Hepatoprotektivni učinak etil-acetatnog ekstrakta biljke Teucrium polium L. na jetru štakora oštećenu tetraklormetanom

Hepatoprotective activity of the ethyl acetate extract of Teucrium polium (L.) was investigated using rats with CCl4-induced liver damage. Specific biochemical parameters (glutathione peroxidase, superoxide dismutase, reduced glutathione and total antioxidative status) were estimated in blood and in liver homogenate. Lipid peroxidation in CCl4-intoxicated rats was evidenced by a marked increment in the levels of thiobarbituric acid reactive substances. Histopatological examinations of the liver were undertaken to monitor the liver status. Silymarin was used as a standard to compare the hepatoprotective activity of the extract. Some biochemical parameters in groups treated with the Teucrium polium extract at a dose of 25 mg kg-1, showed significantly different values than that of the CCl4-treated group. The liver biopsy of all experimental rat groups treated with the Teucrium polium ethyl acetate extract showed significant restoration of the normal histomorphological pattern of liver cells. The study substantiates the potential hepatoprotective activity of the ethyl acetate extract of Teucrium polium L.Hepatoprotektivno djelovanje etil-acetatnog ekstrakta biljke Teucrium polium L. ispitivano je na štakorima čija je jetra oštećena tetraklormetanom. Specifični biokemijski parametri (glutation peroksidaza, superoksid dismutaza, reducirani glutation i ukupni antioksidativni status) procijenjeni su u krvi i homogenatu jetre. Lipidna peroksidacija u štakora intoksiciranih tetraklormetanom dokazana je povećanjem koncentracije reaktivnih derivata tiobarbiturne kiseline. Stanje jetre procijenjeno je histopatološkim ispitivanjima. U ispitivanjima hepatoprotektivnog djelovanja ekstrakta Teucrium polium upotrebljen je silimarin kao standard. Neki biokemijski parametri u skupini životinja tretiranih ispitivanim ekstraktom u dozi od 25 mg kg-1 imali su značajno različite vrijednosti od skupine tretirane s CCl4. Biopsija jetre u svim ispitivanim životinjama tretiranim ekstraktom pokazala je uspostavu normalnih histomorfoloških uvjeta u stanicama, što ukazuje na hepatoprotektivno djelovanje biljke Teucrium polium

Burden and attitude to resistant and refractory migraine: a survey from the European Headache Federation with the endorsement of the European Migraine & Headache Alliance

Background: New treatments are currently offering new opportunities and challenges in clinical management and research in the migraine field. There is the need of homogenous criteria to identify candidates for treatment escalation as well as of reliable criteria to identify refractoriness to treatment. To overcome those issues, the European Headache Federation (EHF) issued a Consensus document to propose criteria to approach difficult-to-treat migraine patients in a standardized way. The Consensus proposed well-defined criteria for resistant migraine (i.e., patients who do not respond to some treatment but who have residual therapeutic opportunities) and refractory migraine (i.e., patients who still have debilitating migraine despite maximal treatment efforts). The aim of this study was to better understand the perceived impact of resistant and refractory migraine and the attitude of physicians involved in migraine care toward those conditions. Methods: We conducted a web-questionnaire-based cross-sectional international study involving physicians with interest in headache care. Results: There were 277 questionnaires available for analysis. A relevant proportion of participants reported that patients with resistant and refractory migraine were frequently seen in their clinical practice (49.5% for resistant and 28.9% for refractory migraine); percentages were higher when considering only those working in specialized headache centers (75% and 46% respectively). However, many physicians reported low or moderate confidence in managing resistant (8.1% and 43.3%, respectively) and refractory (20.7% and 48.4%, respectively) migraine patients; confidence in treating resistant and refractory migraine patients was different according to the level of care and to the number of patients visited per week. Patients with resistant and refractory migraine were infrequently referred to more specialized centers (12% and 19%, respectively); also in this case, figures were different according to the level of care. Conclusions: This report highlights the clinical relevance of difficult-to-treat migraine and the presence of unmet needs in this field. There is the need of more evidence regarding the management of those patients and clear guidance referring to the organization of care and available opportunities