB-CAM and conventional medicine and two BB-CAM products in breast cancer patients (n = 47). Methods From March 2020 to January 2021, consecutive breast cancer patients (n = 47) completed a questionnaire about their medication and BB-CAM intake at the beginning of a new intravenous or oral tumor therapy (time point 1) and again after 10 to 12 weeks (time point 2) at the LMU Breast Center in Munich. The collective was divided into two subgroups based on the time after initial diagnosis; a cutoff of 6 months was used. The survey was available through an eHealth application called CANKADO as electronic patient-reported outcome only. Lexicomp® and AiD Klinik® databases were used for evaluating potentially clinically relevant interactions. As part of routine care, the collected data were evaluated and cross-checked in interdisciplinary cooperation with the University Hospital Pharmacy LMU. Results 43 of the 47 included breast cancer patients (91%) used BB-CAM at some point during their treatment period. We found a significant increase from time point 1 (n = 27) to time point 2 (n = 40) (p = 0.004). Moreover, in the subgroup of newly diagnosed patients, the number significant rose from 17 at time point 1 to 28 at time point 2 (p = 0.007). Overall, we found potentially clinically relevant interactions in 30 of 43 patients (70%). Sixty interactions were detected at both times of investigations. Twenty-three different kinds of BB-CAM-to-BB-CAM (time point 1 [n = 12], time point 2 [n = 11]) or conventional medicine-to-BB-CAM interactions (time point 1 [n = 15], time point 2 [n = 22]) were discovered. Importantly, there was not a single interaction between BB-CAM and an anticancer drug. Conclusion Breast cancer patients frequently use BB-CAM. Interactions were detected at both time points of investigation (time point 1 [n = 27], time point 2 [n = 33]). Interactions were particularly evident between BB-CAM substances as well as between BB-CAM and the patients' medication for pre-existing illnesses. Although no interaction between BB-CAM and an anticancer therapy was found, the use of BB-CAM should be evaluated at the beginning and regularly during therapy in view of the substantial number of interactions detected and the large number of upcoming targeted therapies.
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Affiliation(s)
- Anna Marie Debes
- Breast Center, Department of Gynecology and Obstetrics CCC Munich, LMU University Hospital, Munich, Germany
| | - Alexander Koenig
- Breast Center, Department of Gynecology and Obstetrics CCC Munich, LMU University Hospital, Munich, Germany
| | - Dorothea Strobach
- Hospital Pharmacy and Doctoral Program Clinical Pharmacy, University Hospital Munich, Munich, Germany
| | - Timo Schinkoethe
- Breast Center, Department of Gynecology and Obstetrics CCC Munich, LMU University Hospital, Munich, Germany
- CANKADO Service GmbH, Cologne, Germany
| | - Marie Forster
- Breast Center, Department of Gynecology and Obstetrics CCC Munich, LMU University Hospital, Munich, Germany
| | - Nadia Harbeck
- Breast Center, Department of Gynecology and Obstetrics CCC Munich, LMU University Hospital, Munich, Germany
| | - Rachel Wuerstlein
- Breast Center, Department of Gynecology and Obstetrics CCC Munich, LMU University Hospital, Munich, Germany
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Zhang Y, Liu Y, Ni G, Xu J, Tian Y, Liu X, Gao J, Gao Q, Shen Y, Yan Z. Sulfated modification, basic characterization, antioxidant and anticoagulant potentials of polysaccharide from Sagittaria trifolia. ARAB J CHEM 2023. [DOI: 10.1016/j.arabjc.2023.104812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
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Akgöl J, Özkut B, Denizoğlu İİ, Orhon EŞ, Aycan K, Güven A. Determining Knowledge Level, Attitude, Behaviors Regarding Vocal Hygiene and Use of Medical Drugs and Herbal Medicinal Products for Vocal Health in Second Level Professional Voice Users. J Voice 2022:S0892-1997(22)00288-0. [PMID: 36372675 DOI: 10.1016/j.jvoice.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVES This study aims to determine the knowledge level, attitude, and behaviors regarding vocal hygiene and use of medical drugs and herbal medicinal products for vocal health in second level professional voice users. METHODS The study examined second level professional voice users comprised of amateur singers, religious officials,voice instructors and vocal coaches consisting of academicians working in conservatories and education faculties, music teachers, conservatory students majoring in opera or choir, students majoring in music education, and amateur actors who were reached via online platforms and were administered a 32-item questionnaire RESULTS: A total of 406 participants consisting of conservatory students (26.8%), religious officials (23.2%), academicians (9.1%), amateur or self-taught musicians (14.8%), conservatory graduates (8.6%), and music teachers affiliated with the Ministry of National Education were recruited for the study. It was determined that 78.8% of the participants knew the definition of vocal hygiene, and 60.6% made an effort to maintain vocal hygiene. 57.9% of the participants declared that they had at least one disease affecting their vocal health. According to our research data, 8.9% of the participants were using one or more prescription drugs or over-the-counter products daily to protect their vocal health. Lozenges, vitamins, and allergy medications constituted a large portion of these medicinal products. In total, 62.3% of participants used herbal products for vocal health in their daily life. Participants mostly consumed products containing linden, sage, ginger, chamomile, and turmeric. It was determined that more than 20 different herbal products containing plants in different mixtures and contents were used. Furthermore, 40% of the participants using herbal medicinal products consulted a health care professional.It was found that these products were mostly obtained from herbalists (79.5%), and the source of information regarding these products was quite diverse. The rate of experiencing side effects due to the use of herbal products was 2%. CONCLUSIONS There is a lack of knowledge regarding vocal hygiene and its application on real-life behavior among second-level sound professionals. In particular, the awareness of vocal hygiene should be increased among religious officials. It was observed that the rate of use of herbal products to protect vocal health or to treat hoarseness was quite high. Further studies are needed to prove the benefits of these herbal and medicinal products on vocal health.
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Yun S. Practical Use of Venoactive Drugs for Chronic Venous Disease in Korea. Phlebology 2022. [DOI: 10.37923/phle.2022.20.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sangchul Yun
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
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Kim C, Pfeiffer ML, Chang JR, Burnstine MA. Perioperative Considerations for Antithrombotic Therapy in Oculofacial Surgery: A Review of Current Evidence and Practice Guidelines. Ophthalmic Plast Reconstr Surg 2022; 38:226-233. [PMID: 35019878 PMCID: PMC9093724 DOI: 10.1097/iop.0000000000002058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Recent survey studies have demonstrated wide variability in practice patterns regarding the management of antithrombotic medications in oculofacial plastic surgery. Current evidence and consensus guidelines are reviewed to guide perioperative management of antithrombotic medications. METHODS Comprehensive literature review of PubMed database on perioperative use of antithrombotic medication. RESULTS/CONCLUSIONS Perioperative antithrombotic management is largely guided by retrospective studies, consensus recommendations, and trials in other surgical fields due to the limited number of studies in oculoplastic surgery. This review summarizes evidence-based recommendations from related medical specialties and provides context for surgeons to tailor antithrombotic medication management based on patient's individual risk. The decision to continue or cease antithrombotic medications prior to surgery requires a careful understanding of risk: risk of intraoperative or postoperative bleeding versus risk of a perioperative thromboembolic event. Cessation and resumption of antithrombotic medications after surgery should always be individualized based on the patient's thrombotic risk, surgical and postoperative risk of bleeding, and the particular drugs involved, in conjunction with the prescribing doctors. In general, we recommend that high thromboembolic risk patients undergoing high bleeding risk procedures (orbital or lacrimal surgery) may stop antiplatelet agents, direct oral anticoagulants, and warfarin including bridging warfarin with low-molecular weight heparin. Low-risk patients, regardless of type of procedure performed, may stop all agents. Decision on perioperative management of antithrombotic medications should be made in conjunction with patient's internist, cardiologist, hematologist, or other involved physicians which may limit the role of guidelines depending on patient risk and should be used on a case-by-case basis. Further studies are needed to provide oculofacial-specific evidence-based guidelines.
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Affiliation(s)
- Christian Kim
- Eyesthetica, Los Angeles, California
- Department of Ophthalmology, Loyola University Stritch School of Medicine, Chicago, Illinois
| | - Margaret L Pfeiffer
- Eyesthetica, Los Angeles, California
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, U.S.A
| | - Jessica R Chang
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, U.S.A
| | - Michael A Burnstine
- Eyesthetica, Los Angeles, California
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, U.S.A
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Grześk G, Rogowicz D, Wołowiec Ł, Ratajczak A, Gilewski W, Chudzińska M, Sinkiewicz A, Banach J. The Clinical Significance of Drug-Food Interactions of Direct Oral Anticoagulants. Int J Mol Sci 2021; 22:8531. [PMID: 34445237 PMCID: PMC8395160 DOI: 10.3390/ijms22168531] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 12/25/2022] Open
Abstract
Cardiovascular diseases are the most common cause of death in the world. For almost 60 years, vitamin K antagonists (VKAs) were the mainstay of anticoagulation therapy, but in recent years direct oral anticoagulants (DOACs) have become the anticoagulant treatment of choice. DOACs were initially considered drugs with no significant food interactions; however, clinical observations from daily practice have proved otherwise as interactions with food ingredients have been reported. Food, dietary supplements or herbs may contain substances that, when administered concomitantly with DOACs, can potentially affect the plasma concentration of the drugs. The aim of this paper was to evaluate the clinical significance of drug-food interactions of DOACs, such as dabigatran, rivaroxaban, apixaban, edoxaban and betrixaban. Patients treated with anticoagulants should avoid products containing St. John's wort and take special care with other food ingredients. As the interest in dietary supplements is on the rise, healthcare providers can contribute to the development of well-designed clinical trials on interactions between DOACs and food, and distribute sufficient knowledge about the proper use of these supplements among patients.
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Affiliation(s)
- Grzegorz Grześk
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (G.G.); (Ł.W.); (A.R.); (W.G.); (J.B.)
| | - Daniel Rogowicz
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (G.G.); (Ł.W.); (A.R.); (W.G.); (J.B.)
| | - Łukasz Wołowiec
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (G.G.); (Ł.W.); (A.R.); (W.G.); (J.B.)
| | - Agnieszka Ratajczak
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (G.G.); (Ł.W.); (A.R.); (W.G.); (J.B.)
| | - Wojciech Gilewski
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (G.G.); (Ł.W.); (A.R.); (W.G.); (J.B.)
| | - Małgorzata Chudzińska
- Department of Nutrition and Dietetics, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Dębowa 3 Street, 85-626 Bydgoszcz, Poland;
| | - Anna Sinkiewicz
- Department of Otolaryngology, Audiology and Phoniatrics, University Hospital No. 2, Collegium Medicum, Nicolaus Copernicus University in Toruń, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland;
| | - Joanna Banach
- Department of Cardiology and Clinical Pharmacology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland; (G.G.); (Ł.W.); (A.R.); (W.G.); (J.B.)
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Sarhene M, Ni JY, Duncan ES, Liu Z, Li S, Zhang J, Guo R, Gao S, Gao X, Fan G. Ginsenosides for cardiovascular diseases; update on pre-clinical and clinical evidence, pharmacological effects and the mechanisms of action. Pharmacol Res 2021; 166:105481. [PMID: 33549726 DOI: 10.1016/j.phrs.2021.105481] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/20/2021] [Accepted: 02/02/2021] [Indexed: 12/14/2022]
Abstract
Cardiovascular disease (CVD) remains the major cause of death worldwide, accounting for almost 31% of the global mortality annually. Several preclinical studies have indicated that ginseng and the major bioactive ingredient (ginsenosides) can modulate several CVDs through diverse mechanisms. However, there is paucity in the translation of such experiments into clinical arena for cardiovascular ailments due to lack of conclusive specific pathways through which these activities are initiated and lack of larger, long-term well-structured clinical trials. Therefore, this review elaborates on current pharmacological effects of ginseng and ginsenosides in the cardiovascular system and provides some insights into the safety, toxicity, and synergistic effects in human trials. The review concludes that before ginseng, ginsenosides and their preparations could be utilized in the clinical treatment of CVDs, there should be more preclinical studies in larger animals (like the guinea pig, rabbit, dog, and monkey) to find the specific dosages, address the toxicity, safety and synergistic effects with other conventional drugs. This could lead to the initiation of large-scale, long-term well-structured randomized, and placebo-controlled clinical trials to test whether treatment is effective for a longer period and test the efficacy against other conventional therapies.
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Affiliation(s)
- Michael Sarhene
- First teaching hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Jing Yu Ni
- First teaching hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Esi Sophia Duncan
- First teaching hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Zhihao Liu
- First teaching hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Sheng Li
- First teaching hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Jing Zhang
- First teaching hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Rui Guo
- First teaching hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China
| | - Shan Gao
- First teaching hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiumei Gao
- State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Guanwei Fan
- First teaching hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China; State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; Tianjin Laboratory of Translational Research of TCM Prescription and Syndrome, Tianjin 300193, China.
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Chi D, Ding D, Zhao Q, Liang X, Wu W, Luo J, Wang B. Potential herb-drug interactions in community-dwelling older adults in China: the Shanghai Aging Study. Aging Clin Exp Res 2020; 32:2677-2685. [PMID: 32008224 DOI: 10.1007/s40520-020-01489-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Potential herb-drug interactions (pHDIs) often go unrecognized, and little is known about the prevalence of pHDIs in older adults. AIMS This study aimed to investigate the prevalence of pHDIs in community-dwelling older adults in Shanghai and identify patterns and factors associated with pHDIs. METHODS Baseline data from the Shanghai Aging Study, which was designed to establish a prospective community-based cohort of older adults in Shanghai, were analyzed regarding pHDIs with Lexi-Interact Online software. RESULTS Among 1227 participants who used any combination of drug-herb or herb-herb, 43.3% were exposed to at least one pHDI. A total of 1641 different pHDIs were identified among the study samples. Only seven (0.4%) pHDIs were rated as risk category X, indicating that the combinations were contraindicated and should be avoided. Worryingly, 876 (53.4%) pHDIs were rated as risk category D, indicating that significant interactions may occur and therapeutic modification should be considered. Of particular concern is that 99.8% of pHDIs in risk category D involve herbs with anticoagulant/antiplatelet properties. Individuals with stroke (odds ratio [OR] 2.02), hyperlipidemia (OR 1.51) or heart diseases (OR 1.42) and the number of herbs (2.66), number of drugs (OR 1.21), and age (OR 1.02) were significantly associated with the risk of pHDIs. CONCLUSION 43.3% of community-dwelling older adults who used any combination of drug-herb or herb-herb was exposed to pHDIs, and more than half of pHDIs were related to herbs with anticoagulant/antiplatelet properties. Awareness of the patterns and high-risk groups of these pHDIs may contribute to increased patient safety.
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Oral administration of dermatan sulphate reduces venous thrombus formation in vivo: potential use as a formulation for venous thromboembolism. Inflammopharmacology 2020; 29:525-535. [PMID: 33230702 DOI: 10.1007/s10787-020-00771-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/25/2020] [Indexed: 10/22/2022]
Abstract
Dermatan sulphate (DS) is a sulphated polysaccharide that displays complexity in constituent sulphated disaccharides and interacts with proteins and signalling molecules to modulate numerous biological processes, including inhibition of the coagulation cascade and regulation of blood clotting and fibrinolysis. This study shows the antithrombotic and anticoagulant effects of DS prepared from bovine collagen waste liquor following oral and intravenous administrations in a deep vein thrombosis (DVT) rabbit model. In vitro, the prothrombin time, activated partial thromboplastin time, and thrombin citrated plasma clotting assays revealed that bovine DS had strong antithrombotic and anticoagulant effects comparable to low-molecular-weight heparin [Clexane® (enoxaparin sodium)]. In a DVT rabbit model, animals received intravenous and oral administrations of bovine DS and Clexane® providing further evidence that both agents had strong antithrombotic and anticoagulant effects by significantly reducing or preventing clot formation. Thromboelastography (TEG) assays revealed further that both bovine DS and Clexane® substantially prolonged the clotting time of recalcified citrated whole blood, but only bovine DS could retain clot strength suggesting that bovine DS had less effect on platelet-fibrin interactions. In conclusion, this is the first report that oral administration of DS from bovine collagen waste liquor reduces experimental venous thrombus formation warranting further research into bovine DS as an oral antithrombotic therapeutic.
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Di Matteo G, Spano M, Grosso M, Salvo A, Ingallina C, Russo M, Ritieni A, Mannina L. Food and COVID-19: Preventive/Co-therapeutic Strategies Explored by Current Clinical Trials and in Silico Studies. Foods 2020; 9:E1036. [PMID: 32752217 PMCID: PMC7466271 DOI: 10.3390/foods9081036] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/26/2020] [Accepted: 07/29/2020] [Indexed: 12/13/2022] Open
Abstract
Foods, food ingredients, and their balanced consumption are recognized to have an important role in achieving or maintaining a state of wellbeing by acting as carriers of functional components and bioactive molecules. However, the potential contribution of foods to consumers' health has so far only been partially exploited. The rapidly evolving scenario of the coronavirus disease 2019 (COVID-19) pandemic is stimulating profound reflection on the relationships between food and the etiological agent, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, the status of knowledge regarding food as a possible defense/co-therapeutic strategy against the SARS-CoV-2 coronavirus is considered through the discussion of two main current lines of research. One line of research relates to the role of micronutrients, food components, and diets in the strengthening of the immune system through clinical trials; formulations could be developed as immune system enhancers or as co-adjuvants in therapies. The other line of research relates to investigation of the chemical interactions that specific food compounds can have with host or virus targets so as to interfere with the viral infective cycle of SARS-CoV-2. This line requires, as a first step, an in silico evaluation to discover lead compounds, which may be further developed through drug-design studies, in vitro and in vivo tests, and, finally, clinical trials to obtain therapeutic molecules. All of these promising strategies promote the role of food in preventive/co-therapeutic strategies to tackle the COVID-19 pandemic.
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Affiliation(s)
- Giacomo Di Matteo
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy; (G.D.M.); (M.S.); (A.S.); (C.I.); (L.M.)
| | - Mattia Spano
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy; (G.D.M.); (M.S.); (A.S.); (C.I.); (L.M.)
| | - Michela Grosso
- Department of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples Federico II, CEINGE-Biotecnologie Avanzate, 80131 Naples, Italy;
| | - Andrea Salvo
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy; (G.D.M.); (M.S.); (A.S.); (C.I.); (L.M.)
| | - Cinzia Ingallina
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy; (G.D.M.); (M.S.); (A.S.); (C.I.); (L.M.)
| | - Mariateresa Russo
- Department of Agriculture, Food Chemistry Safety and Sensoromic Laboratory (FoCuSS Lab), University of Reggio Calabria, 89124 Reggio Calabria, Italy;
| | - Alberto Ritieni
- Department of Pharmacy, School of Medicine, University of Naples Federico II, 80131 Naples, Italy
- UNESCO Chair of Health Education and Sustainable Development, University of Naples, 80131 Naples, Italy
| | - Luisa Mannina
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy; (G.D.M.); (M.S.); (A.S.); (C.I.); (L.M.)
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Khadge S, Sharp JG, Thiele GM, McGuire TR, Talmadge JE. Fatty Acid Mediators in the Tumor Microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1259:125-153. [PMID: 32578175 DOI: 10.1007/978-3-030-43093-1_8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Patients with cancer frequently overexpress inflammatory cytokines with an associated neutrophilia both of which may be downregulated by diets with high omega-3 polyunsaturated fatty acids (ω-3 PUFA). The anti-inflammatory activity of dietary ω-3 PUFA has been suggested to have anticancer properties and to improve survival of cancer patients. Currently, the majority of dietary research efforts do not differentiate between obesity and dietary fatty acid consumption as mediators of inflammatory cell expansion and tumor microenvironmental infiltration, initiation, and progression. In this chapter, we discuss the relationships between dietary lipids, inflammation, neoplasia and strategies to regulate these relationships. We posit that dietary composition, notably the ratio of ω-3 vs. ω-6 PUFA, regulates tumor initiation and progression and the frequency and sites of metastasis that, together, impact overall survival (OS). We focus on three broad topics: first, the role of dietary lipids in chronic inflammation and tumor initiation, progression, and regression; second, lipid mediators linking inflammation and cancer; and third, dietary lipid regulation of murine and human tumor initiation, progression, and metastasis.
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Affiliation(s)
- Saraswoti Khadge
- Department of Pathology and Microbiology and Immunology, University of Nebraska Medical Center, Omaha, NE, USA.,Vanderbilt University, Nashville, TN, USA
| | - John Graham Sharp
- Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE, USA
| | - Geoffrey M Thiele
- Department of Pathology and Microbiology and Immunology, University of Nebraska Medical Center, Omaha, NE, USA.,Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.,Veteran Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA
| | - Timothy R McGuire
- Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, NE, USA
| | - James E Talmadge
- Department of Pathology and Microbiology and Immunology, University of Nebraska Medical Center, Omaha, NE, USA. .,Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
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13
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Zhang Y, Wang G, Kong Y, Xu H, Xiao B, Liu Y, Zhou H. A comparative analysis of the essential oils from two species of garlic seedlings cultivated in China: chemical profile and anticoagulant potential. Food Funct 2020; 11:6020-6027. [PMID: 32697212 DOI: 10.1039/d0fo00845a] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Garlic seedlings (GS) and blanched garlic seedlings (BGS) are two kinds of common garlic-derived vegetables in China, but little information is available on their bioactive constituents. In this work, chemical profiles and anticoagulant activities of essential oils from GS (EOGS) and BGS (EOBGS) were disclosed and compared for the first time. Sixteen and fourteen volatile compounds were identified in EOGS and EOBGS by GC-MS analysis, and both of them were rich in sulfur-containing compounds, particularly diallyl sulfides accounting for 74.77% and 85.87%, respectively. EOGS and EOBGS exerted anticoagulant activities via intrinsic, extrinsic, and common coagulation pathways as well as by lowering the content of fibrinogen; EOGS exceeded EOBGS in the activation of intrinsic and extrinsic coagulation pathways, while EOBGS outperformed EOGS on the activation of the common coagulation pathway, which was even superior to that of heparin at the same dose. Herein, the results of the present investigation will give a strong clue that EOGS and EOBGS are more likely to lead to a promising way to vegetable-based anticoagulants.
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Affiliation(s)
- Yang Zhang
- School of Biology and Food Engineering, Changshu Institute of Technology, Changshu 215500, China.
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14
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Preparation and characterization of polyethylene terephthalate-chamomile oil blends with enhanced hydrophilicity and anticoagulant properties. Prog Biomater 2020; 9:97-106. [PMID: 32566967 DOI: 10.1007/s40204-020-00133-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 06/13/2020] [Indexed: 10/24/2022] Open
Abstract
New blend films based on polyethylene terephthalate (PET) with different concentrations (50, 100 and 200 µL) of chamomile oil (CAO) were prepared. The effect of oil on the dielectric properties, structural and surface properties of PET was studied. The wettability of the blend films was evaluated by contact angle measurements. In vitro platelet adhesion on the surface and coagulation assessment were conducted to evaluate the behavior of the new blends for blood contact applications. Results of the study indicate that the wettability of PET-CAO blends up to 100 µL has been enhanced relative to the pure PET as indicated by the decrease in contact angle measurements. The attenuation total reflection-Fourier transform infrared spectra of the blends confirmed the presence of chamomile oil in the polymer matrix and suggested the presence of interaction between them. The permittivity ε' values decreased by increasing oil content upto 100 µL. On the other hand, the values of dielectric loss ε″ were found to increase by increasing oil content to 100 µL after which it decreased. The delay in partial thromboplastin time (PTT) of the blood would validate the anti-coagulant property of PET-CAO blends. The results demonstrated that the PET-CAO blends with concentration of 100 µL could be considered as a promising candidate material in blood contact application.
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15
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A Systematic Review of the Effect of Dietary Supplements on Cognitive Performance in Healthy Young Adults and Military Personnel. Nutrients 2020; 12:nu12020545. [PMID: 32093203 PMCID: PMC7071459 DOI: 10.3390/nu12020545] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/04/2020] [Accepted: 02/14/2020] [Indexed: 12/20/2022] Open
Abstract
Intake of dietary supplements has increased, despite evidence that some of these have adverse side effects and uncertainty about their effectiveness. This systematic review examined the evidence for the cognitive benefits of a wide range of dietary supplements in healthy young adult samples; the aim was to identify if any might be useful for optimising cognitive performance during deployment in military personnel. Searches were conducted in 9 databases and 13 grey literature repositories for relevant studies published between January 2000 and June 2017. Eligible studies recruited healthy young adults (18-35 years), administered a legal dietary supplement, included a comparison control group, and assessed cognitive outcome(s). Thirty-seven of 394 identified studies met inclusion criteria and were included for synthesis. Most research was deemed of low quality (72.97%; SIGN50 guidelines), highlighting the need for sound empirical research in this area. Nonetheless, we suggest that tyrosine or caffeine could be used in healthy young adults in a military context to enhance cognitive performance when personnel are sleep-deprived. Caffeine also has the potential benefit of improving vigilance and attention during sustained operations offering little opportunity for sleep. Inconsistent findings and methodological limitations preclude firm recommendations about the use of other specific dietary supplements.
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18
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Bailey A, Vasicek B, Tao J, Janeczek M, Mitri A, Tung R. Management of keratinocyte carcinoma - Special considerations in the elderly. Int J Womens Dermatol 2019; 5:235-245. [PMID: 31700979 PMCID: PMC6831749 DOI: 10.1016/j.ijwd.2019.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/05/2019] [Accepted: 05/12/2019] [Indexed: 02/06/2023] Open
Abstract
Keratinocyte carcinomas (KCs) are now an epidemic in The United States of America, especially in elderly patients. KCs, including basal cell carcinoma and squamous cell carcinoma, can lead to disfigurement and occasionally death. However, the lower mortality rate associated with KC compared with melanoma allows for increased flexibility in the selection of treatment. Flexibility in treatment is particularly important in the elderly given that this patient population often has medical comorbidities that should be considered. These patients may have multiple KCs, higher risk tolerance to recurrence, and different concerns about cosmetic outcomes compared with their younger counterparts. We review treatment options for KCs and how the selection of each option may affect the elderly patient.
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Affiliation(s)
- Alison Bailey
- Loyola University Chicago, Stritch School of Medicine, Chicago, Illinois
| | - Brooke Vasicek
- Loyola University Chicago, Division of Dermatology, Chicago, Illinois
| | - Joy Tao
- Loyola University Chicago, Stritch School of Medicine, Chicago, Illinois
| | - Monica Janeczek
- Loyola University Chicago, Stritch School of Medicine, Chicago, Illinois
| | - Andia Mitri
- Loyola University Chicago, Stritch School of Medicine, Chicago, Illinois
| | - Rebecca Tung
- Loyola University Chicago, Stritch School of Medicine, Chicago, Illinois
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19
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Acquired platelet function disorders. Thromb Res 2019; 196:561-568. [PMID: 31229273 DOI: 10.1016/j.thromres.2019.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 06/08/2019] [Accepted: 06/14/2019] [Indexed: 12/16/2022]
Abstract
The possibility of an acquired platelet function disorder should be considered in patients who present with recent onset muco-cutaneous bleeding. Despite the availability of newer and faster platelet function assays, light transmission aggregometry (LTA) remains the preferred diagnostic test. This review examines and discusses the causes of acquired platelet dysfunction; most commonly drugs, dietary factors, medical disorders and procedures. In addition to well-known antiplatelet therapies, clinicians should be alert for newer drugs which can affect platelets, such as ibrutinib. There is little clinical trial evidence to guide the management of acquired platelet function defects, but we summarise commonly employed strategies, which include addressing the underlying cause, antifibrinolytic agents, desmopressin infusions, and in selected patients, platelet transfusions.
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Olas B, Bryś M. Effects of coffee, energy drinks and their components on hemostasis: The hypothetical mechanisms of their action. Food Chem Toxicol 2019; 127:31-41. [DOI: 10.1016/j.fct.2019.02.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 01/28/2019] [Accepted: 02/26/2019] [Indexed: 02/08/2023]
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Olas B. Anti-Aggregatory Potential of Selected Vegetables-Promising Dietary Components for the Prevention and Treatment of Cardiovascular Disease. Adv Nutr 2019; 10:280-290. [PMID: 30759176 PMCID: PMC6416036 DOI: 10.1093/advances/nmy085] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/10/2018] [Accepted: 10/01/2018] [Indexed: 12/13/2022] Open
Abstract
Increased blood platelet activation, especially platelet aggregation, plays an important function in cardiovascular disease; however, various dietary components may inhibit platelet activation. Recent clinical and epidemiologic studies indicate that both fruits and vegetables, and their products, contain various phytoprotective substances possessing biological properties such as antiplatelet and antioxidant effects that may work synergistically to ameliorate the effect of cardiovascular disease. In addition, the consumption of vegetables and their products may also play an important role in prevention. However, the mechanisms involved have not been clearly defined. Various studies clearly indicate that certain vegetables (e.g., onions, garlic, and tomatoes) have beneficial effects on blood platelet hyperactivity, an important cardiovascular risk factor, and hence may offer new prophylactic and therapeutic possibilities for the treatment of blood platelet hyperactivation and cardiovascular disease. This mini-review evaluates the current literature on the relationship between the consumption of onion (Allium cepa L.), garlic (Allium sativum L.), tomato (Solanum lycopersicum L.), and beetroot (Beta vulgaris L.), and blood platelet activation, which may have important implications for the prophylaxis and treatment of cardiovascular disease.
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Affiliation(s)
- Beata Olas
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
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22
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Russ DW, Garvey SM, Densmore C, Hawks T, Herman S, Pardi K. Effect of acute muscle contusion injury, with and without dietary fish oil, on adult and aged male rats: contractile and biochemical responses. Exp Gerontol 2018; 111:241-252. [DOI: 10.1016/j.exger.2018.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/26/2018] [Accepted: 08/06/2018] [Indexed: 12/16/2022]
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Which Benefits and Harms of Using Fenugreek as a Galactogogue Need to Be Discussed during Clinical Consultations? A Delphi Study among Breastfeeding Women, Gynecologists, Pediatricians, Family Physicians, Lactation Consultants, and Pharmacists. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:2418673. [PMID: 29849697 PMCID: PMC5937604 DOI: 10.1155/2018/2418673] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/27/2018] [Indexed: 12/15/2022]
Abstract
Background Breastfeeding women with hypogalactia are commonly recommended to use fenugreek as a galactogogue. This study aimed to achieve formal consensus among breastfeeding women and healthcare providers on which potential harms and benefits of using fenugreek need to be communicated and discussed during clinical consultations. Methods A two-iterative round Delphi technique was used in two separate panels of breastfeeding women (n = 65) and healthcare providers (n = 56) to achieve formal consensus on a list of 24 and 16 items related to potential harms and benefits of fenugreek. Results About 70% of the healthcare providers recommended quite often herbal remedies for breastfeeding women and about 68% of the women had been recommended to use herbal remedies many times by their healthcare providers. Consensus was achieved on 21 potential harms and 14 potential benefits of using fenugreek to enhance human milk supply that need to be discussed with breastfeeding women during consultations. Conclusion Probably, potential harms and benefits of recommending fenugreek as herbal galactogogue for breastfeeding women seeking recommendations to increase their human milk supply need to be discussed during clinical consultations. Further observational studies are needed to assess what is being discussed in daily consultations when herbal remedies are recommended.
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24
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Abstract
Dietary supplements can have beneficial effects on a number of risk factors for cardiovascular diseases, and interest in the use of nonpharmacologic nutraceutical-based treatments for cardiovascular disorders is growing. The aim of this review is to present the role of dietary supplements with antiplatelet activity in the prophylaxis and treatment of cardiovascular disorders. In addition, this paper describes their effects on another very important element of hemostasis-blood coagulation. However, because controlled human clinical experiments are too limited to clearly identify the antiplatelet and anticoagulant properties of dietary supplements, used alone or in combination with classical antiplatelet therapy (e.g., with aspirin), most information in this article is based on in vitro studies. Therefore, it cannot be unequivocally stated whether dietary supplements are universally safe and bring benefits to all. Some authors suggest that blood platelet count and function should be monitored in patients taking such supplements, especially before and after surgery, as well as other hemostasis parameters such as coagulation times.
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Affiliation(s)
- Beata Olas
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland,Address correspondence to BO (e-mail: )
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25
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Tanizawa Y, Bando E, Kawamura T, Tokunaga M, Makuuchi R, Iida K, Nanri K, Yoneyama M, Terashima M. Prevalence of deep venous thrombosis detected by ultrasonography before surgery in patients with gastric cancer: a retrospective study of 1140 consecutive patients. Gastric Cancer 2017; 20:878-886. [PMID: 27987041 DOI: 10.1007/s10120-016-0677-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/29/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND The prevalence of deep venous thrombosis (DVT) in patients with gastric cancer before surgery is unknown. This study aimed to clarify the risk factors for DVT of the lower extremities in patients with gastric cancer before surgery and to evaluate the usefulness of ultrasonographic screening for prevention of postoperative pulmonary thromboembolism (PTE). METHODS Patients who had undergone lower-extremity venous ultrasonography before surgery for gastric cancer were retrospectively analyzed. Univariate and multivariate logistic regression analyses were performed to identify the predictors of DVT before surgery. Perioperative management of patients with DVTs and the incidence of postoperative PTE were investigated. RESULTS Of the total 1140 patients, 86 had DVT preoperatively. On univariate analysis, the incidence of DVT was significantly higher with: female sex; age ≥80 years; PS ≥ 1 (vs. PS = 0); stage IV (vs. stages I-III); history of preoperative chemotherapy; and the presence of a central venous catheter (CVC). Multivariate logistic regression analysis demonstrated that sex, age ≥80 years, PS ≥ 1, history of preoperative chemotherapy, and the presence of CVC were significantly correlated with DVT before surgery. Postoperative PTE occurred in 2 patients with proximal DVT. No patients in whom DVT was not detected developed PTE. CONCLUSIONS Female sex, older age, worse PS, the presence of CVC, and a history of preoperative chemotherapy were the independent risk factors for DVT. Routine lower-extremity venous ultrasonographic screening is useful for prevention of PTE because it can identify patients at high or low risk for PTE.
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Affiliation(s)
- Yutaka Tanizawa
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - Etsuro Bando
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - Taiichi Kawamura
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - Masanori Tokunaga
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - Rie Makuuchi
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - Kei Iida
- Division of Cardiology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kazuhide Nanri
- Division of Physiological Examination, Shizuoka Cancer Center, Shizuoka, Japan
| | - Masashi Yoneyama
- Division of Physiological Examination, Shizuoka Cancer Center, Shizuoka, Japan
| | - Masanori Terashima
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
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Fung FY, Wong WH, Ang SK, Koh HL, Kun MC, Lee LH, Li X, Ng HJ, Tan CW, Zhao Y, Linn YC. A randomized, double-blind, placebo- controlled study on the anti-haemostatic effects of Curcuma longa, Angelica sinensis and Panax ginseng. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2017; 32:88-96. [PMID: 28732813 DOI: 10.1016/j.phymed.2017.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 03/27/2017] [Accepted: 04/08/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Herbs with "blood-activating" properties by traditional medicine theory often raise concerns for their possible anti-platelet or anticoagulation effects based on reports from in vitro studies. Such herbs have been implicated for bleeding manifestations based on only anecdotal reports. In particular, the combination of such herbs with anti-platelet agents is often empirically advised against despite lack of good clinical evidence. Here we studied 3 commonly used herbal preparations Curcuma longa, Angelica sinensis and Panax ginseng on their respective anti-platelet and anticoagulation effect, alone and in combination with aspirin. STUDY DESIGN This is a randomized, double-blind, placebo-controlled trial involving 25 healthy volunteers for each herbal preparation. METHODS Each subject underwent 3 phases comprising of herbal product alone, aspirin alone and aspirin with herbal product, where each phase lasted for 3 weeks with 2 weeks of washout between phases. PT/APTT, platelet function by light transmission aggregometry and thrombin generation assay by calibrated automated thrombogram were measured at baseline and after each phase. Information on adverse reaction including bleeding manifestations was collected after each phase. RESULTS On the whole there was no clinically relevant impact on platelet and coagulation function. With the exception of 5 of 24 subjects in the Curcuma longa group, 2 of 24 subjects in the Angelica sinensis group and 1 of 23 subjects in the Panax ginseng group who had an inhibition in arachidonic-acid induced platelet aggregation, there was no effect of these 3 herbals products on platelet aggregation by other agonists. Combination of these herbal products with aspirin respectively did not further aggravate platelet inhibition caused by aspirin. None of the herbs impaired PT/APTT or thrombin generation. There was no significant bleeding manifestation. CONCLUSIONS This study on healthy volunteers provides good evidence on the lack of bleeding risks of Curcuma longa, Angelica sinensis and Panax ginseng either used alone or in combination with aspirin.
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Affiliation(s)
- Foon Yin Fung
- Pharmacy, Singapore General Hospital, Outram Road, Singapore 169608
| | - Wan Hui Wong
- Haematology, Singapore General Hospital, Outram Road, Singapore 169608
| | - Seng Kok Ang
- Pharmacy, National Cancer Centre, Singapore, 11 Hospital Drive, Singapore 169610
| | - Hwee Ling Koh
- Pharmacy, National University of Singapore, 5 Lower Kent Ridge Rd, Singapore 119074
| | - Mei Ching Kun
- Pharmacy, Singapore General Hospital, Outram Road, Singapore 169608
| | - Lai Heng Lee
- Haematology, Singapore General Hospital, Outram Road, Singapore 169608
| | - Xiaomei Li
- Clinical Trial Resource Centre, Singapore General Hospital, Outram Road, Singapore 169608
| | - Heng Joo Ng
- Haematology, Singapore General Hospital, Outram Road, Singapore 169608
| | - Chuen Wen Tan
- Haematology, Singapore General Hospital, Outram Road, Singapore 169608
| | - Yan Zhao
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore 637551
| | - Yeh Ching Linn
- Haematology, Singapore General Hospital, Outram Road, Singapore 169608.
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Cohen O, Shoffel-Havakuk H, Warman M, Tzelnick S, Haimovich Y, Kohlberg GD, Halperin D, Lahav Y. Early and Late Recurrent Epistaxis Admissions: Patterns of Incidence and Risk Factors. Otolaryngol Head Neck Surg 2017; 157:424-431. [PMID: 28463569 DOI: 10.1177/0194599817705619] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Epistaxis is a common complaint, yet few studies have focused on the incidence and risk factors of recurrent epistaxis. Our objective was to determine the patterns of incidence and risk factors for recurrent epistaxis admission (REA). Study Design Case series with chart review. Settings Single academic center. Subjects and Methods The medical records of patients admitted for epistaxis between 1999 and 2015 were reviewed. The follow-up period was defined as 3 years following initial admission. REAs were categorized as early (30 days) and late (31 days to 3 years) following initial admission. Logistic regression was used to identify potential predictors of REAs. Results A total of 653 patients were included. Eighty-six patients (14%) had REAs: 48 (7.5%) early and 38 (6.5%) late. Nonlinear incidence curve was demonstrated for both early and late REAs. Based on logistic regression, prior nasal surgery and anemia were independent risk factors for early REAs. According to multivariate analysis, thrombocytopenia was significantly associated with late REAs. Conclusion Early and late REAs demonstrate different risk predictors. Knowledge of such risk factors may help in risk stratification for this selected group of patients. All patients at risk should be advised on possible preventive measures. Patients at risk for early REA may benefit from a more proactive approach.
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Affiliation(s)
- Oded Cohen
- 1 Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,2 Hadassah Medical School, Hebrew University, Jerusalem, Israel
| | - Hagit Shoffel-Havakuk
- 1 Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,2 Hadassah Medical School, Hebrew University, Jerusalem, Israel
| | - Meir Warman
- 1 Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,2 Hadassah Medical School, Hebrew University, Jerusalem, Israel
| | - Sharon Tzelnick
- 1 Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel
| | - Yaara Haimovich
- 1 Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel
| | - Gavriel D Kohlberg
- 3 Department of Otolaryngology-Head and Neck Surgery, New York Presbyterian Hospital-Columbia and Weill Cornell Campuses, New York, New York, USA
| | - Doron Halperin
- 1 Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,2 Hadassah Medical School, Hebrew University, Jerusalem, Israel
| | - Yonatan Lahav
- 1 Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.,2 Hadassah Medical School, Hebrew University, Jerusalem, Israel
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Atwell TD, Wennberg PW, McMenomy BP, Murthy NS, Anderson JR, Kriegshauser JS, McKinney JM. Peri-procedural use of anticoagulants in radiology: an evidence-based review. Abdom Radiol (NY) 2017; 42:1556-1565. [PMID: 28070656 DOI: 10.1007/s00261-016-1027-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Peri-procedural anticoagulant management hinges on the balance of hemorrhagic and thrombotic complications. The radiologist is tasked with accurately assessing the hemorrhagic risk for patients undergoing procedures, taking into account procedural bleeding rates, underlying coagulopathy based on lab tests, and use of anticoagulants. The purpose of this article is to provide a contemporary review of commonly used anticoagulants and, incorporating published evidence, review their management related to image-guided procedures.
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Omega-3 Fatty Acid Supplementation and Warfarin: A Lethal Combination in Traumatic Brain Injury. J Trauma Nurs 2017; 24:15-18. [DOI: 10.1097/jtn.0000000000000256] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Tan P, Siah W, Malhotra R. Methods for prevention of complications during eyelid and peri-orbital surgery. EXPERT REVIEW OF OPHTHALMOLOGY 2016. [DOI: 10.1080/17469899.2016.1207529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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31
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Chamali B, Finnamore H, Manning R, Laffan MA, Hickson M, Whelan K, Shovlin CL. Dietary supplement use and nosebleeds in hereditary haemorrhagic telangiectasia - an observational study. Intractable Rare Dis Res 2016; 5:109-13. [PMID: 27195194 PMCID: PMC4869576 DOI: 10.5582/irdr.2016.01019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 04/05/2016] [Accepted: 04/07/2016] [Indexed: 12/18/2022] Open
Abstract
Understanding potential provocations of haemorrhage is important in a range of clinical settings, and particularly for people with abnormal vasculature. Patients with hereditary haemorrhagic telangiectasia (HHT) can report haemorrhage from nasal telangiectasia in real time, and suggested dietary factors may precipitate nosebleeds. To examine further, nosebleed severity, dietary supplement use, and blood indices were evaluated in an unselected group of 50 HHT patients recruited from a specialist UK service. Using the validated Epistaxis Severity Score, nosebleed severity ranged from 0 to 9.1 out of 10 (median 3.9). Using a Food Frequency Questionnaire, 24/50 (48%) participants reported use of dietary supplements in the previous year. A third (18/50; 36%) had used self prescribed, non-iron containing dietary supplements, ingesting between 1 and 3 different supplements each day. Eight (16%) used fish oils. Despite having more severe epistaxis (p = 0.012), the 12 iron supplement users had higher serum iron concentrations, and were able to maintain their red blood cell indices. In contrast, there was no evident benefit for the participants using non iron supplements. Furthermore, platelet counts and serum fibrinogen tended to be lower in fish oil/supplement users, and one fish oil user demonstrated reduced in vitro platelet aggregation. In conclusion, in this small study, a third of HHT patients used non-iron dietary supplements, and one in six ingested fish oils, unaware of their known anti-platelet activity. The scale of use, and potential of these "natural health supplements" to exacerbate nosebleeds has not been appreciated previously in HHT.
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Affiliation(s)
- Basel Chamali
- National Heart and Lung Institute Cardiovascular Sciences, Imperial College London, UK
- Imperial College School of Medicine, Imperial College London, UK
| | - Helen Finnamore
- National Heart and Lung Institute Cardiovascular Sciences, Imperial College London, UK
- Diabetes and Nutritional Sciences Division, King's College London, UK
| | - Richard Manning
- Haematology Department, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Michael A Laffan
- Haematology Department, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
- Centre for Haematology, Imperial College London, UK
| | - Mary Hickson
- Nutrition and Dietetics, Imperial College Healthcare NHS Trust, London, UK (Current address: School of Health Professions, Plymouth University, Plymouth, UK)
| | - Kevin Whelan
- Diabetes and Nutritional Sciences Division, King's College London, UK
| | - Claire L Shovlin
- National Heart and Lung Institute Cardiovascular Sciences, Imperial College London, UK
- HHTIC London, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
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Wang CZ, Moss J, Yuan CS. Commonly Used Dietary Supplements on Coagulation Function during Surgery. MEDICINES (BASEL, SWITZERLAND) 2015; 2:157-185. [PMID: 26949700 PMCID: PMC4777343 DOI: 10.3390/medicines2030157] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
BACKGROUND Patients who undergo surgery appear to use dietary supplements significantly more frequently than the general population. Because they contain pharmacologically active compounds, dietary supplements may affect coagulation and platelet function during the perioperative period through direct effects, pharmacodynamic interactions, and pharmacokinetic interactions. However, in this regard, limited studies have been conducted that address the pharmacological interactions of dietary supplements. To avoid possible bleeding risks during surgery, information of potential complications of dietary supplements during perioperative management is important for physicians. METHODS Through a systematic database search of all available years, articles were identified in this review if they included dietary supplements and coagulation/platelet function, while special attention was paid to studies published after 1990. RESULTS Safety concerns are reported in commercially available dietary supplements. Effects of the most commonly used natural products on blood coagulation and platelet function are systematically reviewed, including 11 herbal medicines (echinacea, ephedra, garlic, ginger, ginkgo, ginseng, green tea, kava, saw palmetto, St John's wort, and valerian) and 4 other dietary supplements (coenzyme Q10, glucosamine and chondroitin sulfate, fish oil, and vitamins). Bleeding risks of garlic, ginkgo, ginseng, green tea, saw palmetto, St John's wort, and fish oil are reported. Cardiovascular instability was observed with ephedra, ginseng, and kava. Pharmacodynamic and pharmacokinetic interactions between dietary supplements and drugs used in the perioperative period are discussed. CONCLUSIONS To prevent potential problems associated with the use of dietary supplements, physicians should be familiar with the perioperative effects of commonly used dietary supplements. Since the effects of dietary supplements on coagulation and platelet function are difficult to predict, it is prudent to advise their discontinuation before surgery.
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Affiliation(s)
- Chong-Zhi Wang
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-773-702-0166; Fax: +1-773-834-0601
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Brown DG, Wilkerson EC, Love WE. A review of traditional and novel oral anticoagulant and antiplatelet therapy for dermatologists and dermatologic surgeons. J Am Acad Dermatol 2015; 72:524-34. [DOI: 10.1016/j.jaad.2014.10.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 09/29/2014] [Accepted: 10/16/2014] [Indexed: 12/22/2022]
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Vizer SA, Sycheva ES, Al Quntar AAA, Kurmankulov NB, Yerzhanov KB, Dembitsky VM. Propargylic sulfides: synthesis, properties, and application. Chem Rev 2014; 115:1475-502. [PMID: 25517232 DOI: 10.1021/cr4001435] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Svetlana A Vizer
- A.B. Bekturov Institute of Chemical Sciences , 106 Sh. Walikhanov Street, Almaty 480100, Republic of Kazakhstan
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Miller S, Nitzki-George D, Caprini JA. Balancing the risk of complications in foot and ankle surgical patients taking antithrombotic medication. Foot Ankle Spec 2014; 7:507-14. [PMID: 25053792 DOI: 10.1177/1938640014543356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED This review intends to provide guidance regarding perioperative management of anticoagulation and antiplatelet drug therapy as they relate to foot and ankle surgery. Venous and arterial thromboembolism are conditions in which the blood clots inappropriately, causing considerable morbidity and mortality. With an increase in awareness of thromboembolic risk factors and expansion of therapeutic options, more patients are routinely taking antithrombotic medication. When these patients require invasive procedures, a decision needs to be made if antithrombotic medication should be held perioperatively and if additional precautions are needed in the interim. Understanding the factors affecting the management of thromboembolism during the perioperative period can reduce the potential for complications. LEVELS OF EVIDENCE Therapeutic, Level V: Expert opinion.
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Affiliation(s)
- Steven Miller
- Skokie Foot & Ankle Specialists, Skokie, Illinois (SM)Thrombosis and Anticoagulation Unit of Glenbrook Hospital, NorthShore University HealthSystem, Glenview, Illinois (DNG)Division of Vascular Surgery, NorthShore University HealthSystem, Evanston, Illinois (JAC)
| | - Diane Nitzki-George
- Skokie Foot & Ankle Specialists, Skokie, Illinois (SM)Thrombosis and Anticoagulation Unit of Glenbrook Hospital, NorthShore University HealthSystem, Glenview, Illinois (DNG)Division of Vascular Surgery, NorthShore University HealthSystem, Evanston, Illinois (JAC)
| | - Joseph A Caprini
- Skokie Foot & Ankle Specialists, Skokie, Illinois (SM)Thrombosis and Anticoagulation Unit of Glenbrook Hospital, NorthShore University HealthSystem, Glenview, Illinois (DNG)Division of Vascular Surgery, NorthShore University HealthSystem, Evanston, Illinois (JAC)
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Utilisation des compléments alimentaires à visée ergogénique chez les militaires français : prévalence et modes de consommation lors d’une opération extérieure. Sci Sports 2014. [DOI: 10.1016/j.scispo.2014.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ghauri AJ, Abbott J, Shah P, Gardiner P. Bleeding Risks Associated with Herbal Medicine in Children. Glob Adv Health Med 2014; 3:5. [PMID: 25568817 PMCID: PMC4268605 DOI: 10.7453/gahmj.2014.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
| | - Joe Abbott
- Birmingham Children's Hospital, United Kingdom
| | - Peter Shah
- University Hospitals Birmingham, United Kingdom
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Affiliation(s)
| | - Jorge Rakela
- Transplant Center, Mayo Clinic, Phoenix, Arizona
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39
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Owen-Smith AA, Rand C, Smith DH, Tom JO, Laws R, Waterbury A, Vollmer WM. Use of select dietary supplements among individuals with diabetes or atherosclerotic cardiovascular disease. ACTA ACUST UNITED AC 2014. [DOI: 10.1111/fct.12098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Ashli A Owen-Smith
- The Center for Health Research Southeast; Kaiser Permanente Georgia; Eleven Piedmont Center, Suite 110, 3495 Piedmont Road NE Atlanta Georgia GA 30305 USA
| | - Cynthia Rand
- Johns Hopkins University; Baltimore Maryland MD 21218 USA
| | - David H Smith
- The Center for Health Research Northwest; Kaiser Permanente Northwest; 3800 N Interstate Avenue Portland Oregon OR 97227-1098 USA
| | - Jeffrey O Tom
- The Center for Health Research Hawaii; Kaiser Permanente Hawaii; 501 Alakawa Street, Suite 201 Honolulu HI 96817 Hawaii USA
| | - Reesa Laws
- The Center for Health Research Northwest; Kaiser Permanente Northwest; 3800 N Interstate Avenue Portland Oregon OR 97227-1098 USA
| | - Amy Waterbury
- The Center for Health Research Northwest; Kaiser Permanente Northwest; 3800 N Interstate Avenue Portland Oregon OR 97227-1098 USA
| | - William M Vollmer
- The Center for Health Research Northwest; Kaiser Permanente Northwest; 3800 N Interstate Avenue Portland Oregon OR 97227-1098 USA
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Dietary supplements and the anesthesiologist: Research results and state of the art. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2014. [DOI: 10.1016/j.rcae.2014.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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41
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Franco Ruiz S, González Maldonado P. Los suplementos dietéticos y el anestesiólogo: resultados de investigación y estado del arte. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2014. [DOI: 10.1016/j.rca.2014.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hu M, Fan L, Zhou HH, Tomlinson B. Theranostics meets traditional Chinese medicine: rational prediction of drug–herb interactions. Expert Rev Mol Diagn 2014; 12:815-30. [DOI: 10.1586/erm.12.126] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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44
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Dietary supplements and the anesthesiologist: Research results and state of the art☆. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2014. [DOI: 10.1097/01819236-201442020-00004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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45
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Pastori D, Carnevale R, Cangemi R, Saliola M, Nocella C, Bartimoccia S, Vicario T, Farcomeni A, Violi F, Pignatelli P. Vitamin E serum levels and bleeding risk in patients receiving oral anticoagulant therapy: a retrospective cohort study. J Am Heart Assoc 2013; 2:e000364. [PMID: 24166490 PMCID: PMC3886776 DOI: 10.1161/jaha.113.000364] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Hemorrhagic risk assessment is a crucial issue in patients with nonvalvular atrial fibrillation (NVAF) who are receiving oral anticoagulant therapy (OAT). Our aim was to analyze the relationship between vitamin E, which possesses anticoagulant properties, and bleeding events in NVAF patients. Methods and Results In this retrospective observational study we analyzed baseline serum cholesterol‐adjusted vitamin E (vit E/chol) levels in 566 consecutive patients (59% males, mean age 73.6 years) receiving OAT followed up for a mean time of 22 months. Mean time in therapeutic INR range (TTR) was 64%. The overall incidence rate of any bleeding event was 9.2/100 person‐years. Compared to patients who did not bleed, those who experienced bleeding events (n=92, 73 minor and 15 major bleedings and 4 cerebral hemorrhages according to International Society on Thrombosis and Haemostasis [ISTH] ) classification) showed a significant difference for history of coronary heart disease (P=0.039), HAS‐BLED score (P=0.002), and vit E/chol levels (P<0.001). Higher vit E/chol serum levels were found in patients who bled compared to those who did not (5.27±1.93 versus 4.48±1.97 μmol/cholesterol; P<0.001), with a progressive increase from minor (5.16±1.91 μmol/mmol cholesterol, P=0.006) to major bleedings (5.72±2.0 μmol/mmol cholesterol, P=0.008). A Cox proportional hazard model demonstrated that serum vit E/chol quartiles (global P=0.0189) and HAS‐BLED scores (P=0.005) predicted bleeding events. Conclusions In a NVAF population being treated with warfarin, serum vitamin E predicted hemorrhagic events. Further study is necessary to see if the relationship between serum levels of vitamin E and bleeding is still maintained with the use of new anticoagulants. Clinical Trial Registration URL: ClinicalTrials.gov. Unique identifier NCT01882114.
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Affiliation(s)
- Daniele Pastori
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinico of Rome, Rome, Italy
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46
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Newer hemostatic agents used in the practice of dermatologic surgery. Dermatol Res Pract 2013; 2013:279289. [PMID: 23997764 PMCID: PMC3749606 DOI: 10.1155/2013/279289] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 07/07/2013] [Indexed: 11/18/2022] Open
Abstract
Minor postoperative bleeding is the most common complication of cutaneous surgery. Because of the commonality of this complication, hemostasis is an important concept to address when considering dermatologic procedures. Patients that have a bleeding diathesis, an inherited/acquired coagulopathy, or who are on anticoagulant/antiplatelet medications pose a greater risk for bleeding complications during the postoperative period. Knowledge of these conditions preoperatively is of the utmost importance, allowing for proper preparation and prevention. Also, it is important to be aware of the various hemostatic modalities available, including electrocoagulation, which is among the most effective and widely used techniques. Prompt recognition of hematoma formation and knowledge of postoperative wound care can prevent further complications such as wound dehiscence, infection, or skin-graft necrosis, minimizing poor outcomes.
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47
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Andrew N, Selva D. Postoperative haemorrhage in powered endoscopic dacryocystorhinostomy. Clin Exp Ophthalmol 2013; 42:262-5. [DOI: 10.1111/ceo.12162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 07/03/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Nicholas Andrew
- Department of Ophthalmology and Visual Sciences; University of Adelaide; Adelaide South Australia Australia
| | - Dinesh Selva
- South Australian Institute of Ophthalmology; Royal Adelaide Hospital; Adelaide South Australia Australia
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Hamilton JM, Pribitkin EA. Complementary and integrative treatments: facial cosmetic enhancement. Otolaryngol Clin North Am 2013; 46:461-83. [PMID: 23764822 DOI: 10.1016/j.otc.2013.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Complementary and integrative medicine is particularly popular among patients undergoing facial cosmetic enhancement. This article reviews the efficacy of the most commonly practiced integrative therapies among this surgical population, with a focus on the most current literature regarding the application or potential for application of these treatments to benefit patients undergoing facial aesthetic surgery. Adverse effects of the most popular herbal and dietary supplements are also reviewed. Finally, the potential for interaction among integrative treatments as well as with conventional pharmacologic therapy is discussed.
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Affiliation(s)
- James M Hamilton
- Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Keinan D, Leigh NJ, Nelson JW, De Oleo L, Baker OJ. Understanding resolvin signaling pathways to improve oral health. Int J Mol Sci 2013; 14:5501-18. [PMID: 23528855 PMCID: PMC3634469 DOI: 10.3390/ijms14035501] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 02/19/2013] [Accepted: 02/22/2013] [Indexed: 12/15/2022] Open
Abstract
The discovery of resolvins has been a major breakthrough for understanding the processes involved in resolution of inflammation. Resolvins belong to a family of novel lipid mediators that possess dual anti-inflammatory and pro-resolution actions. Specifically, they protect healthy tissue during immune-inflammatory responses to infection or injury, thereby aiding inflammation resolution and promoting tissue healing. One of the major concerns in modern medicine is the management and treatment of oral diseases, as they are related to systemic outcomes impacting the quality of life of many patients. This review summarizes known signaling pathways utilized by resolvins to regulate inflammatory responses associated with the oral cavity.
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Affiliation(s)
- David Keinan
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mail:
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mails: (N.J.L.); (J.W.N.); (L.D.O.)
| | - Noel J. Leigh
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mails: (N.J.L.); (J.W.N.); (L.D.O.)
| | - Joel W. Nelson
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mails: (N.J.L.); (J.W.N.); (L.D.O.)
| | - Laura De Oleo
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mails: (N.J.L.); (J.W.N.); (L.D.O.)
| | - Olga J. Baker
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, the State University of New York, Buffalo, NY 14214-3932, USA; E-Mails: (N.J.L.); (J.W.N.); (L.D.O.)
- To whom correspondence should be addressed; E-Mail: ; Tel.: +1-716-829-3667; Fax: +1-716-829-3942
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Silva BM, Hosman AE, Devlin HL, Shovlin CL. Lifestyle and Dietary Influences on Nosebleed Severity in Hereditary Hemorrhagic Telangiectasia. Laryngoscope 2013; 123:1092-9. [DOI: 10.1002/lary.23893] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2012] [Indexed: 12/31/2022]
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