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Background: Osteoarthritis (OA) is a significant contributor to chronic pain, mainly affecting lower extremity joints like the knee and hip, and causing considerable impairment in elderly individuals. OA treatment focuses on easing discomfort and enhancing mobility. Despite their adverse unfavorable effects, non-steroidal anti-inflammatory medications (NSAIDs) are frequently used for symptom alleviation. However, there is still a need for secure and efficient alternative therapies that could provide OA patients with both symptomatic relief and disease-modifying benefits. Despite the indisputable fact that the disease has a substantial socioeconomic impact on patients, there is not much research available to reflect on the medicine prescription pattern in OA. Aim and Objectives: The objectives of this study were to assess the prescription pattern and their rationality in patients with OA in a tertiary care hospital. Materials and Methods: A cross-sectional, prospective, and observational study conducted in the orthopedics department for all newly diagnosed and old treated patients with OA. Around 350 patients were taken into the study and their prescriptions were scrutinized. Descriptive statistics were used to analyze the data and present it as percentages. Results: Over 61.7% of females were affected compared to 38.3% of males with OA. The knee joint (76.2%) followed by the hip joint (13.7%) were the most common joints involved. Aceclofenac and diclofenac were the most common NSAIDs used in the patients, whereas piroxicam was the least prescribed drug. Gastroprotective agents, calcium supplements, and SYSDOA were the commonest adjuvants used in the treatment of OA patients. Conclusions: Even though NSAIDs are favored, SYSDOA and non-pharmacological treatments such as lifestyle changes, and frequent mild exercise have changed the treatment plan for OA
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Buccal tablets
Diclofenac sodium
Drug release
Mucoadhesion
Mucoadhesive tablets
Release kinetics
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Objective:To explore the differences of resting-state spontaneous neural activity between migraine without aura (MwoA) patients with response or nonresponse to non-steroidal anti-inflammatory drugs (NSAIDs), and its correlation with migraine-related features.Methods:From February 2021 to April 2022, thirty MwoA patients with response to NSAIDs, 30 MwoA patients with nonresponse to NSAIDs, and 30 healthy controls were recruited in the Affiliated Jiangning Hospital of Nanjing Medical University.All subjects were scanned with a 3.0 T resting-state functional magnetic resonance imaging scanner.The percent amplitude of fluctuation (perAF) approach was used to calculate the differences of the resting state brain functional activities among the three groups (Bonferroni multiple comparison correction). SPSS 24.0 software and RESTplus software were used for statistical analysis.Analysis of variance was used for the perAF values of three groups.Correlation analysis was performed between perAF values of brain regions with significant differences and migraine-related features.Results:The brain areas showing significant differences of perAF among the three groups located in the left anterior cingulate cortex (ACC)( x, y, z = -6, 9, -3), left middle frontal gyrus (MFG)( x, y, z =-39, 48, 9) and left middle temporal gyrus (MTG)( x, y, z = -57, -30, -15)(all P<0.05, Bonferroni correction). Compared with nonresponse group, the perAF in response group showed significant decreased in the left ACC, MFG and MTG.There was positive correlation between the perAF of left ACC and disease duration ( r=0.506, P=0.007). Compared with healthy controls, the perAF of nonresponse group showed increased in the left ACC, which was negatively correlated with frequency ( r=-0.414, P=0.032). Conclusion:The neural activity of prefrontal cortex and ACC may be the neuropathological basis underlying response to NSAIDs in MwoA treatment.Moreover, the ACC has certain correlations with migraine-related characteristics, which may serve as a potential neuroimaging biomarker to evaluate the efficacy of NSAIDs.
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Los antiinflamatorios no esteroideos (AINE) son un grupo de fármacos que han sido comúnmente prescritos por sus propiedades antiinflamato- rias, antipiréticas y analgésicas, mismas que se deben a la inhibición de la formación de prostaglandinas. Este mecanismo ha sido ampliamente respaldado en la literatura; sin embargo, en la actualidad poco se co- noce sobre las propiedades adicionales de estos medicamentos como el efecto antirresortivo y antimicrobiano. La función antirresortiva se debe principalmente al bloqueo de la producción de prostaglandinas en específico la PGE2, que posee gran potencial osteoclastogénico, esencial para la aparición de lesiones periapicales; asimismo, la acción antimicrobiana de los AINE está relacionada con la afectación directa de la perpetuación de biopelícula, potencian la acción de los antibióticos, entre otros. Dichos efectos combinados podrían contribuir en la cura- ción de lesiones periapicales. El objetivo de este estudio es recopilar información actualizada sobre estas funciones agregadas de los AINE, con el fin de dar a conocer a los profesionales estos beneficios en la terapéutica de las lesiones periapicales (AU)
Non-steroidal anti-inflammatory (NSAIDs) are a group of drugs that have been commonly prescribed for their anti-inflammatory, antipyretic and analgesic properties, which are due to the inhibition of prostaglandin formation. This mechanism has been widely supported in the literature; however, currently little is known about the additional properties of these drugs such as the antiresorptive and antimicrobial effect. The antiresorptive function is mainly due to the blockage of prostaglandin production, specifically PGE2, which has great osteoclastogenic potential, and is essential for the appearance of periapical lesions; likewise, the antimicrobial action of NSAIDs is related to the fact that they directly affect the perpetuation of biofilms, enhance the action of antibiotics, among others. These combined effects could contribute to the healing of periapical lesions. The aim of this study is to gather updated information on these added functions of NSAIDs, in order to inform professionals about these benefits in the therapy of periapical lesion (AU)
Subject(s)
Periapical Diseases/drug therapy , Anti-Inflammatory Agents, Non-Steroidal , Bacterial Infections/drug therapy , Tooth Resorption/drug therapyABSTRACT
Stevens-Johnson syndrome (SJS) can be defined as a rare, serious disorder of the skin and mucous membrane characterized by widespread vesiculobullous rash with epidermal sloughing and necrosis involving mainly eyes, oral cavity, and skin. SJS can be diagnosed if there is <10% of the skin involvement. SJS occurs as an idiosyncratic reaction to various medications. Among them, the most common are antimicrobial agents (AMAs), antiepileptics, and non-steroidal anti-inflammatory drugs (NSAIDs). SJS is one of the dermatological emergencies for which initial treatment can only be supportive like fluids and nasogastric or parenteral feeding and symptomatic measures like analgesic mouth rinse for mouth ulcer. Beyond this, no treatment for SJS is approved. Cases of drug-induced SJS as diagnosed by Skin and VD department were included in the study. Interpretations were drawn out from that data and causality assessment was done according to the WHO-UMC causality assessment. Total four cases of drug-induced SJS were available. two cases of male patients and two of female patients. Out of them, three cases were by NSAIDs induced and one case was anti-epileptic (phenytoin) induced. In the present study, it was found that three of the cases of drug-induced SJS were caused NSAIDs and one case by anti-epileptic. According to the WHO-UMC Causality assessment, three cases were probable and one was unclassified.
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Purpose: To compare the efficacy of topical nonsteroidal anti?inflammatory drugs (NSAIDs) and prednisolone acetate in controlling inflammation and preventing cystoid macular edema (CME) after uneventful phacoemulsification. Methods: All patients who underwent uneventful phacoemulsification from December 2020 to Feb 2021 were included in the study. These were randomly assigned to receive any one anti?inflammatory agent among topical nepafenac (0.1%) [96 eyes], bromfenac (0.07%) [93 eyes], preservative?free ketorolac (0.4%) [94 eyes], nepafenac (0.3%) [96 eyes], or prednisolone acetate (1%) [91 eyes]. The efficacy of the drugs was evaluated by comparing the grade of anterior chamber (AC) cells, conjunctival hyperemia, pain score, visual acuity, intraocular pressure (IOP), and central macular thickness (CMT) at 1 and 6 weeks after surgery. Results: At 1 and 6 weeks, there was no significant difference in pain score, conjunctival hyperemia, AC cells, change in IOP, and visual acuity between the prednisolone and the NSAIDs groups, though nepafenac 0.3% was most effective. At 6 weeks, there was no significant difference in the number of patients developing subclinical CME in the prednisolone versus NSAID group. The mean increase in CMT was significantly lower in nepafenac 0.3% than prednisolone at 1 and 6 weeks (P = 0.003 and 0.004, respectively). Conclusion: NSAIDs used in isolation are comparable to prednisolone in preventing inflammation and pain after uneventful phacoemulsification. However, nepafenac 0.3% is most comparable to prednisolone and more efficacious in reducing the incidence of CME. We recommend that nepafenac 0.3% can be used as a sole anti?inflammatory agent in patients with uneventful phacoemulsification.
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Diabetic retinopathy (DR) is a retinal microvascular disease associated with diabetes which is the primary cause of impaired vision in working age population. Inflammatory reaction and inflammatory factors such as tumor necrosis factor-α (TNF-α) and interleukin (IL)-1β play an important role in the occurrence and development of DR, and to target at which anti-inflammatory treatments such as glucocorticoids and non-steroidal anti-inflammatory drugs were used, but with disputes on therapeutic effect and drug selection. This review aims to clarify the research on mechanism of inflammatory reaction in DR, summarize the application status of existing anti-inflammatory therapy, and provide some new ideas for the research and clinical application of the treatment of DR.
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Abstract Two sensitive and selective methods were developed for the simultaneous determination of four commonly used non-steroidal anti-inflammatory drugs (NSAIDs), namely; paracetamol (PCM), diclofenac sodium (DCF), ibuprofen (IBP), and indomethacin (IND) in wastewater effluents. The first method used HPLC for the determination of the studied drugs using a mobile phase consisting of phosphate buffer (pH 3.0) and acetonitrile at a flow rate of 1 mL/min. in gradient elution mode and detection at 220 nm. The separation process was performed on BDS Hypersil Cyano column (250 x 4.6 mm, 5 µm). The second method was a TLC-densitometric one which was performed using n-Hexane: ethyl acetate: acetic acid in the ratio (6:3.5:0.5) as a developing system. The proposed chromatographic methods were successfully applied for the selective determination of the four studied drugs in simulated and real pharmaceutical wastewater samples after their solid-phase extraction
Subject(s)
Industrial Effluents , Anti-Inflammatory Agents, Non-Steroidal/analysis , Drug Industry/classification , Wastewater/parasitology , Chromatography, High Pressure Liquid/methods , Acetates/adverse effectsABSTRACT
A erupção pigmentar fixa (EPF) é uma reação cutânea adversa a drogas relativamente comum, envolvendo cerca de 10% de todas as reações de hipersensibilidade a medicamentos (RHM). Envolve uma reação imunológica não imediata, mediada por células T CD8+ sensibilizadas, relacionada ao mecanismo do tipo IVc na classificação de Gell e Coombs. Um dos grupos mais frequentemente implicados nesse tipo de reação é o dos antiinflamatórios. Relatamos o caso de um homem que, 24 horas após iniciar tratamento com nimesulida para lombalgia, apresentou um quadro de lesões cutâneas tipo máculas eritemato-violáceas bem delimitadas e disseminadas pelo corpo. A nimesulida é um fármaco anti-inflamatório não esteroidal (AINE) pertencente à classe das sulfonanilidas, que atua como inibidor seletivo da enzima da síntese de prostaglandina, a ciclo-oxigenase, inibindo preferencialmente a COX-2. O diagnóstico foi comprovado pela realização do teste de contato, também conhecido como patch test, que traduziu positividade na segunda leitura realizada após 72 horas da sua colocação.
Fixed pigmented erythema (FPE) is a relatively common adverse drug reaction, consisting of approximately 10% of all drug hypersensitivity reactions. It involves a non-immediate immune reaction mediated by sensitized CD8+ T cells and related to the type IVc mechanism in the Gell-Coombs classification. One of the groups most frequently involved in this type of reaction is that of anti-inflammatory drugs. We report the case of a man who, 24 hours after starting treatment with nimesulide for low back pain, presented with well-defined cutaneous lesions consisting of erythematous-violaceous macules and spread throughout the body. Nimesulide is a non-steroidal anti-inflammatory drug (NSAID) belonging to the sulfonanilide class that acts as a selective inhibitor of the prostaglandin synthesis enzyme, cyclooxygenase (COX), preferentially inhibiting COX-2. The diagnosis was confirmed by a patch test, which translated positively in the second reading performed 72 hours after its placement.
Subject(s)
Humans , Male , Middle Aged , Anti-Inflammatory Agents, Non-Steroidal , Drug Hypersensitivity , Erythema , Therapeutics , Patch Tests , Prostaglandin-Endoperoxide Synthases , Low Back Pain , Diagnosis , Drug-Related Side Effects and Adverse ReactionsABSTRACT
Introducción: El dolor asociado a las alteraciones del sistema musculoesquelético debe ser tratado frecuentemente por los especialistas en Ortopedia. Los analgésicos no opioides se ubican dentro de los fármacos que más se prescriben en este Servicio, aunque no siempre de modo adecuado, según los principios de la prescripción racional. Objetivo: Caracterizar el uso de analgésicos no opioides en el servicio de Ortopedia del Hospital Dr. Salvador Allende. Material y Métodos: Estudio descriptivo de utilización de medicamentos del tipo prescripción-indicación y esquema terapéutico. Se revisaron las historias clínicas de 70 pacientes ingresados en el Servicio de Ortopedia del Hospital Dr. Salvador Allende, durante el período comprendido desde septiembre de 2018 hasta enero de 2019. Resultados: Predominó el sexo femenino y la media de edad de 71,3 años en los pacientes estudiados con una desviación estándar de 22.2 años. Los analgésicos más prescritos fueron dipirona, diclofenaco y paracetamol, en indicaciones aprobadas donde destacaron las fracturas, la celulitis y la seudoartrosis. En la totalidad de los casos, las dosis empleadas fueron adecuadas, no así los intervalos de administración ni la duración del tratamiento. Conclusiones: Es alentador el predominio de la prescripción de analgésicos no opioides con buena relación beneficio-riesgo. No obstante, la presencia de prescripciones irracionales en cuanto a intervalos de administración y duración del tratamiento, indica un déficit en la práctica de la terapéutica analgésica que no debe ser ignorado(AU)
Introduction: The pain associated with alterations of the musculoskeletal system should be frequently treated by the specialist in Orthopedics. Non-opioid analgesics are the most prescribed drugs in this medical service although they are not always used appropriately according to the principles of national prescription. Objective: To characterize the use of non-opioid analgesics in the orthopedics service of the Dr. Salvador Allende Hospital. Material and Methods: A descriptive study of the use of prescription-indication medications and therapeutic scheme was conducted. Medical records of 70 patients admitted to the orthopedics service of the Dr. Salvador Allende Hospital during the period between September 2018 and January 2019 were reviewed. Results: The female sex and a mean age of 71.3 years with standard deviation of 22,2 years predominated in the study. The most frequently used analgesics, which were indicated in the treatment of fractures, cellulitis and pseudarthrosis, were dipyrone, diclofenac and paracetamol. In all cases, the doses used were adequate, but not the administration intervals or the duration of treatment. Conclusions: The predominance of the prescription of non-opioid analgesics with a good benefit-risk ratio is encouraging. However, the presence of irrational prescriptions regarding administration intervals and duration of treatment indicates a deficit in analgesic therapy that should not be ignored(AU)
Subject(s)
Humans , Cellulitis/drug therapy , Analgesics, Non-Narcotic/therapeutic use , Fractures, Bone , Duration of Therapy , DosageABSTRACT
Objective:To investigate the predicting effect of the disrupted functional connectivity of the anterior cingulate cortex (ACC) on the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with migraineurs without aura (MwoA).Methods:From January 2019 to January 2021, seventy patients with migraine and thirty-three healthy people in the same period were selected.The functional connectivity analysis based on the ACC was used in MwoA patients with NSAIDS-effective ( n=35), MwoA patients with NSAIDS-ineffective ( n=35), and healthy controls (HCs) ( n=33). The abnormal resting-state functional connectivity patterns among the three groups were analyzed to reveal potential correlations with clinical characteristics in migraine. Then the receiver operating characteristic (ROC) curve was used to analyze the predictive ability of the abnormal ACC functional connectivity on the efficacy of NSAIDs in patients with MwoA. Results:(1)Compared with the MwoA patients with NSAIDs-ineffective, the MwoA patients with NSAIDs-effective showed higher functional connectivity between bilateral ACC and left middle cingulate cortex (MCC) (MNI: x, y, z=0, -24, 48, cluster=14, t=3.380) and postcentral gyrus (PoCG)( MNI: x, y, z=-21, -45, 69, cluster=12, t=3.016) (all P<0.005, Bonferroni correction). Compared with the HCs, patients with MwoA showed increased functional connectivity between left ACC and ipsilateral inferior parietal lobule, middle frontal gyrus (MFG) and angular gyrus (AG), and between right ACC and right precuneus, bilateral MFG and left AG (all P<0.005, Bonferroni correction). (2)There was a positive correlation between the functional connectivity of right ACC to right precuneus and MIDAS scores ( r=0.375, P=0.035) in MwoA patients with NSAIDs-effective. In MwoA patients with NSAIDs-ineffective, there were also significant correlations between the functional connectivity of left ACC to ipsilateral AG and MFG and headache onset duration ( r=0.357, P=0.045) and disease duration ( r=-0.367, P=0.039). (3)ROC curve analysis showed that the area under the curve (AUC) for the functional connectivity between the right ACC and left MCC and between the left ACC and left PoCG to predict the efficacy of NSAIDs were 0.728 and 0.736, respectively. Conclusions:Resting-state functional connectivity of the ACC is involved in the evaluation and prediction for analgesic efficacy of NSAIDs in migraine patients, which provides neuroimaging evidence for further investigations on the neurophysiological mechanism of migraine and assistance in clinical individualized precise treatment.
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Objective To systematically evaluate the efficacy and safety of different non-steroidal anti-inflammatory drugs (NSAIDs) in middle-aged and old Chinese patients with osteoarthritis(OA). Methods A systematic literature search was conducted through PubMed, Cochrane Library, CNKI, Wan Fang Data and VIP databases to collect randomized controlled trials with non-steroidal anti-inflammatory drugs in middle-aged to old Chinese OA patients. The search time was from the establishment of the database to November 17, 2020. Two researchers independently carried out literature screening, data extraction and literature quality evaluation. Bayesian network meta-analysis was conducted with R3.6.0 software. Results 28 RCTs were included with 2531 patients. Based on the last follow-up pain visual analogue scale (VAS) score, the ranking chart showed that Etoricoxib had the highest probability of having the lowest pain VAS score (88.55%). In terms of total effective rate, the ranking chart showed that the probability of Etoricoxib as first choice was the highest (92.49%). As far as safety, diclofenac sodium patch had the lowest adverse effects rate (59.10%). Conclusion The results of this study indicated that Etoricoxib was the most effective treatment for middle-aged and old Chinese OA patients. It can significantly reduce the OA pain. Diclofenac sodium patch had the least adverse effects.
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INTRODUCCIÓN: varios estudios a cargo de la Federación Internacional de Fútbol han identificado el abuso de AINE (Analgésicos Antinflamatorios No Esteroideo) en los futbolistas indicando que casi el 40% de los jugadores del mundial de 2010 tomaron medicamentos para el dolor antes de cada partido. OBJETIVO: identificar el nivel de conocimiento sobre AINE que presentan los futbolistas profesionales de las plantillas de primera división, a través del análisis y realidad de cada equipo. MÉTODO: se aplicaron encuestas validadas por los departamentos médicos de cada club y a través de preguntas abiertas, cerradas y formato de opción múltiple, se determinó que: la edad de los futbolistas profesionales en estudio oscila entre los 15 y 34 años. RESULTADOS: respecto al conocimiento del grupo farmacológico que contrarresta síntomas de dolor, fiebre e inflamación; se determinó que existe gran confusión e ignorancia en relación a la identificación de medicamentos y su conceptualización. Así mismo, respecto a principios activos que tratan dolor, fiebre e inflamación, se notó preferencia por Ibuprofeno, Paracetamol y Diclofenaco. Y que menos del 50% del total de futbolistas reconocen los efectos adversos de los fármacos en estudio. CONCLUSIÓN: existen falencias respecto al conocimiento de medicamentos (AINE), y que debido a la premura con la que requieren volver a las canchas, éstos profesionales del deporte, suelen confiar en personas que no se encuentran capacitados en medicina o en temas farmacológicos.
INTRODUCTION: several studies conducted by the International Football Federation have identified the abuse of NSAIDs (Non-Steroidal Anti-Inflammatory Analgesics) in soccer players, indicating that almost 40% of the 2010 World Cup players took pain medication before each match. OBJECTIVE: to identify the level of knowledge about NSAIDs presented by professional footballers of the first division squads, through the analysis and reality of each team. METHOD: surveys validated by the medical departments of each club were applied and through open and closed questions and multiple choice format, it was determined that: the age of the professional soccer players in the study ranges between 15 and 34 years. RESULTS: regarding the knowledge of the pharmacological group that counteracts symptoms of pain, fever and inflammation; It was determined that there is great confusion and ignorance in relation to the identification of drugs and their conceptualization. Likewise, with respect to active principles that treat pain, fever and inflammation, a preference was noted for Ibuprofen, Paracetamol and Diclofenac. And that less than 50% of all footballers recognize the adverse effects of the drugs under study. CONCLUSION: there are shortcomings regarding the knowledge of medications (NSAIDs), and that due to the haste with which they need to return to the courts, these sports professionals often trust people who are not trained in medicine or pharmacological issues.
INTRODUÇÃO: vários estudos realizados pela Federação Internacional de Futebol identificaram o uso abusivo de NSAIDs (Analgésicos Antiinflamatórios Não Esteróides) em jogadores de futebol, indicando que quase 40% dos jogadores da Copa do Mundo de 2010 tomavam analgésicos antes de cada partida. OBJETIVO: identificar o nível de conhecimento sobre os AINE apresentado por futebolistas profissionais das equipes da primeira divisão, por meio da análise e da realidade de cada equipe. MÉTODO: foram aplicadas pesquisas validadas pelos departamentos médicos de cada clube e por meio de questões abertas e fechadas e no formato de múltipla escolha, determinou-se que: a idade dos jogadores profissionais de futebol em estudo varia entre 15 e 34 anos. RESULTADOS: quanto ao conhecimento do grupo farmacológico que neutraliza os sintomas de dor, febre e inflamação; Constatou-se que existe grande confusão e desconhecimento em relação à identificação dos medicamentos e sua conceituação. Da mesma forma, no que diz respeito aos princípios ativos que tratam a dor, febre e inflamação, foi observada uma preferência para ibuprofeno, paracetamol e diclofenaco. E que menos de 50% de todos os jogadores de futebol reconhecem os efeitos adversos das drogas em estudo. CONCLUSÃO: há lacunas no conhecimento sobre medicamentos (NSAIDs) e que, devido à pressa com que precisam retornar às quadras, esses profissionais do esporte costumam confiar em pessoas sem formação em medicina ou farmacologia.
Subject(s)
Humans , Male , Adult , Pain , Soccer , Knowledge , Anti-Inflammatory Agents, Non-Steroidal , Ibuprofen , Equipment and Supplies , Fever , Analgesics , InflammationABSTRACT
Background: Post-partum family planning is prevention of unintended and closely spaced pregnancies during first 12 months following childbirth. Postpartum IUCD is the best method of all as it is the safest, most effective, has no effect on breast feeding, reliable and with minimum complications.Methods: The cross-sectional study was conducted in AIMSR Bathinda on 400 postpartum patients. It was a prospective, observational study of women who received PPIUCD in our region.Results: Out of total 400, 58% had normal vaginal delivery and 42% had cesarean section. PPIUCD was done in all cases after applying exclusion criteria and the females were called for follow up. 53% cases who had cesarean and 47% of normal vaginal delivery turned up for follow up. Acceptance is more in multipara (20.7%) than in primi patients (13.7%). Almost 90% patients had good continuation rate. There were few problems faced by patients like irregular bleeding for first few months, pain lower abdomen, leucorrhea etc. which were removed by good counseling and some treatment like NSAIDs for bleeding.Conclusions: The acceptance of PPIUCD was high in present study in both types of females delivered by normal vaginal delivery or post LSCS but with good counseling efforts. It was safe and effective and had high retention rate when done at good timing by trained service provider that is within 10 minutes of placental delivery. So the need of time is creating awareness of public towards it and removing fear from minds, breaking taboos and myths.
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Los antiinflamatorios no esteroideos son ampliamente recetados en niños. Constituyen la segunda causa de reacciones a medicamentos en pediatría después de los antibióticos betalactámicos; sin embargo, solo una parte de estas son reacciones de hipersensibilidad. La prevalencia de dichas reacciones a antiinflamatorios no esteroideos en niños es del 0,3 % y aumenta al 5 % en asmáticos.Los mecanismos fisiopatológicos involucrados (inhibición de la ciclooxigenasa, hipersensibilidad mediada por inmunoglobulina E, linfocitos T reactivos y/o afectación de la inmunidad innata) darán lugar a diferentes entidades clínicas con sintomatología dispar.La confusión con síntomas propios de procesos virales y la variabilidad clínica hacen del diagnóstico de certeza un verdadero desafío. Una historia clínica detallada, análisis de laboratorio, pruebas cutáneas y de provocación controlada permitirán definir estrategias para cada paciente en particular sin etiquetar como alérgico a un niño que no lo es ni exponer a riesgos innecesarios a quien está sensibilizado.
Nonsteroidal anti-inflammatory drugs are widely prescribed in children. They are the second cause of drug Ìs reactions in pediatrics after beta-lactam antibiotics, however only a part of them are hypersensitivity reactions. The prevalence of these reactions to nonsteroidal anti-inflammatory drugs in children is 0.3 %, increasing to 5 % in asthmatics.The different physiopathological mechanisms involved (inhibition of cyclooxygenase, immunoglobulin E-mediated hypersensitivity, reactive T lymphocytes and/or disturbance of innate immunity) will cause different clinical entities with diverse symptoms.The confusion between the common symptoms of a viral infection and a hypersensitivity reaction, and the variability of the clinical presentations make diagnosis a real challenge.A detailed clinical history, laboratory, skin and controlled provocation tests will provide strategies for each patient, without labeling a child who is not an allergic one, or taking unnecessary risks with those who are sensitized.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Anti-Inflammatory Agents, Non-Steroidal , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/drug therapy , Skin Tests , Cross Reactions , Drug Hypersensitivity/prevention & controlABSTRACT
Objectives of the study: Non-steroidal anti-inflammatory drugs (NSAIDs) belong to a group of drugs used in themanagement of pain. The aim of this study is to assess dentists’ knowledge of NSAIDs risks and to determine the mostprescribed NSAIDs by dentists.Materials and Methods: We collected information concerning the dentists’ knowledge of NSAIDs use and adverseeffects. A questionnaire consisting of 22 questions was distributed to 123 Albanian dentists reached in different dentalclinics, out of which only 87 agreed to participate. Only 70.73% of the distributed questionnaires were completed.Results: Respondents demonstrated poor knowledge of NSAIDs. Most of the respondents did not respond correctlyto the questions with 39.08% of incorrect answers regarding the implications of NSAIDs in elderly patients and only3.44% responded correctly to the contraindication of NSAIDs. The most common prescriptions were ketoprofen,ibuprofen, followed by ketorolac, aspirin, and diclofenac.Conclusions: Dentists who participated in the survey have limited knowledge of NSAIDs use, contraindication, andsafety limitation which can affect patients’ safety and well-being. Dentists should pay particular attention to informingpatients on NSAIDs use and should also keep updated on NSAIDs, through continuing education programs.
ABSTRACT
OBJECTIVE：To investigate the effects of parecoxib sodium ，flurbiprofen axetil and lornoxicam combined with patient controlled intravenous analgesia （PICA） on postoperative analgesia in patients undergoing gynecological laparoscopic surgery and its effect on serum related factors. METHODS ：A total of 280 patients who underwent gynecologic laparoscopic surgery in the Second Affiliated Hospital of Hainan Medical University from Mar. 2017 to Mar. 2019 were randomly divided into control group （group C ），parecoxib sodium group （group P ），and flurbiprofen axetil group （group F ）and lornoxicam group （group L ）acording to random number table ，with 70 patients in each group. Four groups of patients received Sodium chloride injection 5 mL，Parecoxib sodium for injection 40 mg，Flurbiprofen axetil injection 50 mg and Lornoxicam for injection 8 mg （added 8 mg when the effect was not good ）intravenously at 30 min before the end of surgery. At the end of surgery ，they were given PICA of Sufentanil citrate injection and Dizosin injection for analgesia. The situation of pain and nausea symptom were evaluated at 6，12，24 and 48 h after surgery by using numerical rating scale （NRS）. The levels of serum CRP ，IL-6，SP and PGE 2 were detected by chemiluminescence method and ELISA. The times of pressing PICA pump and the dosage of analgesic were recorded in 4 groups within 24 h after surgery. The ADRs of patients within 48 h after surgery were recorded ，such as bloating ， dizziness，itchy skin ，respiratory depression and urinary retention. RESULTS ：At different time points ，the NRS scores of pain of group P ，F and L were significantly lower than those of group C ；and 48 h after surgery ，NRS score of pain of group L was significantly lower than those of group P and F （P＜0.05）. There was no statistical significance in the level of CRP ，IL-6，SP and PGE2 of 4 groups before surger （P＞0.05）. The CRP ，IL-6，SP and PGE 2 levels at each time point after surgery of group P ，F and L were significantly lower than those of group C ；compared with group P ，serum level of SP at 48 h after surgery as well as serum levels of PGE 2 at 12，24 and 48 h after surgery were significantly decreased in group F ，and serum level of IL- 6 at 48 h after surgery，serum levels of SP at 24 and 48 h after surgery ，serum levels of PGE 2 at 12，24，48 h after surgery were decreased significantly in group L ；compared with group F ，serum level of SP at 48 h after surgery as well as serum levels of PGE 2 at 12， 24，48 h after surgery were all decreased significantly in group L （P＜0.05）. There was no statistical significance in the incidence of anausea and vomiting among 4 groups（P＞0.05）. CONCLUSIONS ：Parecoxib sodium ，flurbiprofen axetil and lornoxicam combined with PICA can effectively relieve the pain of patients after gynecological laparoscopic surgery and reduce the levels of serum related factor ，and lornoxicam has the most obvious effect.
ABSTRACT
Dysmenorrhea is the most common gynecologic condition in women during the reproductive period. Severe dysmenorrhea pain affects their social activities, sleep, and quality of life. Nevertheless, the proportion of women with dysmenorrhea do not receive adequate medical counseling or pharmacological treatments. Primary dysmenorrhea is diagnosed clinically, and the secondary causes that can cause pelvic pain should be identified. The treatment of choice for primary dysmenorrhea is non-steroidal anti-inflammatory drugs (NSAIDs). In order to maximize the therapeutic effect, it is necessary to ensure that the appropriate medication is administered in a proper way. NSAIDs can cause adverse effects, including gastrointestinal disorders. If side effects occur or are anticipated with NSAIDs, the use of hormonal contraceptives may be recommended when contraception is considered. In addition to these pharmacological treatments, heat, dietary, and behavioral therapies have been tried and reported to have some effects. However, further research is required for robust conclusions.
Subject(s)
Female , Humans , Anti-Inflammatory Agents, Non-Steroidal , Contraception , Contraceptive Agents , Counseling , Dysmenorrhea , Hot Temperature , Menstruation , Pelvic Pain , Quality of Life , ReproductionABSTRACT
The neurochemical mechanisms underlying neuropathic pain (NP) are related to peripheral and central sensitization caused by the release of inflammatory mediators in the peripheral damaged tissue and ectopic discharges from the injured nerve, leading to a hyperexcitable state of spinal dorsal horn neurons. The aim of this work was to clarify the role played by cyclooxygenase (COX) in the lesioned peripheral nerve in the development and maintenance of NP by evaluating at which moment the non-steroidal anti-inflammatory drug indomethacin, a non-selective COX inhibitor, attenuated mechanical allodynia after placing one loose ligature around the nervus ischiadicus, an adaptation of Bennett and Xie's model in rodents. NP was induced in male Wistar rats by subjecting them to chronic constriction injury (CCI) of the nervus ischiadicus, placing one loose ligature around the peripheral nerve, and a sham surgery (without CCI) was used as control. Indomethacin (2 mg/kg) or vehicle was intraperitoneally and acutely administered in each group of rats and at different time windows (1, 2, 4, 7, 14, 21, and 28 days) after the CCI or sham surgical procedures, followed by von Frey's test for 30 min. The data showed that indomethacin decreased the mechanical allodynia threshold of rats on the first, second, and fourth days after CCI (P<0.05). These findings suggested that inflammatory mechanisms are involved in the induction of NP and that COX-1 and COX-2 are involved in the induction but not in the maintenance of NP.
Subject(s)
Animals , Male , Rats , Sciatic Nerve/injuries , Pain Measurement , Indomethacin/administration & dosage , Neuralgia/drug therapy , Rats, Wistar , Rats, Sprague-Dawley , Pain Threshold , Constriction , Disease Models, Animal , Neuralgia/etiologyABSTRACT
ABSTRACT Introduction: Pain related to orthodontic tooth movement is common and cause dissatisfaction and discomfort. Objective: The present study aimed to compare the efficacy of naproxen patches in pain control during orthodontic tooth separation, by means of visual analogue scale (VAS) and interleukin 1β (IL-1β) levels in gingival crevicular fluid (GCF). Methods: In this split-mouth triple-blind clinical trial, with 40 patients following separation, 5% naproxen or placebo patches were randomly placed on the upper right or left first molars every 8 hours. Pain intensity scores were determined after 2 and 6 hours, sleep time, 24 hours, days 2, 3 and 7 by the patients using a 100-mm VAS ruler. IL-1β levels in GCF were evaluated by ELISA at baseline, 1 and 24 hours and 7 days. Paired samples t-tests and two-way repeated measures ANOVA analysis of variance with a significance level of 0.05 were applied. Results: A total number of 30 patients (13 males and 17 females) finished the trial. Significant differences were found in pain scores (p< 0.0001) and IL-1β levels (p= 0.047) between naproxen and placebo groups. Lower pain scores were reported for the patients using naproxen patches at all time points, except 1 hour after separation. IL-1β levels were lower for the patients using naproxen patches only 1 hour after separation (p= 0.047). The peak of pain scores and IL-1β levels were calculated at 24 hours. Conclusion: In the light of VAS scores and IL-1β levels, naproxen patches reduced the pain caused by separator placement.
RESUMO Introdução: a dor relacionada à movimentação dentária ortodôntica é comum e causa insatisfação e desconforto. Objetivo: o presente estudo teve como objetivo avaliar a eficácia de curativos de naproxeno no controle da dor durante a separação ortodôntica dos dentes, por meio de escalas visuais analógicas (EVA) e dos níveis de interleucina 1β (IL-1β) no fluido crevicular gengival (FCG). Métodos: neste ensaio clínico, triplo-cego, boca dividida, com 40 pacientes após a separação dos dentes, foram aplicados, de forma aleatória, curativos com naproxeno a 5% ou placebo, nos primeiros molares superiores, direito ou esquerdo, a cada 8 horas. Os escores de intensidade da dor foram registrados pelos pacientes após 2 e 6 horas, durante o sono, após 24 horas, 2, 3 e 7 dias, usando uma EVA de 100 mm. Os níveis de IL-1β no FCG foram avaliados pelo ELISA no momento inicial, e após 1 e 24 horas e 7 dias. Foram aplicados testes t para amostras pareadas e ANOVA de duas vias para medidas repetidas, com nível de significância de 0,05. Resultados: no total, 30 pacientes (13 homens e 17 mulheres) terminaram o ensaio clínico. Diferenças significativas foram encontradas nos escores de dor (p< 0,0001) e níveis de IL-1β (p= 0,047) entre os grupos naproxeno e placebo. Índices mais baixos de dor foram relatados pelos pacientes que usaram curativos de naproxeno em todos os tempos avaliados, com exceção de 1 hora após a separação. Os níveis de IL-1β foram menores nos pacientes que usaram os curativos de naproxeno apenas 1 'hora após a separação (p= 0,047). Os picos dos escores de dor e dos níveis de IL-1β foram registrados 24 horas após a separação. Conclusão: considerando-se os escores das EVAs e os níveis de IL-1β, pode-se concluir que os curativos de naproxeno reduziram a dor causada pela instalação dos separadores ortodônticos.