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The effect of probiotics on functional constipation in the elderly
No full textKonstipacija je jedna od najčešćih kroničnih gastrointestinalnih tegoba. Dosadašnja klinička istraživanja upućuju
na zaključak da probiotici mogu poboljšati stanje osoba koje pate od konstipacije. Stoga je cilj ovog istraživanja
bio ispitati utjecaj odabranih sojeva probiotika na funkcionalnu konstipaciju osoba starije životne dobi smještenih
u domu za starije i nemoćne, koristeći randomizirani, dvostruko slijepi, placebom kontrolirani, paralelni dizajn
studije. Sudionici u studiji s probioticima su randomizirani u dvije skupine kroz 12 tjedana intervencije s
probiotičkim sojevima Bifidobacterium animalis subsp. lactis BLC1, Lactobacillus acidophilus LA 3,
Lactobacillus casei BGP93 ili placebom. Primarni cilj bio je ispitati učinak odabranih probiotičkih sojeva na broj
dnevnih stolica tijekom 12 tjedana. Sekundarni ciljevi istraživanja obuhvatili su procjenu učinka odabranih
probiotičkih sojeva na biljege upale, pokazatelje metabolizma glukoze i lipida, jetrene enzime i druge
laboratorijske parametre kompletne krvne slike, kao i učinka ljekarničkih intervencija na poboljšanje terapijskih
ishoda i kvalitete života osoba starije životne dobi s funkcionalnom konstipacijom smještenih u domu za starije i
nemoćne osobe. Nakon 12 tjedana tretmana kontinuirano se povećavao kumulativni broj stolica u usporedbi s
placebom, ali bez statističke značajnosti. No, isključenjem podataka o broju stolica u dane kad je evidentirana
primjena laksativa, statistička značajnost se dostigla 71. dana tretmana. Na krvne parametre nije bilo statistički
značajnih promjena. Ljekarničke intervencije su se pokazale kao važan dio skrbi za osobe starije životne dobi
smještenih u domu za starije i nemoćne.Constipation is a common gastrointestinal complaint. Clinical research suggests that probiotics may improve
people's condition of constipation. Therefore, this study aimed to examine the impact of selected strains of
probiotics on the functional constipation of elderly placed in a nursing home, using a randomized, double-blind,
placebo-controlled, parallel study design. Participants in the probiotic study were randomized into two groups
over 12 weeks of intervention with probiotic strains of Bifidobacterium animalis subsp. lactis BLC1,
Lactobacillus acidophilus LA 3, Lactobacillus casei BGP93 or placebo. The primary objective was to examine
the effect of selected probiotic strains on the number of daily stools over 12 weeks. Secondary objectives of the
study included assessing the effect of selected probiotic strains on markers of inflammation, glucose and lipid
metabolism indicators, liver enzymes and other laboratory parameters of complete blood count, as well as the
effect of pharmacy interventions on improving therapeutic outcomes and quality of life of elderly with functional
constipation in a nursery home. After 12 weeks of treatment, the cumulative stool count increased continuously
compared with placebo, but without statistical significance. However, excluding stool count data on days when
laxative use was recorded, statistical significance was reached on day 71 of treatment. There, was no significant
changes in blood parameters. Pharmacy interventions were an essential part of pharmaceutical care in a nursing
home
High-throughput N-glycosylation analysis of alpha-1-acid glycoprotein in the identification of diabetes mellitus biomarkers
No full textN-glikozilacija, proces enzimski posredovanog vezanja šećernih struktura na asparaginske ostatke proteina,
istraživana je u brojnim bolestima, u mnogima od kojih su promjene i potvrđene. Pronalazak specifičnih promjena
N-glikozilacije nudi mogućnost razvoja predikcijskih, dijagnostičkih i prognostičkih alata potrebnih u sprječavanju
i liječenju različitih bolesti. Studije ukupne N-glikozilacije proteina plazme provedene u istraživanju predispozicije
za šećernu bolest tipa 2, kao i istraživanju šećerne bolesti zrele dobi kod mladih osoba (MODY), identificirale su
promjene u glikozilaciji za koje se vjeruje da potječu s alfa-1-kiseloga glikoproteina (AGP). S ciljem detaljnijeg
istraživanja ovih promjena, razvijena je metoda za visokoprotočnu analizu N-glikozilacije AGP-a koja uključuje
obogaćenje ovog proteina te analizu njegovih glikopeptida metodom tekućinske kromatografije spregnute sa
spektometrijom masa (LC-MS). Inicijalnom analizom 14 zdravih ispitanika utvrđena je temporalna stabilnost Nglikoma
AGP-a, kao općeniti preduvjet za dijagnostičku upotrebu. Novorazvijenom metodom zatim je analizirana
glikozilacija AGP-a 108 ispitanika koji se razlikuju po svojoj predispoziciji za razvoj šećerne bolesti tipa 2 te je
utvrđena povezanost porasta grananja i smanjenja sijalinizacije glikana AGP-a s povećanim rizikom od razvoja
šećerne bolesti tipa 2. Nadalje, kod 466 pacijenata oboljelih od različitih tipova šećerne bolesti (HNF1A-, HNF4AMODY,
šećerna bolesti tipa 1 i tipa 2) analizom fukozilacije AGP-a ustanovljeno je njezino smanjenje koje je
pokazano specifično za HNF1A-MODY. Nadalje, analizom uzoraka 98 pacijenata oboljelih od šećerne bolesti ranog
nastupa bez autoimunosne podloge, pokazano je da je smanjena fukozilacija prisutna samo kod pacijenata s
oštećujućim HNF1A mutacijama – sržnim uzrokom bolesti. Također, pokazana je visoka uspješnost identifikacije
HNF1A-MODY pacijenata na temelju individualnih glikopeptida AGP-a. Prikupljene spoznaje upućuju na
mogućnost upotrebe glikozilacije AGP-a kao predikcijskog biljega za šećernu bolest tipa 2, kao i biljega
identifikacije pacijenata oboljelih od HNF1A-MODY-a što bi dalo velik doprinos pravovremenom prepoznavanju
rizika kao i diferencijalnoj dijagnostici šećerne bolesti.N-glycosylation, the process of enzymatically mediated binding of sugar structures to proteins' asparagine residues,
has been investigated in a number of diseases, in many of which the changes have been confirmed. The discovery
of specific N-glycosylation changes offers a possibility for development of prediction, diagnostic and prognostic
tools needed in the prevention and treatment of various diseases. Studies of total plasma protein N-glycosylation
performed in type 2 diabetes predisposition research, as well as in the research of maturity-onset diabetes of the
young (MODY), identified changes in glycosylation believed to originate from alpha-1-acid glycoprotein (AGP).
In order to investigate these changes in more detail, a method for high-throughput AGP N-glycosylation analysis
was developed. The method is based on enrichment of AGP and analysis of its glycopeptides by liquid
chromatography coupled to mass spectrometry (LC-MS). Initial analysis performed on 14 healthy subjects
confirmed the temporal stability of AGP N-glycome, as a general prerequisite for diagnostic use. The newly
developed method was then used to analyze AGP glycosylation in 108 subjects differing in their predisposition for
type 2 diabetes development. The results confirmed an association of increased branching and decreased sialylation
of AGP glycans with an increased risk of type 2 diabetes development. Analysis of samples from 466 patients
diagnosed with different types of diabetes (HNF1A-, HNF4A-MODY, type 1 and type 2 diabetes) revealed a
reduction in AGP fucosylation, which was shown to be specific for HNF1A-MODY. Furthermore, analysis of
samples from 98 patients with early-onset non-autoimmune diabetes showed that decreased fucosylation was
present only in patients carrying damaging HNF1A mutations - the core cause of the disease. Also, high success
rate of identification of HNF1A-MODY patients based on individual AGP glycopeptides was demonstrated. The
findings suggest the possibility of utilizing AGP glycosylation as a predictor of type 2 diabetes, as well as a marker
for identification of HNF1A-MODY patients. This would present a valuable contribution to timely risk
identification and differential diagnosis of diabetes
Izolacija i identifikacija eteričnog ulja stolisne ruže (Rosa x centifolia L. 'Fantin-Latour')
No full textCilj istraživanja
Cilj ovog specijalističkog rada je po prvi put provesti izolaciju i identifikaciju eteričnog ulja
jednog od najstarijih kultivara stolisne ruže, Rosa x centifolia L. 'Fantin Latour', uzgojenog u
Hrvatskoj.
Materijali i metode
Sadržaj eteričnog ulja u cvjetovima stolisne ruže određen je metodom destilacije pomoću
vodene pare. Identifikacija izoliranog eteričnog ulja provedena je primjenom plinske
kromatografije i spektrometrije masa (GC-MS).
Rezultati
Svježe latice biljnog uzorka uzgojenog u središnjoj kontinentalnoj Hrvatskoj sadržavao je 0,08
mg/kg eteričnog ulja. Identificirana je 31 sastavnica, što predstavlja 98,12 % eteričnog ulja.
Glavne sastavnice bile su alifatski ugljikovodici C17-C29 (61,99 %) i alifatski alkohol
heksadekanol (17,65 %). U slabo zastupljenoj terpenskoj frakciji, dominirali su geraniol (9,58
%) i citronelol + nerol (4,27 %).
Zaključci
Dobiveni rezultati ukazuju na potencijal korištenja kultivara stolisne ruže 'Fantin Latour' iz
hrvatskog uzgoja u parfemskoj, kozmetičkoj i farmaceutskoj industriji. Stoga se očekuju
opsežnija daljnja istraživanja utjecaja uzgoja i obrade biljnog materijala na prinos i sastav
eteričnog ulja te iznalaženje drugih mogućnosti izolacije eteričnog ulja.Objectives
The aim of this study is to isolate and identify for the first time the essential oil of one of the
oldest cultivars of Provence (cabbage) rose, Rosa x centifolia L. 'Fantin Latour', grown in
Croatia.
Materials and methods
The essential oil content of rose petals was determined by steam distillation. Rose essential oil
was identified by gas chromatography and mass spectrometry (GC-MS).
Results
Fresh petals of the sample from continental central Croatia contained 0.08 mg/kg essential oil.
Thirty-one components were identified, accounting for 98.12 % of the essential oil. The main
components were aliphatic hydrocarbons C17-C29 (61.99 %) and aliphatic alcohol hexadecanol
(17.65%). Geraniol (9.58%) and citronellol + nerol (4.27 %) dominated the weakly represented
terpene fraction.
Conclusion
The obtained results indicate the potential of Rosa x centifolia L. 'Fantin Latour' from Croatian
cultivation for perfume, cosmetic and pharmaceutical industries. Therefore, it is expected that
further extensive research will be conducted on the influence of growing conditions and
processing of the plant material on the yield and composition of the essential oil, as well as on
other ways of isolation of essential oils
Ispitivanje toksičnosti na staničnim kulturama
No full textIn recent years significant efforts have been made to reduce the
number of studies on experimental animals used for toxicity
testing of new compounds. In addition to the already existing 3R principle (replacement, reduction, refinement), the aim was to develop alternative in vitro
methods that would enable the same level of protection as in vivo research after
successful validation process. T herefore, special emphasis was placed on cell cultures
used in toxicology studies. This review paper gives insight into the cell
cultures used in such assays, the most commonly used cytotoxicity assays as well
as statistical models that can be used to determine the toxicity of a test compound.
In addition, guidelines of the regulatory bodies according to which such
research should be conducted are also presented in this paper
Usporedba zadovoljstva i adherencije pacijenata na terapiji varfarinom i direktnim oralnim antikoagulansima
No full textAlthough warfarin was the most commonly used oral anticoagulant,
the DOACs ( direct oral anticoagulants - dabigatran,
apixaban and rivaroxaban) are the mainsteream of anticoagulation therapy
today. Patients' satisfaction with anticoagulation therapy is important because it
can effect adherence and therapy outcomes. Validated questionnaires used to
measure patients' satisfaction with anticoagulants exist, like the DASS questionnaire
(Duke anticoagulation satisfation scale). Until now, in Croatia, testing of
anticoagulants satisfaction with DASS was carried out only for warfarin.
The aim of the study was to compare the satisfaction and adherance of patients
on warfarin and DOACs. The research was conducted from November 2017 to
May 2018 with the help of public pharmacies in the area of Zagreb and Slavonski Brod and its surroundings. Patients over the age of 18 who use therapy for more
than three months were included after signing the informed consent. The demographic
and clinical information were collected patients filled out the DASS and
adherence questionnaire. The study included 88 patients, of whom 46 were on
warfarin and 42 on DOACs. Of the total number of patients on DOACs, half of
the patients had used warfarin before the present therapy.
The average DASS sum of all patients in total showed high satisfaction with
therapy (56.14 ± 21.79). Patients on DOACs showed statistically significantly
greater satisfaction than those on warfarin (p = 0.007). In the category of psychological
effects, those who currently use DOAC and have used warfarin earlier
have also shown greater sastifaction than those who have not previously used it.
There was a statistically significant correlation between bleeding and poorer
satisfaction, as much as poorer satisfaction and lower adherence.
Adherence was measured by the MMAS-4 scale (Morisky Medication
Adherence Scale) and based on adherence patients were divided in three groups
(low, middle and high level of adherence). The majority of patients from both
groups were categorized as middle level adherence, and there was a statistically
significant difference in the number of patients with middle level adherence
between DOAC and warfarin groups (chi-square test, p=0,012). The variability
of adherence was higher in the warfarin group compared to the DOAC group.
Low level of adherence was detected in 7,1 % of patients taking warfarin, while
there were no patients with low adherence in DOAC group. High level of adherence
was measured for 45,2% of patients in warfarin group compared to 26,8%
of patients in DOAC group, with no statistical difference.
It is important to realize how patients feel about their therapy and how
much they know about it and also connect their satisfaction to certain patient
subgroups with regard to demographic and clinical data in order to improve the
quality of their life. lt is also important to assess the degree of adherence, its
impact on therapy, and satisfaction, and identify the reasons for poor adherence
so that healthcare professionals know how to act for its improvement
Antidepresivi i suicidalnost
No full textCilj istraživanja: Cilj ovog istraživanja je utvrditi utjecaj antidepresiva na suicidalnost kod depresivnih pacijenata, njihov protektivni učinak, ali i povećan rizik od suicida. Rad bi mogao doprinijeti u budućem kreiranju smjernica za liječenje depresije i pristupu prema pacijentima sklonim suicidalnim ideacijama. U konačnici, praćenjem sigurnosti antidepresiva i njihovog učinka s obzirom na težinu bolesti i dob, tim pacijentima bi se mogla povećati kvaliteta života i smanjiti broj recidiva.
Ispitanici i metode: Prilikom izrade i oblikovanja ovog rada, pretraženi su objavljeni izvorni i pregledni znanstveni radovi. Osnovu rada činile su kliničke studije. Literatura je sustavno pregledana iz područja duševnih poremećaja povezanih sa suicidalnosti. Korišteni su sažetci opisa svojstava i djelovanja lijekova i baza lijekova za tražene terapijske skupine. Bibliografske baze podataka PubMed, Web of Science, Google Scholar, Cochrane pretražene su prema ključnim riječima: major depressive disorder, antidepressants, suicidality, suicidal behaviour, suicidal ideation, young adults, children, side effect, safety, efficacy.
Zaključak: Analizom velike količine podataka dolazi se do zaključka da se suicidalne ideacije, događaji i sam čin samoubojstva u rijetkim slučajevima mogu potaknuti liječenjem antidepresivima, primarno inhibitorima ponovne pohrane serotonina. Kliničke karakteristike poput agitacije, ego-distoničnih misli i impulzivnosti možemo smatrati znakovima upozorenja, zbog čega je potrebno navedenim pacijentima posvetiti pozornost, osobito u prva 2 tjedna terapije antidepresivima. Podaci ukazuju na mogućnost prevencije neželjenih suicidalnih događaja kombiniranjem terapije antidepresiva s antipsihoticima na samom početku liječenja. Posebno se intrigantnim čini antisuicidalni učinak ketamina i esketamina u malim dozama. Sve se više dokaza navodi o ulozi opioidnog sustava u suicidalnom ponašanju. Neke studije sugeriraju da suicidalni pacijenti imaju disfunkciju opioidnog sustava, čime se otvaraju potencijalno nove terapijske mogućnosti.Aim of the study: The aim of this study was to determine the impact of antidepressants on suicidality in depressed patients, their protective effect, but also an increased risk of suicide. The paper could contribute to the future development of guidelines for the treatment of depression and the approach to patients prone to suicidal ideation. Ultimately, by monitoring the safety of antidepressants and their effect with respect to disease severity and age, these patients could be able to increase their quality of life and reduce their relapse.
Respondents and methods: During the preparation and formation of this paper, published original and reviewed scientific papers were studied. The work was based on clinical studies. The literature has been systematically reviewed in the area of mental disorders associated with suicidality. Summaries of descriptions of drug properties and effects and drug databases for the required therapeutic groups were used. Bibliographic databases PubMed, Web of Science, Google Scholar, Cochrane were searched, and the following keywords were used: major depressive disorder, antidepressants, suicidality, suicidal behavior, suicidal ideation, young adults, children, side effect, safety, efficacy.
Conclusion: By analyzing a large amount of data leads to the conclusion that suicidal ideations, events and the act of suicide itself in rare cases can be triggered by treatment with antidepressants, primarily serotonin reuptake inhibitors. Clinical characteristics such as agitation, ego-dystonic thoughts and impulsivity can be considered warning signs, which is why it is necessary to pay attention to these patients, especially in the first 2 weeks of antidepressant therapy. Data suggest the possibility of preventing adverse suicidal events by combining antidepressant therapy with antipsychotics at the outset of treatment. The antisuicidal effect of ketamine and esketamine in small doses seems particularly intriguing. There is growing evidence of the role of the opioid system in suicidal behavior. Some studies suggest suicidal
patients have opioid system dysfunction, which potentially opens up new therapeutic possibilities
Use of senotherapeutics in the treatment of chronic pulmonary diseases
No full textKod kroničnih plućnih bolesti postoje nakupine senescentnih stanica. Senoterapeutici djeluju na sam uzrok bolesti i time se sprječava progresija plućnih bolesti. Senolitici su lijekovi koji potiču apoptozu senescentnih stanica. Prirodni senolitici su kvercetin, fisetin, piperlongumin, kurkumin i kardiotonični glikozidi. Nedostatak im je slaba bioraspoloživost, a prednost im je niska toksičnost. Sintetizirani su sintetski senolitici, ali dosta njih ima nuspojave. Senolitici onemogućavaju SCAP antiapoptozne putove kojima se senescentna stanica štiti od apoptoze. Time se potiče apoptoza senescentnih stanica. Postoje galaktoza-konjugirani senolitički prolijekovi, inhibitori Hsp90, dasatinib, panobinostat, A1331852, A1155463, navitoklaks (ABT263), sintetski peptid FOXO4-DRI te imunosna terapija CAR T stanicama. S druge strane, postoje senostatici koji sprječavaju stanice da postanu senescentne blokirajući signalne putove koji vode u senescenciju. Kombinacijom senolitika sa senostaticima se može djelovati na različite mehanizme istovremeno. Senostatici blokiraju PI3K-mTOR signalni put. Senostatici su rapamicin, metformin, AICAR, biljni polifenol resveratrol, STAC, antagomiri miR-34a/miR-570 te antioksidansi, uključujući melatonin. Sprječavanjem oksidacijskog stresa se sprječava oštećenje DNA, a time i senescencija. Zbog nuspojava rapamicina razvijeni su manje toksični lijekovi rapalogs. Zbog slabe bioraspoloživosti resveratrola razvijeni su sintetski STAC lijekovi. Većinom su sva ispitivanja provedena na miševima pa je potrebno još puno istraživanja provesti da bi se dokazala učinkovitost i sigurnost ovakvih lijekova na ljudima. Jedino ispitivanje na ljudima je provedeno s kombinacijom dasatinib i kvercetin čime se dokazala učinkovitost uz prihvatljive nuspojave.In chronic lung diseases, there are clusters of senescent cells. Senotherapeutics act on the cause of the disease and thus prevent the progression of lung diseases. Senolytics are drugs that promote apoptosis of senescent cells. Natural senolytics are quercetin, fisetin, piperlongumin, curcumin and cardiotonic glycosides. Their disadvantage is poor bioavailability, and their advantage is low toxicity. Synthetic senolytics have been synthesized, but many have side effects. Senolytics disable SCAP antiapoptotic pathways that protect the senescent cell from apoptosis. This promotes apoptosis of senescent cells. There are galactose-conjugated senolytic prodrugs, Hsp90 inhibitors, dasatinib, panobinostat, A1331852, A1155463, navitoclax (ABT263), the synthetic peptide FOXO4-DRI, and CAR T cell immune therapy. On the other hand, there are senostatics that prevent cells from becoming senescent by blocking signaling pathways leading to senescence. By combining senolytics with senostatics, different mechanisms can be acted upon simultaneously. Senostatics block the PI3K-mTOR signaling pathway. Senostatics include rapamycin, metformin, AICAR, plant polyphenol resveratrol, STAC, miR-34a / miR-570 antagonists, and antioxidants including melatonin. Preventing oxidative stress prevents DNA damage and thus senescence. Due to the side effects of rapamycin, less toxic drugs rapalogs have been developed. Due to the poor bioavailability of resveratrol, synthetic STAC drugs have been developed. Most of the tests have been performed on mice, so much more research is needed to prove the effectiveness and safety of such drugs in humans. The only human study was performed with a combination of dasatinib and quercetin to demonstrate efficacy with acceptable side effects
Hitni psihijatrijski sindromi izazvani lijekovima
No full textCilj istraživanja: Cilj ovog rada je pregledno prikazati potencijalne jatrogene hitne psihijatrijske sindrome izazvane lijekovima.
Materijali i metode: Pri izradi ovog rada korištena je znanstvena i stručna literatura iz područja psihijatrije i psihofarmakoterapije, pretraženi su objavljeni izvorni i pregledni znanstveni radovi, relevantni psihijatrijski dijagnostički priručnici i medicinska literatura, baza lijekova Hrvatske agencije za lijekove i medicinske proizvode te drugi raspoloživi izvori.
Rezultati: Identificirani su i na jednom mjestu pregledno prikazani hitni psihijatrijski sindromi izazvani lijekovima - klinička slika, klinička procjena i klinička intervencija, kao i specifičnosti svakog pojedinog sindroma. Psihijatrijske sindrome koji predstavljaju hitna stanja najčešće uzrokuju psihofarmaci iz skupine antipsihotika i antidepresiva, a ti sindromi su: akatizija, akutna distonija, parkinsonizam, tardivna diskinezija, neuroleptički maligni sindrom i serotoninski sindrom.
Zaključak: Porastom broja korištenih psihofarmaka u posljednjih nekoliko desetaka godina, povećan je rizik razvoja neželjenih pojava. Nuspojave psihofarmaka predstavljaju hitne psihijatrijske sindrome, a prezentiraju se u obliku poremećaja pokreta. Pravovremenim prepoznavanjem poremećaja i sindroma izazvanih lijekovima moguće je sprječavanje daljnjih komplikacija. Magistri farmacije kao najdostupniji zdravstveni djelatnici koji posjeduju specifična znanja vezana uz lijekove, poznajući željene i neželjene učinke lijekova, mogu identificirati terapijske probleme te na vrijeme uputiti pacijenta liječniku. Uključivanjem magistra farmacije u proces skrbi mogli bi se postići bolji ishodi liječenja te izbjeći potencijalno ozbiljne i hitne nuspojave psihofarmaka.The goal of this research: The goal of this thesis is to present the potential iatrogenic drug-induced emergency psychiatric syndromes.
Research methods: In the design of this thesis a variety of scientific and professional literature in the field of psychiatry and psychopharmacotherapy was used, as well as published original and reviewed scientific studies, relevant psychiatric diagnosis manuals and medical literature, the Agency for Medicinal Products and Medical Devices database and other available sources.
Results: Drug-induced emergency psychiatric syndromes – clinical picture, clinical assessment and clinical intervention, as well as specificities of each individual syndrome were identified and presented in one place. Psychiatric syndromes that present emergencies are most often caused by psychopharmaceuticals from the group of antipsychotics and antidepressants, and these syndromes are: akathisia, acute dystonia, parkinsonism, tardive dyskinesia, neuroleptic malignant syndrome and serotonin syndrome.
Conclusion: With increasing number of used psychopharmaceuticals in the last few decades, the risk of developing adverse drug reaction has also increased. The side effects of psychopharmaceuticals are emergency psychiatric syndromes which are presented like movement disorders. If these disorders and syndromes are recognized in time, it is possible to prevent further complications. Pharmacists, as the most accessible healthcare providers with drug-specific knowledge, including desired and undesired drug effects, can identify therapeutic problems and refer a patient to the doctor in time. Involving the pharmacist in the patient care process could improve treatment outcome and avoid potential severe and emergency psychopharmaceuticals side effects
Doping in sport
No full textDoping predstavlja kršenje jednog ili više pravila koja su definirana Svjetskim antidopinškim kodeksom, a
najčešće uključuje primjenu zabranjenih sredstava i/ili metoda u svrhu poboljšanja sportskih performansi.
Problem dopinga raširio se izvan granica elitnog sporta te je postao dio svakodnevnog života mnogih
rekreativnih sportaša, čija je težnja poboljšati fizički izgled. WADA (engl. World Antidoping Agency) je
objavila Popis zabranjenih sredstava u kojem se nalazi preko 200 spojeva podijeljenih u tri skupine: tvari i
metode zabranjene tijekom i izvan natjecanja, tvari zabranjene tijekom natjecanja te tvari zabranjene u
pojedinim sportovima. Različite skupine doping sredstava omogućuju sportašima povećanje fizičke izvedbe
zahvaljujući brojnim učincima: povećavaju izdržljivost i aerobnog kapaciteta, zatim ubrzavaju oporavak od
ozljeda, povećavaju prag boli, povećavaju mišićnu masu, smanjuju masno tkivo, maskiraju upotrebu drugih
doping supstancija itd. Nažalost, zloupotreba lijekova izvan terapijskih indikacija uključuje cijeli niz
negativnih učinaka na zdravlje, a nekada čak i fatalne posljedice. Sve duži popis zabranjenih sredstava i
suvremeni trendovi u doping praksi stavili su antidopinške agencije pred nove izazove. WADA-ini
akreditirani laboratoriji neprestano razvijaju nove tehnike otkrivanja dopinga te ulažu u napredak postojećih
metoda detekcije. U borbi protiv dopinga ključna je edukacija sportaša o neželjenim i štetnim posljedicama
upotrebe dopinga. Farmaceut ima važnu ulogu u pružanju točnih i relevantnih informacija, davanju savjeta i
preporuka te upozoravanju pacijenta sportaša o mogućem kršenju antidopinških pravila.Doping is a violation of one or more of the rules defined by the World Anti-Doping Code defined by the
World Anti-Doping Agency (WADA). Most common doping practices include the use of illicit substances
or methods with the goal of enhancing an athlete’s performance. The doping problem has spread beyond the
boundaries of elite sports and has become a part of daily lives of many recreational athletes wishing to
improve their physical appearance. The list of banned substances from 2021 includes over 200 compounds
divided into 3 groups: substances and methods banned during and out of competition, substances banned
during competition and substances banned in certain sports. Different doping agent groups allow athletes to
increase their physical performance thanks to a number of effects: increased endurance and aerobic capacity,
accelerated recovery from injuries, increased pain threshold, increased muscle mass, reduced fat, masking the
use of other doping agents, etc. Unfortunately, drug abuse outside of therapeutic indications involves a whole
range of negative health effects, and sometimes even fatal consequences. The growing list of illicit drugs and
modern trends in doping practice have put anti-doping agencies at odds with new challenges. WADA
accredited laboratories are constantly developing new doping detection techniques and are investing in
advancing existing detection methods. A crucial part in fighting doping is the education of athletes about the
unwanted and harmful consequences of doping. Pharmacists have an important role to play in promoting
clean and fair sports, when counseling their patients-athletes about risks and potential consequences of
doping
Biljni lijekovi za liječenje kašlja u djece
No full textCilj istraživanja
Cilj ovog specijalističkog rada je sveobuhvatan pregled znanstvenih spoznaja o biljnim
lijekovima odobrenim u Republici Hrvatskoj koji se primjenjuju u liječenju kašlja u djece, s
posebnim naglaskom na kliničke studije.
Materijal i metode
Istraživanje u okviru ovog rada je teorijskog karaktera i uključuje pregled dostupne stručne i
znanstvene literature o predloženoj temi. Pregled biljnih lijekova za liječenje kašlja u djece
odobrenih u Republici Hrvatskoj napravljen je pretraživanjem „Baze lijekova“ dostupne na
mrežnim stranica Agencije za lijekove i medicinske proizvode. U pretraživanju radova
relevantnih za temu ovoga rada korištene su elektronske bibliografske baze podataka kao što
su: PubMed (Medline), Science Direct, Scopus i Cochrane Library. Važan izvor informacija
bile su i monografije biljnih droga od Europske agencije za lijekove.
Rezultati
U Republici Hrvatskoj odobrena su 22 biljna lijeka za liječenje kašlja u djece u kategoriji biljnih
lijekova s provjerenom medicinskom primjenom (12) i tradicionalnih biljnih lijekova (10).
Njihove djelatne tvari koje djeluju na kašalj su ekstrakti bršljana (Hederae folium), timijana
(Thymi herba), jaglaca (Primulae radix), uskolisnog trputca (Plantaginis lanceolatae folium),
islandskog lišaja (Lichen islandicus), bijelog (Althaeae radix) i/ili crnog sljeza (Malvae
sylvestris flos). U skupini ekspektoransa odobren je i biljni lijek kojem je djelatna tvar
standardizirani mirtol (ELOM-080), destilat mješavine pročišćenih eteričnih ulja eukaliptusa,
slatke naranče, limuna i mirte. Među navedenim biljnim drogama klinički su najbolje istraženi
pripravci s bršljanovim listom te su provedene kontrolirane studije potvrdile učinkovitost i
sigurnost primjene bršljana kao ekspektoransa kod produktivnog kašlja u odraslih i djece.
Dosadašnja klinička istraživanja timijana uglavnom su provedena u kombinaciji s jaglacem i
bršljanom, ali samo nekoliko studija je procjenjivalo djelotvornost u djece. Kliničkih dokaza o
učinku jaglaca i crnog sljeza na kašalj u djece nema, dok je učinkovitost bijelog sljeza,
uskolisnog trputca i islandskog lišaja ispitana u malom broju nekontroliranih studija. Niz dobro
dizajniranih kliničkih istraživanja govori u prilog primjene standardiziranog mirtola u liječenju
akutnog i kroničnog bronhitisa i sinusitisa u odraslih, dok su studije u pedijatrijskoj populaciji
još uvijek malobrojne.
Zaključak
Najviše kliničkih studija i znanstvenih dokaza govori u prilog primjene bršljana i
standardiziranog mirtola kao ekspektoransa kod produktivnog kašlja. Dosadašnja pretklinička
istraživanja i malobrojne kliničke studije također podupiru dugotrajnu primjenu timijana,
jaglaca, bijelog i crnog sljeza, uskolisnog trputca i islandskog lišaja u terapiji kašlja. No,
potrebna su daljina klinička istraživanja koja će osigurati veću razinu dokaza o njihovoj
primjeni u pedijatrijskoj populaciji.Objectives
The aim of this work is to provide a comprehensive review of the scientific evidence on herbal
medicines approved in the Republic of Croatia that are used in the treatment of cough in
children, with a focus on clinical trials.
Material and Methods
The present work is a theoretical study and includes a detailed review of the available
professional and scientific data on the proposed subject. The review of herbal medicines for
cough in children approved in the Republic of Croatia was made by searching the "Medicinal
Products Database" available on the website of the Agency for Medicines and Medical Products
of Croatia. Relevant bibliographic databases such as Current Contents, ScienceDirect, Scopus,
PubMed, Medline and Cochrane Library were searched. The herbal drug monographs of the
European Medicines Agency were also important sources of information.
Results
In the Republic of Croatia, 22 herbal medicines have been approved for the treatment of cough
in children in the category of well-established (12) and traditional herbal medicinal products
(10). Their active ingredients which act on cough are extracts of ivy (Hederae folium), thyme
(Thymi herba), primrose (Primulae radix), ribwort plantain (Plantaginis lanceolatae folium),
Iceland moos (Lichen islandicus), marshmallow (Althaeae radix) and/or common mallow
(Malvae sylvestris flos). The herbal medicine with active substance Myrtol standardized
(ELOM-080), a mixture of rectified essential oils of eucalyptus, sweet orange, lemon and
myrtle, has also been approved as expectorant. Among the listed herbal drugs, preparations
from ivy lea are the most studied clinically, and controlled studies have been conducted that
have confirmed the effectiveness and safety of ivy use as an expectorant in case of productive
cough in adults and children. Clinical research on thyme to date has mostly been conducted in
combination with primrose and ivy, but only a few studies have evaluated efficacy in children.
There is no clinical evidence of the effect of primrose and marshmallow on cough in children,
while the effectiveness of marshmallow, ribwort plantain and Iceland moos has been examined
in a small number of uncontrolled studies. A number of well-designed clinical trials speak in
favor of Myrtol standardized in the treatment of acute and chronic bronchitis and sinusitis in
adults, while studies in the pediatric population are still few.
Conclusion
Most clinical studies and scientific evidence support the effectiveness of ivy and Myrtol
standardized in the treatment of cough. Previous preclinical research and a small number of
clinical studies also support the long-standing use of thyme, primrose, marshmallow, common
mallow, ribwort plantain and Iceland moos in the therapy of cough. However, further clinical
studies are needed to provide a higher level of evidence for their use in the pediatric population