Polish pharmacy professionals' beliefs about homeopathic medicines - a survey.

Introduction: Homeopathy is an alternative therapeutic metod based on the principle of similarity, which was developed by Samuel Hahnemann in the 18th century. This method involves administering substances that may produce symptoms similar to the patient's reported ailment, in high dilutions. Despite scientific evidence speaking against this method, homeopathic products are defined as medicines by European law and undergo a special, simplified authorization procedure. In Poland, patients can only purchase homeopathic medicinal products at a pharmacy. Therefore, the recommendation obtained there may influence whether the patient decides to use a homeopathic medicine or not. Materials and methods: The study aimed to analyse the attitude of Polish pharmacists and pharmacy technicians towards homeopathic medicines. An anonymous questionnaire was conducted among professional pharmacy staff to assess their knowledge, beliefs, and recommendations regarding homeopathic medicines. Between January and April 2023, 298 respondents - 279 pharmacists and 19 technicians - completed the survey. The collected responses were statistically analyzed using STATISTICA v. 13.3. Statistical significance was checked using Pearson's χ2 test of concordance, assuming a p-value ≤ 0.05 as the level of significance. PCA principal component analysis was used to assess global relationships between the key variables analyzed regardless of scale. The constructed PCA model was estimated using the NIPALS iterative algorithm. Results: Out of the 298 survey respondents, 285 worked in community pharmacies. More than two-thirds of the respondents had personal experience using homeopathic medicines, and about one-third of them recommended such medicines to their patients. The willingness to recommend homeopathic medicines correlated with the respondent's history of positive effects of homeopathic medicines. Homeopathic medicines were most often recommended by women and people over 50 years of age. More than half of the professional pharmacy staff considered homeopathic medicines to be ineffective and to show only a placebo effect. When asked which conditions they recommended homeopathic medicines for, pharmacists and technicians most often indicated cold and flu symptoms, painful teething, and bruises and hematomas. Conclusions: The results of the survey suggest that most members of the professional pharmacy staff do not recommend homeopathic medicines to their patients. The problem of evaluating preparations with no proven therapeutic effect as effective mainly affects women over 50 and respondents from small towns. It is worth deepening the following study in the future, focusing on these groups of respondents. The knowledge gained in this way will make it possible to assess the extent to which this group of workers relies on scientific evidence and whether they are aware of making decisions based only on their own beliefs

Over the Counter Pain Medications Used by Adults: A Need for Pharmacist Intervention

Background: The safety of pharmacotherapy for geriatric patients is an essential aspect of the demographic perspective in view of the increasing size of this population. Non-opioid analgesics (NOAs) are among the most popular and often overused over-the-counter medications (OTC). The reasons for drug abuse are common in the geriatric population: musculoskeletal disorders, colds, inflammation and pain of various origins. The popularity of self-medication and the ability to easily access OTC drugs outside the pharmacy creates the danger of their misuse and the incidence of adverse drug reactions (ADRs). The survey included 142 respondents aged 50–90 years. The relationship between the prevalence of ADRs and the NOAs used, age, presence of chronic diseases, and place of purchasing and obtaining information about the mentioned drugs were evaluated. The results of the observations were statistically analyzed using Statistica 13.3. The most commonly used NOAs among the elderly included paracetamol, acetylsalicylic acid (ASA) and ibuprofen. Patients consumed the medications for intractable headaches, toothaches, fevers, colds and joint disorders. Respondents indicated the pharmacy as the main location for purchasing medications, and the physician as the source of information for selecting the therapy. ADRs were reported most frequently to the physician, and less frequently to the pharmacist and nurse. More than one-third of respondents indicated that the physician during the consultation did not take a medical history and did not ask about concomitant diseases. It is necessary to extend pharmaceutical care to geriatric patients that includes advice on adverse drug reactions, especially drug interactions. Due to the popularity of self-medication, and the availability of NOAs, long-term measures should be taken to increase the role of pharmacists in providing effective, safe health care to seniors. We are targeting pharmacists with this survey to draw attention to the problem of the prevalence of selling NOAs to geriatric patients. Pharmacists should educate seniors about the possibility of ADRs and approach patients with polypragmasy and polypharmacy with caution. Pharmaceutical care is an essential aspect in the treatment of geriatric patients, which can contribute to better results in their existing treatment and increase the safety of medication intake. Therefore, it is important to improve the development of pharmaceutical care in Poland in order to enhance patient outcomes

Contrast Media Adverse Drug Reactions in Highly Polluted Environment

Iodinated- (ICM) and gadolinium-based (GCM) contrast media are used in radiology imaging techniques, such as computer tomography (CT) and magnetic resonance (MR), respectively. The paper aims to analyze the adverse drug reactions of ICM and GCM on different sites of the body in a highly polluted environment. We analyzed the pharmacovigilance in contrast media on the basis of reports submitted to the Regional Center for Monitoring of Adverse Drug Reactions (ADR) at the Department of Clinical Pharmacology in Wrocław. Safety profiles were compared between different ICM and GCM and at the system organ level using the proportional reporting ratio (PRR). We analyzed 124 reports of adverse reactions related to contrast agents between 2006 and 2021. Our findings revealed that ADR combinations occurred more frequently after the use of iodinated contrast agents (72.08%) than gadolinium contrast agents (27.92%). Iomeprol and Iopromide were identified as the most frequently reported media. Each medium presented a different safety profile. Skin disorders are the most common adverse drug reactions among patients using both iodine- and gadolinium-based contrast media. Gadolinium-based contrast agents are characterized by similar organ toxicity. Conversely, iodine-based contrast agents are more diverse—some of which show tissue specificity, such as Iodixanol for the gastrointestinal system or Iohexol for the respiratory tract. This study shows relatively high occurrence of respiratory tract related ADRs in Wrocław. We also prove that it is possible to choose the most optimal contrast agent for patients with specific organ site problems to omit the possible complications

Effects of Non-Opioid Analgesics on the Cell Membrane of Skin and Gastrointestinal Cancers

Skin and gastrointestinal cancer cells are the target of research by many scientists due to the increasing morbidity and mortality rates around the world. New indications for drugs used in various conditions are being discovered. Non-opioid analgesics are worth noting as very popular, widely available, relatively cheap medications. They also have the ability to modulate the membrane components of tumor cells. The aim of this review is to analyze the impact of diclofenac, ibuprofen, naproxen, acetylsalicylic acid and paracetamol on skin and gastrointestinal cancers cell membrane. These drugs may affect the membrane through topical application, at the in vitro and in vivo level after oral or parenteral administration. They can lead to up- or downregulated expression of receptors, transporters and other molecules associated with plasma membrane. Medications may also alter the lipid bilayer composition of membrane, resulting in changes in its integrity and fluidity. Described modulations can cause the visualization of cancer cells, enhanced response of the immune system and the initiation of cell death. The outcome of this is inhibition of progression or reduction of tumor mass and supports chemotherapy. In conclusion, non-opioid analgesics may be used in the future as adjunctive therapy for the treatment of these cancers

LAG-3 as a Potent Target for Novel Anticancer Therapies of a Wide Range of Tumors

LAG-3 (Lymphocyte activation gene 3) protein is a checkpoint receptor that interacts with LSEC-tin, Galectin-3 and FGL1. This interaction leads to reduced production of IL-2 and IFN-γ. LAG-3 is widely expressed in different tumor types and modulates the tumor microenvironment through immunosuppressive effects. Differential expression in various tumor types influences patient prognosis, which is often associated with coexpression with immune checkpoint inhibitors, such as TIM-3, PD-1 and CTLA-4. Here, we discuss expression profiles in different tumor types. To date, many clinical trials have been conducted using LAG-3 inhibitors, which can be divided into anti-LAG-3 monoclonal antibodies, anti-LAG-3 bispecifics and soluble LAG-3-Ig fusion proteins. LAG-3 inhibitors supress T-cell proliferation and activation by disallowing for the interaction between LAG-3 to MHC-II. The process enhances anti-tumor immune response. In this paper, we will review the current state of knowledge on the structure, function and expression of LAG-3 in various types of cancer, as well as its correlation with overall prognosis, involvement in cell-based therapies and experimental medicine. We will consider the role of compounds targeting LAG-3 in clinical trials both as monotherapy and in combination, which will provide data relating to the efficacy and safety of proposed drug candidates

Promising uses of probiotic bacteria as depression and neurodegenerative diseases therapy support - recent studies review

The intestinal microbiota – the living organisms that populate the gastrointestinal tract – plays a key role in proper body functioning. Disturbances to its homeostasis negatively affect the function of many organs, contributing to the development of diseases – for instance they negatively affect the functioning of the gastrointestinal tract and the intestinal barrier, which can lead to the development of metabolic disorders, autoimmune and psychiatric diseases. Intestinal dysbiosis has been found in patients with functional gastrointestinal disorders, irritable bowel syndrome, atopic dermatitis and psychiatric disorders including depression, Alzheimer's disease and schizophrenia. The aim of this study is to review current scientific publications regarding recent studies conducted in animal models and clinical trials assessing the impact and role of probiotics in the treatment of depression, neurodegenerative diseases and to clarify the concept of the brain-gut axis. Probiotics and prebiotics that play a role in the functioning of the gut-brain axis, populating the gastrointestinal tract seal the intestinal barrier, support the function of the nervous system (through the synthesis of serotonin, norepinephrine, acetylcholine, gamma-aminobutyric acid, among others), the endocrine system (reduce cortisol levels) and the immune system (stimulate the synthesis of anti-inflammatory cells). In the case of neurodegenerative diseases, i.e. Parkinson's or Alzheimer's disease, probiotic bacteria alleviate accompanying symptoms, improve intestinal and brain function, increase patients' quality of life and, in addition, contribute to inhibiting the development of these conditions. Current data confirm changes in the gut microflora in the aforementioned diseases, and suggest positive effects on health and brain activity. The microbiota has been proven to be involved in the production of neurotransmitters, affecting the hypothalamic-pituitary-adrenal axis, which is important in the course of depression and some psychiatric disorders. Despite numerous studies confirming the efficacy of supplementing the gut microbiota with defined bacterial strains, this promising often practiced method requires further clinical studies and a deeper understanding of the underlying mechanisms

Identification of Unknown Impurity of Azelaic Acid in Liposomal Formulation Assessed by HPLC-ELSD, GC-FID, and GC-MS

The identification of new contaminants is critical in the development of new medicinal products. Many impurities, such as pentanedioic acid, hexanedioic acid, heptanedioic acid, octanedioic acid, decanedioic acid, undecanedioic acid, dodecanedioic acid, tridecanedioic acid, and tetradecanedioic acid, have been identified in samples of azelaic acid. The aim of this study was to identify impurities observed during the stability tests of a new liposomal dosage form of azelaic acid that is composed of phosphatidylcholine and a mixture of ethyl alcohol and water, using high-performance liquid chromatography with evaporative light-scattering detector (HPLC-ELSD), gas chromatography–flame ionisation detection (GC-FID), and gas chromatography–mass spectrometry (GC-MS) methods. During the research and development of a new liposomal formulation of azelaic acid, we developed a method for determining the contamination of azelaic acid using HPLC-ELSD. During our analytical tests, we identified a previously unknown impurity of a liposomal preparation of azelaic acid that appeared in the liposomal formulation of azelaic acid during preliminary stability studies. The procedure led to the conclusion that the impurity was caused by the reaction of azelaic acid with one of the excipients that was applied in the product. The impurity was finally identified as an ethyl monoester of azelaic acid. The identification procedure of this compound was carried out in a series of experiments comparing the chromatograms that were obtained via the following chromatographic methods: HPLC-ELSD, GC-FID, and GC-MS. The final identification of the compound was carried out by GC with MS

The Impact of COVID-19 on the Mental Well-Being of College Students

The COVID-19 pandemic has caused an overall increase in stress and depression in society. The aim of the present research was to evaluate the psychological condition of college students during the COVID-19 pandemic and explore factors influencing their daily functioning. The study focused on four main aspects such as mental well-being, sexuality, concern about financial status, and trust in medical authorities. The study was based on a specially designed survey. The questionnaire was created using Google Forms and shared on social media sites. A total of 630 students participated in the survey, 17 surveys were excluded due to incomplete data and 613 surveys (97.30%) were considered for the final analysis. During isolation, 68.0% of students experienced fear of missing out (FOMO). A total of 73.4% were frustrated due to spending a lot of time in front of a computer. A significant decrease in motivation to study was reported by 78.1% of the respondents. Students showed significantly different attitudes towards sexuality. Concern about the financial situation was reported by 48.7% of respondents. The state of the Polish economy was of concern to 86.4% of respondents. A total of 74.5% of students declared concern about their career development. During the pandemic, 59.0% of respondents became concerned about their health. The attitude towards vaccination was described as positive by 82.5% of the respondents. The percentage of respondents experiencing negative psychological effects relative to the overall epidemiological situation of COVID-19 is troubling. Given the unexpected length and severity of the pandemic, we suggest that students’ concerns be more thoroughly understood and addressed

Promising uses of probiotic bacteria and prebiotics in the course of COVID-19 - a review of recent studies

COVID-19 is a disease caused by the coronavirus Sars-CoV-2. The most common symptoms are fever, cough and high temperature, which can lead to complications ranging from the widely documented pneumonia to less obvious ones such as intestinal dysfunction. In recent years, there has been a great deal of research into the impact of the gut microbiota on the course of many diseases, including COVID-19. Microbiota play an important role in maintaining general health and immune function. The connection between the gastrointestinal tract and the respiratory system can be both direct, where the oral microbiome colonises the respiratory tract, and indirect, involving the passage of microbiota from the gut into the bloodstream. Susceptibility to SARS-CoV-2 virus infection varies and depends on sanitation standards, immunity, as well as the presence of other medical conditions. There are also reports indicating a positive role for the microbiota in reducing the body's susceptibility to viral infection. Microbiota supports the regulation of the immune response, influences receptor expression, limits viral entry into host cells, and exerts an inhibitory effect on the development of inflammation, which is a risk factor for Covid-19 complications, which can manifest as so-called post covid with respiratory, circulatory and nervous system symptoms. The composition of the microbiota and its changes due to diseases and therapies used correlate with susceptibility to viral infections. Studies show that disruption of the tightness of the intestinal barrier affects the course of many diseases, including the respiratory system. Intestinal microbiota disorders leading to dysbiosis have a negative impact on the prognosis of patients with acute respiratory failure due to viral infections. The aim of this paper is to review PubMed, Scopus and Google Scholar databases of recent studies on the effects of probiotics in the treatment and support of COVID-19. The review presented here discusses the potential for probiotics as agents used in the prevention and support of therapy of viral infection. The principles of quality assurance and safety of the probiotic product are also included