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The aim of this study was to investigate the influence of melatonin on metabolism and the implementation of the sleep-wake cycle. Methodology. Publications for this review were collected from PubMed, MedLine, and Google Scholar databases. Results. Melatonin is the main hormone that communicates the main circadian clock, located in the suprachiasmatic nucleus of the hypothalamus, and the peripheral biological clock located in brain cells and other organs. Melatonin production is related to day and night cycles, with peak production of the hormone occurring at night. Considering the pathophysiological mechanisms triggered by melatonin deficiency, the question reasonably arises about the possibilities of treating metabolic disorders (including type 2 diabetes), cardiovascular pathology and sleep disorders with melatonin preparations. Domestic and foreign publications provide reports of the clinically successful use of such drugs to improve sleep quality, increase sensitivity to glucose, lower blood pressure, reduce myocardial ischemia, and improve anthropometric parameters. All this makes melatonin a promising drug for managing cardiovascular risks against the background of metabolic disorders. [ABSTRACT FROM AUTHOR]

Background: The present study was carried out to evaluate the effect of melatonin and placebo in the patients with atypical facial pain (AFP). Method: This double blind randomized controlled study was carried out on 30 patients who were suffering from AFP. During this period, patients were divided in 2 study and control groups. Then, they were treated with melatonin. Melatonin group used four 3-mg daily and placebo group received 4 placebo which were similar in size, shape, color with melatonin until the end of treatment, and then the severity of burning sensation was measured by physician. Sleep quality was measured using the visual analog scale using the Petersburg questionnaire. Result: The results of the present study show that the use of melatonin and placebo in patients with AFP reduces sensation and improves their sleep quality, although it may not reduce it completely. In this study, severity of burning was 5.71±1.42 after treatment in the study group and 5.93±2.65 in the control group, which was not statistically significant (p=.46). The mean score of sleep before treatment was not significantly different between the study (9±1.23) and the control (8±1.56) groups. The mean score of sleep after treatment between the study group (8±1.45) and the control group (7±1.23) was not significantly different (p=.43). Conclusion: According to the result of the study, melatonin was not superior placebo in treatment of AFP. Resumen: Antecedentes: El presenteestudio se realizó para evaluar el efecto de la Melatonina y Placebo en el paciente con Dolor Facial Atípico (PFA). Método: Este estudiocontrolado, aleatorio, dobleciego se llevó a caboen 30 pacientes que padecían AFP. Durante esteperíodo, lospacientes se dividieronen 2 grupos de estudio y control. Luegofuerontratados con melatonina. El grupo de melatoninautilizócuatrodosis de 3 mg al día y el grupo de placebo recibió 4 placebos que eransimilaresentamaño, forma y color a la melatonina hasta el final del tratamiento, y luego el médicomidió la gravedad de la sensación de ardor. La calidad del sueño se midiómediante la escala VAS utilizando el cuestionario de Petersburgo. Resultado: Los resultados del presenteestudiomuestran que el uso de melatonina y placebo enpacientes con AFP reduce la sensación y mejora la calidad del sueño, aunquepuede no reducirloporcompleto. Enesteestudio, la gravedad del ardor fue de 5,71 ± 1,42 después del tratamientoen el grupo de estudio y de 5,93 ± 2,65 en el grupo de control, lo que no fueestadísticamentesignificativo (P = 0,46). La puntuación media del sueño antes del tratamiento no fuesignificativamentediferente entre losgrupos de estudio (9 ± 1,23) y de control (8 ± 1,56). La puntuación media del sueñodespués del tratamiento entre el grupo de estudio (8 ± 1,45) y el grupo de control (7 ± 1,23) no fuesignificativamentediferente (P = 0,43). Conclusión: Segúnlosresultados del estudio, la melatonina no fue superior al placebo en el tratamiento de la AFP.

Heart failure is a clinical syndrome associated with poor quality of life, substantial healthcare resource utilization, and premature mortality, in large part related to high rates of hospitalizations. The clinical manifestations of heart failure are similar regardless of the ejection fraction. Unlike heart failure with reduced ejection fraction, there are few therapeutic options for treating heart failure with preserved ejection fraction. Molecular therapies that have shown reduced mortality and morbidity in heart failure with reduced ejection have not been proven to be effective for patients with heart failure and preserved ejection fraction. The study of pathophysiological processes involved in the production of heart failure with preserved ejection fraction is the basis for identifying new therapeutic means. In this narrative review, we intend to synthesize the existing therapeutic means, but also those under research (metabolic and microRNA therapy) for the treatment of heart failure with preserved ejection fraction. [ABSTRACT FROM AUTHOR]

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OBJETIVO: Ciclofosfamida (Cf) produce daño oxidativo en glándula submandibular (GSM) de ratas. En el presente trabajo se evaluó el efecto protector antioxidante de melatonina (MLT) en GSM de ratas tratadas con Cf. METODO: Se utilizaron 40 ratas Wistar machos adultas divididas en 5 grupos (G): G1: control; G2: Control+Etanol: tratados con etanol al 1% durante 10 días consecutivos. Los días 11 y 12 recibieron una dosis de solución salina; G3: Cf: tratados con etanol al 1% durante 12 días, días 11 y 12 recibieron una dosis intraperitoneal (i.p.) de Cf de 50 mg/Kg de pc; G4: Cf + MLT: se administró diariamente MLT (5 mg/Kg pc, intraperitoneal, disuelta en etanol al 1%), días 11 y 12 recibieron Cf igual que G3; G5: MLT: tratamiento 12 días consecutivos con MLT (igual dosis de G4). Los animales fueron anestesiados, extirpándose ambas GSM y sacrificados, previo ayuno 24 hs. Se midió la concentración de ácido úrico (AU), peróxidos lipídicos (PL) y acuosos (PA) y actividad de superóxido dismutasa (SOD) en homogenato de GSM. Análisis estadístico: ANOVA y test de Bonferroni, considerando significativo p

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Health & Society is the property of Instituto de Ensino e Pesquisa Periodicojs and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: scientific evidence has highlighted the role of chronobiological disruptions in promoting obesity through mechanisms involving important circadian rhythm hormones: melatonin and cortisol. These hormones are present in human colostrum and serve as crucial maternal and child protection mechanisms against obesity and childhood infections, owing to the intense interaction between mother and child during pregnancy and breastfeeding. Consequently, the melatonin and cortisol hormones present in human colostrum hold promise as potential candidates for yielding clinically applicable results and supporting future intervention strategies aimed at reducing obesity and neonatal infections. However, there is a scarcity of literature on this subject. Objective: the objective of this study is to to analyze the impact of maternal obesity on the levels and functions of melatonin and cortisol in colostrum and breast milk. Methods: a systematic review of the scientific literature was conducted following the recommendations outlined in the PRISMA protocol. Original articles published in English were searched in the PubMed, Medline, Lilacs, and Scopus databases. There were no restrictions on the publication year. Results: a total of 37 articles were identified from the searched databases. After removing duplicates and applying the inclusion and exclusion criteria, only five studies were relevant to the topic: two studies addressing melatonin and three studies analyzing cortisol. This review revealed that melatonin levels are elevated in the colostrum of obese women, and for this particular group, it has the potential to restore phagocyte activity and increase lymphocyte proliferation. Studies on cortisol have demonstrated that maternal obesity does not alter the levels of this hormone in breast milk. Conclusion: breastfeeding should be encouraged for all populations, and further original research should be conducted to elucidate the protective mechanisms of colostrum and breast milk. [ABSTRACT FROM AUTHOR]

Introdução: A obesidade é uma doença de etiologia multifatorial responsável por gerar um estado de inflamação crônica subclínica. A melatonina, hormônio produzido fisiologicamente pela glândula pineal, vem sendo amplamente estudada por seu efeito anti-inflamatório em diversas doenças. Objetivo: Analisar os efeitos anti-inflamatórios da suplementação de melatonina no tratamento da obesidade. Materiais e Métodos: Esta revisão narrativa foi realizada por meio de levantamento de literatura, utilizando as bases de dados digitais Pubmed, Scielo, Lilacs, Google Acadêmico e Periódicos da CAPES. Resultados: Um estudo duplo cego randomizado, avaliou 44 mulheres com obesidade, que foram divididas de forma randomizada em um grupo que fez uso de melatonina (n=22) e em outro grupo que fez uso de placebo (n=22). Foi observado que apenas o grupo de pacientes que fez uso da melatonina apresentou redução significativa nas concentrações séricas de marcadores inflamatórios como TNF alfa, IL-6, hsCRP e MDA. Outro estudo duplo-cego randomizado, analisou 30 pacientes com obesidade que foram randomizados em 2 grupos, grupo 1 (n=15) recebeu 10 mg de melatonina e o grupo 2 (n=15) recebeu placebo. Com a suplementação de melatonina as concentrações de adiponectina omentina 1 e GPx (enzima antioxidante) aumentaram significativamente, enquanto os níveis de MDA (marcador de estresse oxidativo) diminuíram significativamente. Conclusão: Apesar dos estudos clínicos sobre este tema serem escassos e os existentes apresentarem um número amostral reduzido, os resultados até então demonstraram a eficácia da melatonina em contrabalancear os efeitos deletérios do excesso de tecido adiposo.

Melatonin is the main hormone involved in the control of the sleep-wake cycle. It is easily synthesisable and can be administered orally, which has led to interest in its use as a treatment for insomnia. Moreover, as production of the hormone decreases with age, in inverse correlation with the frequency of poor sleep quality, it has been suggested that melatonin deficit is at least partly responsible for sleep disorders. Treating this age-related deficit would therefore appear to be a natural way of restoring sleep quality, which is lost as patients age. However, despite the undeniable theoretical appeal of this approach to insomnia, little scientific evidence is available that supports any benefit of this substitutive therapy. Furthermore, the most suitable dose ranges and pharmaceutical preparations for melatonin administration are yet to be clearly defined. This review addresses the physiology of melatonin, the different pharmaceutical preparations, and data on its clinical usefulness. Resumen: La melatonina es la principal hormona implicada en la regulación de la oscilación entre sueño y vigilia. Es fácilmente sintetizable y administrable por vía oral, lo que ha propiciado el interés para usarla en el tratamiento de una de las patologías humanas más prevalentes, el insomnio. Además, el hecho de que su producción se reduzca con la edad, en una relación inversamente proporcional a la frecuencia de mala calidad de sueño, ha reforzado la idea de que su déficit es, al menos en parte, responsable de estos trastornos. En esta línea de pensamiento, remontar el déficit que se va instaurando a medida que transcurre la vida sería un modo natural de restaurar la integridad del sueño, que se va perdiendo con la edad. Sin embargo, a pesar del innegable atractivo teórico de esta aproximación al problema del insomnio, la evidencia científica que sustenta el posible beneficio de esta terapia sustitutiva es escasa. Ni siquiera están bien definidos los rangos de dosis a los que administrarla o la formulación farmacológica más adecuada. En la presente revisión se repasa la fisiología de la melatonina, se revisan las características farmacológicas de su administración exógena y se analizan los datos existentes sobre su utilidad clínica.

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Heart failure is a clinical syndrome associated with poor quality of life, substantial healthcare resource utilization, and premature mortality, in large part related to high rates of hospitalizations. The clinical manifestations of heart failure are similar regardless of the ejection fraction. Unlike heart failure with reduced ejection fraction, there are few therapeutic options for treating heart failure with preserved ejection fraction. Molecular therapies that have shown reduced mortality and morbidity in heart failure with reduced ejection have not been proven to be effective for patients with heart failure and preserved ejection fraction. The study of pathophysiological processes involved in the production of heart failure with preserved ejection fraction is the basis for identifying new therapeutic means. In this narrative review, we intend to synthesize the existing therapeutic means, but also those under research (metabolic and microRNA therapy) for the treatment of heart failure with preserved ejection fraction.

Objective: The aim of this study is to assess the correlation between precocious puberty and pineal cysts in children. Materials and methods: The brain MRI scans of 122 patients with precocious puberty and 122 children in control group were evaluated for the presence and size of pineal cysts. Pineal cysts were assessed as true cyst and cystic transformation in terms of their sizes. The presence of pineal cysts/cystic transformation was compared between the two groups. In the precocious puberty group, the baseline and peak LH levels of patients with pineal cyst, cystic transformation and no cyst-cystic transformation were compared. Results: The chi-square test indicated no significant correlation between precocious puberty and pineal cyst, and between precocious puberty and pineal cystic transformation (p=0.2537 and p=0.8797 respectively). There was no significant difference in the basale and peak LH levels between the patients with pineal cyst, cystic transformation and no cyst-cystic transformation in the precocious puberty group (p=0.566 and p= 0.367 respectively). Conclusion: According to the results of the present study, there was no correlation between pineal cysts and precocious puberty. Therefore, it is a correct approach to accept pineal cysts detected in MRI scans as incidental findings in cases with precocious puberty.

Microsurgical procedures are the treatment of choice of peripheral nerve injuries, but often fail to reach full functional recovery. Melatonin has neuroprotective actions and might be used as a possible proregenerative pharmacological support. Therefore, the aim of this study was to analyze the time-dependence of the neuroprotective effect of melatonin on the overall fascicular structures of both ends of the transected nerve. Sciatic nerve transection was performed in 34 adult male Wistar rats divided in four groups: two vehicle groups (N=7) treated intraperitoneally for 7 (V7) or 21 (V21) consecutive days with vehicle (5 % ethanol in Ringer solution) and two melatonin groups (N=10) administered intraperitoneally 30 mg/kg of melatonin for 7 (M7) or 21 (M21) consecutive days. At the end of the experiment, proximal stump neuroma and distal stump fibroma were excised and processed for qualitative and quantitative histological analysis. Intrafascicular neural structures were better preserved and the collagen deposition was reduced in the melatonin treated groups than in the vehicle groups. Myelin sheath regeneration observed through its thickness measurement was statistically significantly (p<0,05) more pronounced in the M21 (1,23±0,18 µm) vs. V21 group (0,98±0,13 µm). The mean volume density of the endoneurium was lower in both melatonin treated groups in comparison to the matching vehicle treated groups. Although not statistically different, the endoneural tube diameter was larger in both melatonin groups vs. vehicle groups, and the effect of melatonin was more pronounced after 21 days (24,97 % increase) vs. 7 days of melatonin treatment (18,8 % increase). Melatonin exerts a time-dependent proregenerative effect on nerve fibers in the proximal stump and an anti-scarring effect in both stumps. [ABSTRACT FROM AUTHOR]

The present study investigated the possible protective effects of melatonin on Bleomycin, Cisplatin and etoposide (BEP) chemotherapy regimens using immunohistochemistry. Forty male Wistar rats were divided into four groups of ten as; group 1 as untreated control; group 2 as BEP group which received the three cycles of 21 days’ regimen each of 0.5¥ dose levels of BEP (bleomycin 0.75 mg/kg, etoposide 7.5 mg/kg and cisplatin 1.5 mg/kg). Rats in the group 3 (MEL group) received 10 mg/kg/day melatonin once daily. Group 4 received the melatonin (30 min before the BEP injections) and BEP as in groups 2. Proliferating cell nuclear antigen (PCNA) staining was used to detect cell proliferation and caspase-3, caspase-9 and Caspase-8 were detected to investigate apoptosis. PCNA immunostaining in alveolar epithelium, alveolar macrophages and bronchus was weak to moderate in BEP group. However, diffuse and strong caspase immunoreactions for caspase-3, caspase 8- and caspase-9 were detected in the bronchioles epithelium, vascular endothelium, alveolar luminal macrophages in the BEP group. PCNA and caspase immunoreactivities in MEL and Mel + BEP groups were close to the control one. The surface are in the BEP group was significantly reduced as compared to the control one ((P<0.05). However, in MEL and Mel + BEP groups, it was close to the control value (P>0.05). It can be concluded that BEP regimen can affects negatively on lung tissue and melatonin inhibits lung tissue injuries during BEP chemotherapy. [ABSTRACT FROM AUTHOR]

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5-Hydroxytryptophan (5-HTP) is a precursor to serotonin and has been used as an antidepressant. Its antidepressant potential has been evaluated under different experimental conditions with moderate results. However, it is considered to have poor pharmacokinetics and its use as an alternative treatment for mood disorders has even been questioned. This disadvantage seems to disappear when slow-release 5HTP is used. This study determined whether the combination of slow-release 5-HTP plus the combination with melatonin can reduce symptoms in patients who reported depression. This research consisted of a pre-experimental observational method (qualitative and quantitative). The participants were 20 adults between 25 and 50 years old with a previous diagnosis of depression issued by a mental health professional. Baseline values of depression, sleep quality, and working memory were measured. Subsequently, the participants were randomly assigned to the control group (n = 10) or the experimental group (n = 10). The control group only received information on general aspects of depression, while the experimental group received the combination of 100 mg of 5HTP/10 mg of melatonin for 1 month. The results indicated an improvement in mood, quality of sleep, and both verbal and visual working memory. It is concluded that the tested combination can be an effective alternative to the use of antidepressants. [ABSTRACT FROM AUTHOR]

Insomnia is a psychological disorder that afflicts a third of the world population and it is associated with several negative health consequences. The European guidelines have recently indicated Cognitive Behavioral Therapy for Insomnia (CBT-I) as the first line treatment for insomnia disorder. Nevertheless, previous literature highlighted a strong discrepancy between the current guidelines, based on empirical evidence, and the actual clinical offer. Patient with insomnia disorder frequently use alternative treatments such as melatonin, phototherapy, exercise, complementary and alternative medicine, and mindfulness. However, the effectiveness of these interventions has been poorly evaluated. This article aims to summarize the state of the art on the evidences of efficacy derived from randomized and controlled clinical trials on these treatments for the insomnia disorder, for which there are still no clear indications, in order to deepen the available clinical guidelines. The evaluated interventions were not supported by empirical evidences compared to CBT-I. Little evidences emerges for the efficacy of melatonin in improving sleep onset latency and of mindfulness for the daytime symptoms of insomnia. These results suggest the potential use of these interventions for patients with specific problems. Therefore, CBT-I intervention should be offered as a first choice but it could be integrated with specific modules. Despite that, evidences on the effectiveness of these interventions are scarce and, not always, meet the quality criteria indicated by international guidelines. There is therefore an urgent need for a clearer understanding of the effectiveness of these protocols through qualitatively valid studies and the evaluation of the integration of some of their components in standard and recommended treatments for insomnia. [ABSTRACT FROM AUTHOR]

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Copyright of General Medicine & Health Sciences / Medycyna Ogólna i Nauki o Zdrowiu is the property of Witold Chodzki Institute of Rural Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Today, one of the pathologies with the highest mortality and morbidity rates prevalent worldwide is cancer, one of the greatest public health challenges in Brazil and worldwide. Melatonin is a natural sleep regulating hormone produced endogenously in the body and secreted mainly by the pineal gland. Common effects have several intrinsic relationships in the pathophysiological mechanism of the development of cell neoplasms. This article is a bibliographic review based on the online medical literature available in the Public Medline database (PUBMED) and in the database of the brazilian Virtual Health Library (VHL), where the health descriptors "Melatonin" and "Cancer" were applied. During the research, the three main themes were: the pathophysiology of cancer, the pharmacology of melatonin and the antineoplastic actions of this hormone in the body. Briefly, we have grouped these antitumor actions into 5 major areas: antioxidant effect, antiproliferative effect, immunomodulatory effect, potential as a chemoradiotherapeutic adjunct and potential as a biological marker. In summary, therefore, our research seeks to highlight the importance of inserting this natural hormone in dense scientific research that must be carried out in order to benefit not only cancer patients but also humanity in general. [ABSTRACT FROM AUTHOR]

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Introduction: Multiple sclerosis (MS) is a chronic, demyelinating, autoimmune disease of the central nervous system causing neuroinflammation. Experimental autoimmune encephalitis (EAE) is a model of the disease. MS is classically treated with interferon beta (IFN-β) and glatiramer acetate (GA). Melatonin (MLT) has been reported to modulate immune system responses. The aim of the present study is to analyse the effects of MLT administration in comparison with the first-line treatments for MS (IFN-β and GA). Methods: EAE was induced in male Sprague-Dawley rats; the animals subsequently received either IFN-β, GA, or MLT. Cerebrospinal fluid (CSF) samples were analysed by multiplex assay to determine the levels of proinflammatory cytokines. The neurological evaluation of EAE was also recorded. Results: All immunised animals developed EAE. We evaluated the first relapse-remission cycle, observing that IFN-β and GA had better results than MLT in the clinical evaluation. Neither EAE nor any of the treatments administered modified CSF IL-1β and IL-12p70 concentrations. However, IFN-β and MLT did decrease CSF TNF-α concentrations. Conclusion: Further studies are needed to evaluate the molecular mechanisms involved in the behaviour of MLT in EAE, and to quantify other cytokines in different biological media in order for MLT to be considered an anti-inflammatory agent capable of regulating MS. Resumen: Introducción: La esclerosis múltiple (EM) es una enfermedad crónica desmielinizante autoinmune del sistema nervioso central (SNC) que produce neuroinflamación, un modelo es la encefalitis autoinmune experimental (EAE). La EM ha sido tratada con interferón beta (IFN-beta) y acetato de glatiramero (AG). Se ha descrito que la melatonina (MLT) modula la respuesta del sistema inmune. El objetivo de este estudio fue observar el efecto de la administración de melatonina contra los tratamientos de primera línea utilizados en la EM (IFN-β y AG). Métodos: A ratas macho Sprague Dawley se les indujo EAE y se administraron IFN-β, AG o MLT. Se colectó líquido cefalorraquídeo y se midieron citocinas proinflamatorias por multiplex, además del registro de la evaluación neurológica de la EAE. Resultados: Todos los animales inmunizados establecieron la EAE. Se evaluó el primer ciclo de recaída-remisión, observando que IFN-β y AG tienen mejores resultados que MLT en la evaluación clínica. La concentración en el LCR tanto de IL-1β e IL-12p70 no se vio modificada por el modelo o por los tratamientos administrados. EL TNF-α se vio disminuido en el LCR por el IFN-β y MLT bajo el modelo de MS. Conclusiones: Es necesario realizar estudios posteriores para evaluar los mecanismos moleculares involucrados en el comportamiento de la MLT en la EAE, así como la cuantificación de otras citocinas en diferentes matrices biológicas para poder considerar a la MLT como un agente antiinflamatorio regulador de la EM.

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Introduction: Obesity is a disease of multifactorial etiology responsible for generating a state of subclinical chronic inflammation. Melatonin, a hormone physiologically produced by the pineal gland, has been widely studied for its antiinflammatory effect in several diseases. Objective: To analyze the anti-inflammatory effects of melatonin supplementation in the treatment of obesity. Materials and Methods: This narrative review was carried out through a bibliographic survey, using the digital databases Pubmed, Scielo, Lilacs, Google Scholar and CAPES Periodicals. Results: A double-blind randomized study evaluated 44 women with obesity, who were randomly divided into a group that used melatonin (n=22) and another group that used placebo (n=22). It was observed that only the group of patients who used melatonin showed a significant reduction in the serum concentrations of inflammatory markers such as TNF alpha, IL-6, hsCRP and MDA. Another randomized double-blind study analyzed 30 patients with obesity who were randomized into 2 groups, group 1 (n=15) received 10 mg of melatonin and group 2 (n=15) received placebo. With melatonin supplementation, concentrations of adiponectin omentin 1 and GPx (antioxidant enzyme) increased significantly, while levels of MDA (marker of oxidative stress) decreased significantly. Conclusion: Although clinical studies on this topic are scarce and the existing ones have a small sample number, the results so far have demonstrated the effectiveness of melatonin in counterbalancing the deleterious effects of excess adipose tissue. [ABSTRACT FROM AUTHOR]

Contexto: la melatonina fue aislada por primera vez, en 1958, por el dermatólogo Aaron Lerner a partir de una glándula pineal bovina. Para 1970 se descubrió su rol en la regulación del ritmo circadiano y los estados de sueño-vigilia, papel en el cual se han enfocado la mayoría de los estudios clínicos. Su síntesis ocurre a partir del triptófano, a través de procesos de hidroxilación y acetilación, para posteriormente convertirse en melatonina. Desde su descubrimiento, se han planteado múltiples beneficios biológicos, todos ellos basados en sus efectos como reguladora del estrés oxidativo. Es por ello que los estudios clínicos demuestran que la suplementación de esta hormona, aparte de regular el ritmo circadiano, tiene potenciales efectos en el manejo de enfermedades crónicas no transmisibles Objetivo: aportar nueva evidencia acerca de los mecanismos fisiológicos y bioquímicos de la melatonina y controvertir su posible uso terapéutico. Metodología: revisión bibliográfica en la base de datos PubMed y Scopus utilizando los términos MeSH: “melatonin”, “circadian clocks”, “circadian rhythm”, “cancer”, “oxidative stress”. Resultados: existe gran evidencia bibliográfica acerca de la historia de la melatonina y sus posibles efectos metabólicos, los cuales van muy de la mano de su rol como reguladora del ritmo circadiano, por medio de los estados sueño-vigilia y luz-oscuridad. Conclusiones: la melatonina puede servir como coadyuvante en el manejo de enfermedades crónicas no transmisibles como cáncer, obesidad, hígado graso, mucositis y en manejo de pacientes críticamente enfermos.

According to medical research, we can say that serotonin is one of the most influential neurotransmitters our body needs to have a truly remarkable state of health. Serotonin is also called the “hormone of happiness“ because it is involved in the most important neuropsychoendocrine processes of the body, such as nutrition, memory, exercise, immunity, emotion management, recovery of organs affected by oxidative stress, rest, to give us a state of well, mentally, physically and emotionally. This article contains references to therapeutic aspects related to the functions of serotonin, carcinoid syndrome, serotonergic syndrome and obsessivecompulsive disorder (OCD). The recommendations for a healthy lifestyle are highlighted by the pro-serotonin diet and the Serotonin Program to maintain vitality. Serotonin is for the human body what the Silk Road represented for the economies of the countries where it passed through, because it brought prosperity, recovery and innovation. Serotonin does the same for us, it brings us regeneration, protection and a good mood, if we know how to respect its principles of optimal functioning. Let’s not forget to give serotonin a chance every day, to give us a life full of happiness, if we know how to feed it properly! [ABSTRACT FROM AUTHOR]

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Since ancient times, mankind has sought the elixir of youth and vitality. At the moment, when COVID-19 seizes our smile and saddens our lives, medical specialists are looking for alternatives for people’s health to return to normal. This article highlights the benefits of melatonin, a scientifically proven diet recommended for the endogenous production of this polyvalent hormone with access to all cells of the human body. The article also contains practical advice on sleep hygiene, the melatonin program for vitality and the sleep quality assessment questionnaire. Melatonin represents the royal way of restoring the body in convalescence, boosting immunity and preventing premature aging. Let’s give it this chance every night, through an intelligent effort of will. [ABSTRACT FROM AUTHOR]

Sindromul algic și tulburările de somn sunt unele din cele mai actuale probleme medicale cauzate de modul modern de viață. Prevenția, diagnosticarea și tratamentul acestora la momentul actual încep să aibă o nouă abordare și anume prin prisma ritmului circadian. Ultimele cercetări demonstrează ubicuitatea și importanța ritmurilor biologice sincronizate de nucleul suprachiasmatic și genele-ceas ale tuturor celulelor corpului uman. Sincronizarea se realizează atât între toate procesele fiziologice interne ale organismului, cât și între organism și mediul înconjurător, principalul factor extern care participă la această sincronizare este lumina, iar principalul neuromediator implicat în sincronizarea organismului cu mediul extern este melatonina. Melatonina influențează un șir de procese fundamentale ale sistemului nervos atât prin intermediul unei varietăți mari de receptori proprii, cât și prin receptorii altor sisteme neuroaminergice. Efectul principal al stimulării acestor receptori este inhibiția SNC în cadrul pregătirii organismului pentru somn și apoi declanșarea și menținerea somnului. Totodată, melatonina participă în activarea unor procese imuno-modulatoare. Dereglarea secreției melatoninei ca urmare a modificării timpului și frecvenței expunerii la factorii externi determină dereglarea ritmului circadian și a funcțiilor acestuia, în special a somnului. În același timp, la pacienții care suferă de diverse sindroame algice, dereglarea ritmului circadian poate influența negativ sistemele antalgice și astfel acutiza și prelungi durerea. Acest fapt este valabil și pentru sindroamele cefalalgice, tot mai multe cercetări demonstrând influența tulburărilor de ritm circadian (inclusiv și tulburările de somn) asupra patogenezei cefaleei.

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Objective: to determine changes and correlations of salivary melatonin levels, food intake, serum concentrations of leptin, insulin and glucose and insulin resistance index (IRI) after seven night shifts. Higher risk of obesity and diabetes and modi-fications in melatonin concentrations have been registered in night shift workers. Materials and Methods: ten male security guards who work day shifts from 6a.m. to 3 p.m. and night shifts from 10 p.m. to 6 a.m. were chosen to participate in this comparative - descriptive exploratory study. Anthropometric variables from the subjects were taken. Food intake data was taken the last daily shift and after the end of the last night shift. Also blood and saliva samples were taken at 7 a.m. and saliva samples were taken at 1 p.m. 9 p.m and 2 p.m in order to determine several biochemical parameters. Results: after seven nights of work, the levels of melatonin, glycemia and leptin at 1pm were greater. Total consumption of calories increased, at the expense of proteins and carbohydrates. The negative correlation between melatonin and insulin resistance was not statistically significant. Conclusions: the effects of the night shift over melatonin levels were confirmed the day after the work shift ended. Throughout the night shift, workers consumed more calories, and had higher levels of glycemia increasing the risk of developing obesity and diabetes. Leptin level increases were also observed, which may increment the risk of suffering metabolic syndrome. [ABSTRACT FROM AUTHOR]

Insomnia is a psychological disorder that afflicts a third of the world population and it is associated with several negative health consequences. The European guidelines have recently indicated Cognitive Behavioral Therapy for Insomnia (CBT-I) as the first line treatment for insomnia disorder. Nevertheless, previous literature highlighted a strong discrepancy between the current guidelines, based on empirical evidence, and the actual clinical offer. Patient with insomnia disorder frequently use alternative treatments such as melatonin, phototherapy, exercise, complementary and alternative medicine, and mindfulness. However, the effectiveness of these interventions has been poorly evaluated. This article aims to summarize the state of the art on the evidences of efficacy derived from randomized and controlled clinical trials on these treatments for the insomnia disorder, for which there are still no clear indications, in order to deepen the available clinical guidelines. The evaluated interventions were not supported by empirical evidences compared to CBT-I. Little evidences emerges for the efficacy of melatonin in improving sleep onset latency and of mindfulness for the daytime symptoms of insomnia. These results suggest the potential use of these interventions for patients with specific problems. Therefore, CBT-I intervention should be offered as a first choice but it could be integrated with specific modules. Despite that, evidences on the effectiveness of these interventions are scarce and, not always, meet the quality criteria indicated by international guidelines. There is therefore an urgent need for a clearer understanding of the effectiveness of these protocols through qualitatively valid studies and the evaluation of the integration of some of their components in standard and recommended treatments for insomnia. [ABSTRACT FROM AUTHOR]

Las investigaciones sobre el proceso del sueño han considerado el estudio de diversos factores y variables, tanto ambientales como biológicas, que influencian el desarrollo y curso de la cronobiología del sueño, entre éstas, se ha destacado la relevancia funcional del hipotálamo sobre la actividad del ciclo sueño/vigilia y particularmente del núcleo supraquiasmático como regulador de esta actividad. Además, se ha reconocido la importancia de neurotransmisores como la serotonina en la inducción del sueño a partir de la síntesis de melatonina, y de la acetilcolina y el GABA sobre la consolidación de la actividad cognitiva que tiene lugar durante este periodo. Así, investigaciones recientes han demostrado la relevancia del sueño sobre la función cerebral y han llegado a establecer correlaciones de las alteraciones del sueño con la clínica neuropsiquiátrica y neuropsicológica, donde trastornos como el TAB, la esquizofrenia, la depresión, el trastorno afectivo estacional y alteraciones en aprendizaje, memoria y toma de decisiones, entre otros, presentan influencia del sueño sobre sus síntomas y disfunciones.

Zaburzenia ze spektrum autyzmu należą do najczęściej występujących zaburzeń neurorozwojowych i stanowią wyzwanie zarówno diagnostyczne, jak i terapeutyczne. Objawy obserwowane są od wczesnego dzieciństwa, co przekłada się na konieczność właściwego szkolenia lekarzy pediatrów. Badania ujawniają wieloczynnikową etiologię zaburzeń, co utrudnia poszukiwania jednoznacznej przyczyny autyzmu, a w konsekwencji – opracowanie odpowiedniego leczenia. Coraz więcej uwagi poświęca się badaniom zaburzeń towarzyszących, takich jak zespół nadpobudliwości ruchowej z zaburzeniami koncentracji uwagi, zaburzenia odżywiania, tiki, padaczka, agresja i autoagresja czy zaburzenia snu. Szacuje się, że problem zaburzeń rytmów okołodobowych (mowa tu głównie o bezsenności, lękach nocnych, koszmarach sennych, wczesnym wybudzaniu i wzmożonej senności w ciągu dnia) dotyczy 50–80% dzieci z zaburzeniami ze spektrum autyzmu. W tej grupie pacjentów częściej obserwuje się trudności z koncentracją, obniżoną sprawność intelektualną, zaburzenia zachowania, a także problemy z efektywną terapią napadów padaczkowych. Badania wskazują na wieloczynnikową etiologię nieprawidłowości w strukturze snu, obejmującą zaburzenia funkcjonowania neurotransmiterów i gospodarki hormonalnej, przede wszystkim melatoniny i kortyzolu, zaburzenia pracy przewodu pokarmowego czy nieprawidłowe nawyki związane z higieną snu. Wśród pacjentów, u których wdrożono terapię zaburzeń rytmów okołodobowych, odnotowano redukcję zaburzeń zachowania, agresji i autoagresji oraz poprawę pamięci i koncentracji. Obiecujące wyniki uzyskano w badaniach, w których przeprowadzono psychoedukację i szkolenie rodziców w celu wdrożenia dobrych nawyków dotyczących przygotowań do snu. W trakcie wizyt diagnostycznych należy ustalić, czy u pacjenta występują nieprawidłowości związane ze snem. Rozpowszechnienie omawianego problemu w populacji dzieci i młodzieży z zaburzeniami ze spektrum autyzmu oraz jego wpływ na codzienne funkcjonowanie jednoznacznie wskazują na konieczność ustalenia właściwych form oddziaływań – zarówno pozafarmakologicznych, jak i farmakologicznych – w toku dalszych badań.

Introduction: The loss of the circadian rhythm caused by sleep disorders is considered an important risk factor for developing metabolic diseases such as hyperglycemia and insulin resistance. Objective: Analyze the existing information regarding studies on circadian dyssynchrony in workers and its influence on metabolic syndrome of anthropometric parameters. Method: A search was carried out in electronic databases such as EBSCO, Thompson Reuters, PubMed, and Scopus; the selected search terms were shift work, melatonin, cortisol, metabolic syndrome, night shift, and circadian rhythm in Spanish and English published from January 2015 to December 2018. The extraction was carried out using a predesigned form. Results: The search in the databases yielded 5,953 papers; after the investigation and depuration of the aforementioned papers applying the eligibility criteria, 13 papers were obtained which were organized in two dimensions for their analysis, these were called a) shift work and metabolic risk factors, and b) shift work and the circadian cycle. Conclusions: The relationship between night work or rotating shift with various metabolic disorders is consistent. [ABSTRACT FROM AUTHOR]

The article analyses three clinical cases of patients in a permanent vegetative state due to cardiac arrest and prolonged cardiopulmonary resuscitation. All patients were admitted to Federal State Budget Scientific Institution -- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia. For diagnosing and prognosis for the progression of the disease a detailed examination was held, including electroencephalography, polysomnography, positron emission computed tomography, single-photon emission computed tomography, functional perfusion computed tomography, electroneuromyography, evoked potentials studies, laboratory studies, and other available tests. Instrumental diagnostics methods confirm the principal component that determines the level of consciousness in this type of damage -- diffuse damage to the cerebral cortex. To conclude realization of the rehabilitation potential of such patients is impossible without the control of nutritional support. Amino acid profile is one of the markers and ways to control metabolic function. [ABSTRACT FROM AUTHOR]

Background: Migraine is one of the common neurological diseases. the aims of this study are to compare the effectiveness and tolerability of Topiramate and Melatonin drugs as monotherapy in the prophylaxis of migraine and to support the use of Melatonin as a preventive therapy. Materials and Methods: a prospective, comparative study, in which 200 Patients diagnosed with migraine were enrolled. Monthly headache frequency, headache severity, mean attack duration in hours, and disability, were assessed at the baseline and at the end of 3rd month of follow up. Tolerability measures including the incidence of adverse events were recorded also. Results: Forty patients withdrew from the study, the analysis was performed for the remaining cases, 160 patients, (76 in topiramate group and 84 in melatonin group). There was a significant improvement in the clinical response after 3 months of treatment in all parameters, and without significant differences between both groups. Conclusion: this study showed that the Melatonin is effective as, if not superior to, Topiramate for episodic migraine prophylaxis. Moreover, it is more tolerated and has less adverse events than Topiramate. [ABSTRACT FROM AUTHOR]

Introdução: Rever a evidência existente acerca do uso da melatonina como fotoprotetor e agente redutor do envelhecimento cutâneo. Métodos: Pesquisa nas bases de dados National Guideline Clearinghouse, NICE Guidelines Finder, The Cochrane Library e MEDLINE/PubMed, de normas de orientação clínica (NOC), revisões sistemáticas (RS), meta-análises (MA) e ensaios clínicos aleatorizados (ECA), publicados entre janeiro de 1998 e janeiro de 2018, usando os termos MeSH "skin", "melatonin" e "stress". A pesquisa foi limitada a artigos escritos em inglês e português. Resultados: Foram incluídos 7 ECA de uma pesquisa inicial de 93 artigos. Não foram incluídas RS, MA ou NOC por não se enquadrarem nos critérios de inclusão. Os artigos selecionados demonstraram uma clara eficácia do uso da melatonina na redução de sinais de fotoenvelhecimento cutâneo e eritema pós-exposição, se usados antes da exposição solar ou radiação ultravioleta; se usado posteriormente, o seu efeito foi nulo. Conclusões: A terapia com melatonina tem, a curto prazo, efeito fotoprotetor e retardador do envelhecimento cutâneo. Os estudos incluídos nesta revisão tinham amostras de pequenas dimensões e um curto período de follow-up. São necessários estudos com amostras de maiores dimensões e com maior período de follow-up, para testar a eficácia e a segurança da melatonina como terapêutica a longo prazo.

This study aimed to investigate the changes in testis tissue of thioacetamide-induced rats and the effect of melatonin on these changes. Thirty-five male Wistar Albino rats were divided into five groups. Group I; Control (n=7), Group II; Melatonin (Mel) (10 mg/kg) a single dose (i.p)(n=7), Group III; Thioacetamide (TAA) (300 mg/kg) (i.p) 2 times with 24 hour intervals (n=7), Group IV;TAA (300 mg/kg) was administered at 24-hour intervals, afterwards of 10 mg/kg single dose of Mel (n=7), Group V; Mel was administered10 mg/kg a single dose 24 hours before the administration of TAA (n=7). Testis was evaluated histologically, immunohistochemically (Heat Shock Proteins (HSP) 70 and 90), blood serum testosterone, total antioxidant status(TAS) and total oxidant status(TOS) in tissue. The tissue sections of Group III decreased seminiferous tubule diameters, and germinal epithelium spills were observed. HSP70 andHSP90 expressions were increased. There wasn’t a statistically significant change in testosterone levels among the groups. While TAS levels decreased in Group III compared to control, TOS levels didn’t change. HSP70 and HSP90 decreased in groups with Mel-treated. Mel was found to have both protective and therapeutic effects. According to our results, the therapeutic effect of Mel in thioacetamide-induced acute testicular injury is greater than its protective effect. [ABSTRACT FROM AUTHOR]

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Um dos principais objetivos da na reprodução e peixes é a produção de um grande número de gametas viáveis e alta sobrevivência da prole. Nos últimos anos, foram realizados importantes progressos na melhoria da eficiência na produção de gametas e viabilidade da prole. No entanto, existem lacunas importantes no que diz respeito ao compreendimento dos processos dinâmicos fisiológicos associados à gametogênese. O conhecimento das estruturas que compõe as gônadas, bem como o todos os mecanismos neuroendócrinos e de sinalização molecular é de extrema importância na elaboração de protocolos reprodutivos de peixes. Entre os desafios encontrados, destaca-se a ampla gama de espécies de peixes de diferentes famílias, os quais, na maioria das vezes, possuem mecanismos fisiológicos espécie-específico. No mecanismo neuroendócrino da reprodução de peixes é dado ênfase ao Hormônio liberador de gonadotrofinas (GnRH), neurotransmissor produzido e secretado pelo hipotálamo, que atua como fator estimulador na liberação de LH e, em menor grau, do FSH. Os hormônios gonadotróficos folículo estimulante e luteinizante (FSH e LH) atuam como os principais reguladores durante a vitelogênese e maturação dos gametas. Acreditava-se que a melatonina estaria envolvida no mecanismo neuroendócrino como resposta ao fotoperíodo, inibindo a liberação de GnRH. Recentemente, estudos evidenciaram que a melatonina atua também acelerando a ação do hormônio indutor da maturação (MIH) e, consequentemente, a retomada do ciclo celular meiótico. Desta forma, o objetivo desta revisão é esclarecer os mecanismos fisiológicos da reprodução de peixes teleósteos, partindo da descrição da morfologia das gônadas, compreendimento dos mecanismos neuroendócrinos e da sinalização molecular.