PubMed · 15127062
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Amy F Subar. 2004. Developing dietary assessment tools.. https://doi.org/10.1016/j.jada.2004.02.007
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PURPOSE/OBJECTIVES: To provide evidence-based research information about 27 herbs and natural products that have the potential to cause cancer and harm. DATA SOURCES: Natural Medicines Comprehensive Database and Lawrence Review of Natural Products Monograph System. Information about these herbs has been found in evidence-based studies cited in the references. DATA SYNTHESIS: Early research shows that some herbs and natural products appear to have the potential to cause cancer and harm. Oncology nurses who receive this information can become resources for patients and other healthcare professionals. CONCLUSIONS: Consumers and healthcare professionals are wise to weigh the benefits or risks and possibly limit or avoid the use of these products. IMPLICATIONS FOR NURSING: The table and text in this article are presented as quick resources for healthcare professionals working in clinical oncology.
Mutagenicity is one of the numerous adverse properties of a compound that hampers its potential to become a marketable drug. Toxic properties can often be related to chemical structure, more specifically, to particular substructures, which are generally identified as toxicophores. A number of toxicophores have already been identified in the literature. This study aims at increasing the current degree of reliability and accuracy of mutagenicity predictions by identifying novel toxicophores from the application of new criteria for toxicophore rule derivation and validation to a considerably sized mutagenicity dataset. For this purpose, a dataset of 4337 molecular structures with corresponding Ames test data (2401 mutagens and 1936 nonmutagens) was constructed. An initial substructure-search of this dataset showed that most mutagens were detected by applying only eight general toxicophores. From these eight, more specific toxicophores were derived and approved by employing chemical and mechanistic knowledge in combination with statistical criteria. A final set of 29 toxicophores containing new substructures was assembled that could classify the mutagenicity of the investigated dataset with a total classification error of 18%. Furthermore, mutagenicity predictions of an independent validation set of 535 compounds were performed with an error percentage of 15%. Since these error percentages approach the average interlaboratory reproducibility error of Ames tests, which is 15%, it was concluded that these toxicophores can be applied to risk assessment processes and can guide the design of chemical libraries for hit and lead optimization.
PURPOSE: To develop and compare three operational definitions of polypharmacy using a large prescription database. METHODS: We defined Cumulative polypharmacy as all prescriptions filled during a 178 day window--which captured 95% of eventual refills as calculated from Kaplan-Meier and cumulative incidence curves. Continuous polypharmacy was all prescriptions filled in two such windows 6 months apart. Simultaneous polypharmacy was the number of prescriptions active on a particular day, as determined by fill dates and amount of medication given. We applied these definitions to the outpatient prescription files of New England veterans and compared the resulting estimates of polypharmacy using descriptive statistics. RESULTS: 118,013 patients received at least one prescription between January 1998 and July 1999. Cumulative polypharmacy averaged 3.54 (SD = 4.95) medications and continuous polypharmacy averaged 1.96 (SD = 3.23). Examination of simultaneous polypharmacy over 40 2-week intervals revealed an average of 2.63 (CI 2.61-2.65), a minimum of 1.09 (CI 1.08-1.10) and maximum of 4.94 (CI 4.92-4.96). One arbitrarily selected observation point had an average of 3.87 (SD = 3.17). CONCLUSIONS: Our definitions of cumulative and continuous polypharmacy serve to set upper and lower bounds for the estimate of polypharmacy. Our method for simultaneous polypharmacy gives numbers that diverge in some respects, but it is better at showing transient changes in medications. The methods are complementary and allow exploration of various aspects of medication use, such as cumulative medication exposure over time, the influence of chronic medical problems, and the causes of rapid changes in medications.