Ana Paula Simões-Wüst

Cisplatin activates Akt in small cell lung cancer cells and attenuates apoptosis by survivin upregulation

The inhibitor of apoptosis protein (IAP) survivin is overexpressed in many tumors but is absent in most normal adult tissues. We report high levels of survivin expression in small cell lung cancer (SCLC), and describe the role of the phosphatidylinositol 3‐kinase (PI3K)/Akt pathway in survivin upregulation. Moreover, the cytoprotective function of survivin in response to the anti‐cancer agent cisplatin (CDDP) was investigated. Negative modulation of PI3K/Akt using pharmacological inhibitors or dominant negative Akt (DN‐Akt) decreased Akt kinase activity and resulted in decreased survivin expression and phosphorylation on Thr34, whereas transfection of constitutively active Akt (CA‐Akt) increased survivin expression and phosphorylation. Interestingly, we found that treatment of SCLC cells with CDDP further increased survivin expression in a cell cycle independent manner by activation of Akt. CA‐Akt or lentiviral survivin also inhibited apoptosis induced by CDDP, whereas DN‐Akt or survivin‐specific RNA interference sensitized cells to CDDP. We identified survivin as an anti‐apoptotic protein in SCLC cells that is regulated by Akt, and demonstrate that treatment with the DNA damaging agent CDDP activates the PI3K/Akt/survivin pathway that in part protects cells from drug‐induced apoptosis.

Fatty acids in breast milk and development of atopic eczema and allergic sensitisation in infancy

To cite this article: Thijs C, Müller A, Rist L, Kummeling I, Snijders BEP, Huber M, van Ree R, Simões‐Wüst AP, Dagnelie PC, van den Brandt PA. Fatty acids in breast milk and development of atopic eczema and allergic sensitisation in infancy. Allergy 2011; 66: 58–67.

Use of complementary and alternative medicine by patients presenting to a paediatric Emergency Department

Although the popularity of complementary and alternative medicine (CAM) has risen in the last decade, information about its use by paediatric patients presenting to an Emergency Department is still sparse. We report here the results of a cross-sectional survey of paediatric patients presenting to an urban, tertiary paediatric Emergency Department between October 2006 and March 2007. In total, 1143 questionnaires (68% of those distributed) were completed and available for analysis. Of these, 58% (n = 665) of all respondents admitted that their child had received some form of CAM therapy, while 25% (n = 291) admitted that their child was receiving CAM for the present illness. In 31% of the respondents (n = 354), CAM had been prescribed by a physician, while 50% (n = 575) used CAM as self-medication. Patients presented to the Emergency Department mostly because of an infection (42% of total; 29% of these used CAM) or a trauma (38% of total; 19% of these used CAM). Parents of CAM-users were significantly older, more often born in Switzerland and had significantly higher school education than those of the non-users. Nearly two-thirds of the administered CAM therapies were not prescribed by a physician, and 50% of the families using CAM did not discuss this with their general practitioner. Parental requirements implied that medical professionals on a paediatric Emergency Department should know the effects and side-effects of CAM therapies and even be able to recommend them. The study population, even trauma patients, frequently used CAM. The use of CAM is characterised by a high rate of self-medication and the exclusion of the physicians from the decision-making process. The parents of paediatric patients frequently demand that CAM be considered as a possible treatment option and wish to have an open discussion with the medical professionals on this topic.

Accidental intakes of remedies from complementary and alternative medicine in children—analysis of data from the Swiss Toxicological Information Centre

The use of complementary and alternative medicine (CAM) in Switzerland is rather high, and therefore, the occurrence of accidental intakes of CAM remedies by children and associated intoxications is to be expected. In the present study, the inquiries to the Swiss Toxicological Information Centre that took place from 1998 until 2007 and concerned accidental, unintended intakes of CAM remedies by children were analysed. Inquiries for information were performed by concerned care-givers, physicians, pharmacists and others in case of acute accidental intake of CAM remedies. Feedbacks from physicians about paediatric patients with acute intoxication possibly associated with the accidental ingestion of CAM remedies were as well considered. During the study period, 3,158 accidental intakes of CAM remedies (1,015 of herbal and 2,143 of homeopathic remedies) were reported, corresponding to 8.6% of all reported accidental intakes of pharmaceutical products by children. No significant increase of the yearly number of accidental intakes of CAM remedies was detected during the study period. There was no accidental intake of CAM remedies leading to severe signs or symptoms. Concerning the herbal remedies, three intoxications of moderate and 28 of minor severity were reported. Nine children with intoxication from homeopathic remedies were reported, with minor symptoms only. All other accidental intakes of CAM remedies did not lead to intoxications and evolved without manifestations. The data show that accidental, unintended intake of CAM remedies happened in children, but developed mostly harmlessly. Comparing herbal with homeopathic remedies, accidental intakes with homeopathic remedies were more common, but intoxications associated with manifestations were observed more frequently with herbal remedies.

Self-Reported Health Characteristics and Medication Consumption by CAM Users and Nonusers: A Swiss Cross-Sectional Survey

OBJECTIVES Complementary and alternative medicine (CAM) is very popular in Switzerland. The objective of this work was to find out whether the use of CAM therapies is associated with distinct health characteristics and altered consumption of conventional medications. DESIGN AND PARTICIPANTS Self-reported data from the 2007 Swiss Health Survey were analyzed. Two groups of participants were defined and compared with each other: CAM users (those who had used CAM during the last 12 months, n=3333) and nonusers (those who stated they had not used CAM during the last 12 months, n=9821). OUTCOME MEASURES Multivariate logistic regression models were used to determine the predictors of CAM use and to address relevance and magnitude of the differences in medication consumption between CAM users and nonusers. RESULTS Comparatively lower body-mass index (BMI) values and migraine, arthritis, allergies, and depression were associated with increased probability of CAM use. Multivariate logistic regression models that adjusted for the effects of relevant demographic factors, BMI, and perceived health status showed that CAM users consumed fewer medications for cardiovascular diseases--high blood pressure and high cholesterol (and, by trend, heart problems and diabetes)--than nonusers. On the other hand, their consumption of analgesics and medications for depression and for constipation (and, by trend, sedatives and soporifics), was higher than that of nonusers. CONCLUSIONS Migraine, arthritis, depression, and constipation might lead patients to use CAM therapies and, in addition, to consume more of some conventional medications. Given the long intake period and considerable adverse effects of medications, the lower consumption of these agents for chronic cardiovascular problems by CAM users might be beneficial and deserves further investigations.

Influence of alternative lifestyles on self-reported body weight and health characteristics in women

BACKGROUND Alternative lifestyles are often associated with distinct practices with respect to nutrition, physical activity, smoking, alcohol use and usage of complementary medicine. Evidence concerning effects of these lifestyle-related practices on health status is still fragmentary. OBJECTIVE To describe maternal health characteristics related to alternative lifestyles, with emphasis on body-weight status, during pregnancy and maternity periods. METHODS We compared self-reported health-related features of mothers with alternative lifestyles and conventional lifestyles during pregnancy and maternity period in the KOALA Birth Cohort Study. This cohort comprises two recruitment groups of mother-infant pairs, one with a conventional (no selection based on lifestyle, n = 2333), the other with an alternative lifestyle (selected via organic food shops, anthroposophic clinicians and midwives, anthroposophic under-five clinics, Rudolf Steiner schools and relevant magazines, n = 485). Mothers in the alternative group more frequently chose organic foods, adhered to specific living rules, practised vegetarianism and identified themselves with anthroposophy. RESULTS Mothers in the alternative group showed lower BMI and lower prevalence of overweight and obesity than the conventional group, before pregnancy as well as 4-5 years after delivery. This difference was partly retained after adjusting for potential confounders. Furthermore, women in the alternative group had a lower prevalence of pregnancy-related hypertension, more often started breastfeeding and gave exclusive and prolonged breastfeeding for a longer period. Finally, they smoked less often, but more often drunk alcohol during pregnancy. CONCLUSION The results suggest that an alternative lifestyle is associated with favourable body weight and with several differences in other health features.

Consumption of dairy products of biodynamic origin is correlated with increased contents of rumenic and trans-vaccenic acid in the breast milk of lactating women

Our previous work showed that incorporation of organic dairy products in the maternal diet may lead to increased contents of the conjugated linoleic acid isomers (CLA) in human breast milk, which might positively affect infant’s health. Now, the effect of biodynamic—a special form of organic—dairy products in the diet on the CLA content in human breast milk has been analysed. The content of rumenic acid (the main CLA) in breast milk was higher in the women consuming biodynamic products (n = 64, 0.323% of total fat, P < 0.001) than in the women with a conventional diet (n = 175, 0.254%), with the group of women consuming other dairy products including organic (but not biodynamic) showing an intermediate value (n = 44, 0.279%). The contents of the CLA-precursor trans-vaccenic acid (TVA) paralleled those of rumenic acid, whereas the opposite was found for those of elaidic acid that often occurs in high concentrations in partially hydrogenated fats. Both the higher contents of CLA and TVA as well as the lower level of elaidic acid in the milk of women consuming biodynamic products might conceivably contribute to a better infant’s health.

Die Abteilung Komplementär- und Phytoarzneimittel der Swissmedic unter neuer Leitung

Die Anforderungen für die Zulassung von Komplementärund Phytoarzneimitteln (KPA) geben immer wieder Anlass zu Diskussionen. Die Abteilung, die bei Swissmedic darüber entscheidet, hat jetzt einen neuen Leiter. Es ist der Biochemiker Dr. Martin Ziak. Sein Ziel: Die Zulassung dieser Heilmittel soll noch einfacher werden, damit die Vielfalt des Angebots für die Patienten erhalten bleibt. Für die Zukunft der KPA sieht er ein grosses Potenzial.

1. Spagyrik-Kongress in Luzern

Den ersten Kongresstag rundete ein Podiumsgespräch mit Traugott Steger, Hans-Josef Fritschi, Helena Flühler, Hans Ambauen und Dr. med. Meret Bühler zum Thema «Schulmedizin – Komplementärmedizin – eine fruchtbare Beziehung» ab (Moderation: Ursula Zybach, Präsidentin Public Health Schweiz). Veranstalterin des Kongresses war die Firma Heidak AG (Organisation: Janna Steger, Heidak, Leiterin Bildung) (Abb. 2), die sich seit 1975 aktiv für verschiedene komplementärmedizinische Heilmethoden einsetzt. Ende April fand in Luzern der 1. Spagyrik-Kongress zum Thema «Spagyrik hautnah» statt. Am 26. April 2015, dem ersten Kongresstag, standen sowohl Vorträge für Fachpersonen als auch Input-Referate für Spagyrik-Einsteiger auf dem Programm. Der zweite und der dritte Kurstag (27. und 28. April) waren ausschliesslich für Spagyrik-Fachpersonen reserviert. Referenten und Referentinnen waren: – Dr. med. Ralf Oettmeier, Arzt der Paracelsus Klinik Lustmühle («Die Chancen der biologischen Medizin»); – Hans-Josef Fritschi (Abb. 1), Heilpraktiker, Spagyriker und Autor zahlreicher Spagyrik-Fachbücher («Wenn’s zum Aus-der-Haut-Fahren ist! Chronische Hautprobleme» wie auch «Barriere Haut – Auswirkungen der Umwelteinflüsse und der Psyche auf die Haut» und «Stoffwechselorgan Haut – Einsatz an vielen Fronten»); – Manfred Meier, dipl. Drogist HF, Spagyriker, Homöopath und Spagyrik-Buchautor («Barriere Haut – Auswirkungen der Umwelteinflüsse und der Psyche auf die Haut» und «Stoffwechselorgan Haut – Einsatz an vielen Fronten»); – Hans Ambauen, dipl. Drogist HF, Naturheilpraktiker und Homöopath («Was ist Spagyrik? Die ganzheitliche Wirkung der Spagyrik» sowie «Die Haut als Spiegel der Seele»); – Helena Flühler, Drogistin EFZ und Naturheilpraktikerin («Spagyrik für die ganze Familie»);

Wie Patienten Wickelanwendungen (ein)schätzen: Ergebnisse einer Umfrage in einem anthroposophischen Akutspital

Hintergrund: Wickelanwendungen bilden einen festen Bestandteil in der anthroposophischen Medizin und Pflege. Einerseits sollen sie zur Linderung akuter wie chronischer Beschwerden und andererseits zur gezielten Unterstützung von Medikamentenwirkung und Therapien beitragen. Patienten und Methode: Zwischen April 2008 und Februar 2009 wurden an alle stationär behandelten Patienten nach deren Spitalaustritt insgesamt 900 Fragebogen zur Anwendung von Wickeln versendet. Von diesen wurden 394 Fragebögen retourniert (44%), davon 233 von Patienten, die mindestens einmal während ihres Spitalaufenthalts eine Wickelanwendung bekommen hatten (59%). 221 Patienten waren volljährig und gaben an, die Wickelwirkung bewerten zu können; die Angaben dieser Gruppe wurden für die vorliegende Auswertung verwendet. Ergebnisse: 70% der Patienten nahmen eine deutliche oder sehr deutliche Verbesserung ihres Zustands wahr, die sie den Wickeln zuschrieben. In 71% der Fälle war diese Verbesserung kurzfristig (für den Moment oder für den Tag). Die Mehrheit der Patienten konnte sich durch die Wickel erholen: Für 33% war die Erholung deutlich, für 36% gut, für 16% hervorragend. Der Erfolg der Wickel, der durch vier verschiedene, sich ergänzende und untermauernde Fragen erfasst wurde, wurde von 30% der Patienten als deutlich, von 30% als hoch und von 16% als sehr hoch eingestuft. Bei kritischerem Gesundheitszustand wurde die Wickelwirkung als etwas weniger erfolgreich eingeschätzt. Die Frauenpopulation – am stärksten die Patientinnen, die aufgrund einer Mutterschaft das Spital aufsuchten – schätzte die Wickelwirkung tendenziell positiver ein als die Männerpopulation. Schlussfolgerung: Zusammenfassend zeigt die hier beschriebene Umfrage auf, dass die Mehrheit der Patienten eine hohe Wirksamkeit der Wickel wahrgenommen hat.