ABSTRACT
Os anti-inflamatórios não esteroidais (AINE) estão entre os medicamentos mais utilizados no mundo e são os fármacos mais frequentemente associados à ocorrência de reações de hipersensibilidade na América Latina. As reações têm grande variabilidade de apresentações clínicas e, consequentemente, com abordagem terapêutica difícil. Nesta revisão, abordamos aspectos farmacológicos dos AINE, bem como as definições, epidemiologia e fisiopatologia das reações de hipersensibilidade aos AINE. Por fim, discutimos aspectos genéticos associados à intolerância e alergia a esses fármacos.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used medications worldwide and the drugs most frequently associated with the occurrence of hypersensitivity reactions in Latin America. The clinical presentation of the reactions varies widely, which makes them difficult to treat. In this review, we address pharmacological aspects of NSAIDs, as well as the definitions, epidemiology, and pathophysiology of hypersensitivity reactions to NSAIDs. Finally, we discuss genetic factors associated with intolerance and allergy to these drugs.
Subject(s)
Humans , Epidemiology , Genetic PhenomenaABSTRACT
Excessive infection and inflammation are the most common complications associated with castration. The objective of this study was to compare the efficacy of flunixin meglumine (FM), meloxicam (MX), or firocoxib (FX) for inflammation control after castration in horses using acute-phase proteins (APP) as markers of inflammation. Thirty healthy, unbroken, mixed-breed horses (body weight 358.62±45.57kg and age 4.99±2.63 years) were randomly (n=10 animals/group) allocated to receive one of three different post-castration anti-inflammatory medicines: Group 1 (FM 1.1mg/kg bwt, IV, s.i.d for 5 days); Group 2 (MX 0.6mg/kg bwt, IV, s.i.d for 5 days); and Group 3 (FX 0.1mg/kg bwt, IV, s.i.d for 5 days). All horses were castrated in standing position, using the open technique. Serum and peritoneal APP concentrations were measured by sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis (PAGE) and determined before castration (0), and 3, 5, 24, 48, 72, 120 and 168 hours after castration. The results were submitted to analysis of variance using the SAS statistical program, and means were compared by the Student-Newman-Keuls test (p<0.05). Three animals from the MX group developed hyperthermia (with rectal temperatures of 39.8, 39.3 and 38.9°C on day 4, 5 and 6, respectively) and showed local clinical signs of inflammation (inguinal and excessive scrotal edema) and reluctance to walk, as well as a rigid gait of the hind limbs. The same complications were observed in one FX horse. No complications were observed among the FM animals. The castration resulted in significant changes in serum and peritoneal values of total proteins, ceruloplasmin (Cp), transferrin (Tf), albumin (Alb), haptoglobin (Hp) and α1-acid glycoprotein (Gp) in animals of all experimental groups. However, the animals of the MX and FX groups presented more intense acute phase response compared to the animals of the FM group. Changes in the APP were associated with the surgical trauma of castration, but the differences between groups were associated with the ability of the nonsteroidal anti-inflammatory drug to control the inflammation. In conclusion, and based on the findings of acute phase proteins, flunixin is more efficient to control the magnitude of inflammation following castration as compared to meloxicam and firocoxib.(AU)
Infecção e inflamação excessivas são as complicações mais comuns associadas à castração. O objetivo deste estudo foi comparar a eficácia do flunixin meglumine (FM), meloxicam (MX) ou firocoxib (FX) no controle da inflamação após a castração em cavalos usando proteínas da fase aguda (APP) como marcadores de inflamação. Trinta equinos saudáveis (358,62±45,57kg; 4,99±2,63 anos) foram em função dos anti-inflamatórios utilizados após as castrações aleatoriamente (n= 10 animais/grupo) alocados em três diferentes grupos: Grupo 1 (FM 1,1mg/kg de peso, IV, sid por 5 dias); Grupo 2 (MX 0,6mg/kg de peso, IV, s.i.d por 5 dias); e Grupo 3 (FX 0,1mg/kg de peso, IV, s.i.d por 5 dias). Todos os cavalos foram castrados em posição quadrupedal, utilizando a técnica aberta. As concentrações de APP sérica e peritoneal foram separadas por eletroforese em gel de poliacrilamida (PAGE) com dodecil-sulfato de sódio (SDS) e determinadas no momento 0 (antes da castração) e com 3, 5, 24, 48, 72, 120 e 168 horas após a castração. Os resultados foram submetidos à análise de variância pelo programa estatístico SAS e as médias foram comparadas pelo teste de Student-Newman-Keuls (p<0,05). Três animais do grupo MX desenvolveram hipertermia (com temperatura retal de 39,8, 39,3 e 38,9° C nos dias 4, 5 e 6, respectivamente) e mostraram sinais clínicos locais de inflamação (edema inguinal e escrotal excessivo) e relutância em andar, bem como marcha rígida dos membros posteriores. As mesmas complicações foram observadas em um cavalo do FX. Não foram observadas complicações entre os animais do FM. Independente do grupo, a castração resultou em alterações significativas nos valores séricos e peritoneais de proteínas totais, ceruloplasmina (Cp), transferrina (Tf), albumina (Alb), haptoglobina (Hp) e glicoproteína ácida α1 (Gp). No entanto, os animais dos grupos MX e FX apresentaram resposta de fase aguda mais intensa quando comparados aos animais do FM. Alterações na resposta de fase aguda deveram-se ao trauma cirúrgico da castração, mas as diferenças entre os grupos foram associadas à capacidade do anti-inflamatório em controlar a inflamação. Em conclusão, baseado da resposta de fase aguda, o flunixin em comparação com o meloxicam e o firocoxib é mais eficiente no controle da inflamação após a castração em equinos.(AU)
Subject(s)
Animals , Male , Acute-Phase Proteins , Castration , Meloxicam , Horses/surgery , Anti-Inflammatory Agents/administration & dosage , Body Weight , OrchiectomyABSTRACT
ABSTRACT: Excessive infection and inflammation are the most common complications associated with castration. The objective of this study was to compare the efficacy of flunixin meglumine (FM), meloxicam (MX), or firocoxib (FX) for inflammation control after castration in horses using acute-phase proteins (APP) as markers of inflammation. Thirty healthy, unbroken, mixed-breed horses (body weight 358.62±45.57kg and age 4.99±2.63 years) were randomly (n=10 animals/group) allocated to receive one of three different post-castration anti-inflammatory medicines: Group 1 (FM 1.1mg/kg bwt, IV, s.i.d for 5 days); Group 2 (MX 0.6mg/kg bwt, IV, s.i.d for 5 days); and Group 3 (FX 0.1mg/kg bwt, IV, s.i.d for 5 days). All horses were castrated in standing position, using the open technique. Serum and peritoneal APP concentrations were measured by sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis (PAGE) and determined before castration (0), and 3, 5, 24, 48, 72, 120 and 168 hours after castration. The results were submitted to analysis of variance using the SAS statistical program, and means were compared by the Student-Newman-Keuls test (p 0.05). Three animals from the MX group developed hyperthermia (with rectal temperatures of 39.8, 39.3 and 38.9°C on day 4, 5 and 6, respectively) and showed local clinical signs of inflammation (inguinal and excessive scrotal edema) and reluctance to walk, as well as a rigid gait of the hind limbs. The same complications were observed in one FX horse. No complications were observed among the FM animals. The castration resulted in significant changes in serum and peritoneal values of total proteins, ceruloplasmin (Cp), transferrin (Tf), albumin (Alb), haptoglobin (Hp) and 1-acid glycoprotein (Gp) in animals of all experimental groups. However, the animals of the MX and FX groups presented more intense acute phase response compared to the animals of the FM group. Changes in the APP were associated with the surgical trauma of castration, but the differences between groups were associated with the ability of the nonsteroidal anti-inflammatory drug to control the inflammation. In conclusion, and based on the findings of acute phase proteins, flunixin is more efficient to control the magnitude of inflammation following castration as compared to meloxicam and firocoxib.
RESUMO: Infecção e inflamação excessivas são as complicações mais comuns associadas à castração. O objetivo deste estudo foi comparar a eficácia do flunixin meglumine (FM), meloxicam (MX) ou firocoxib (FX) no controle da inflamação após a castração em cavalos usando proteínas da fase aguda (APP) como marcadores de inflamação. Trinta equinos saudáveis (358,62±45,57kg; 4,99±2,63 anos) foram em função dos anti-inflamatórios utilizados após as castrações aleatoriamente (n= 10 animais/grupo) alocados em três diferentes grupos: Grupo 1 (FM 1,1mg/kg de peso, IV, sid por 5 dias); Grupo 2 (MX 0,6mg/kg de peso, IV, s.i.d por 5 dias); e Grupo 3 (FX 0,1mg/kg de peso, IV, s.i.d por 5 dias). Todos os cavalos foram castrados em posição quadrupedal, utilizando a técnica aberta. As concentrações de APP sérica e peritoneal foram separadas por eletroforese em gel de poliacrilamida (PAGE) com dodecil-sulfato de sódio (SDS) e determinadas no momento 0 (antes da castração) e com 3, 5, 24, 48, 72, 120 e 168 horas após a castração. Os resultados foram submetidos à análise de variância pelo programa estatístico SAS e as médias foram comparadas pelo teste de Student-Newman-Keuls (p 0,05). Três animais do grupo MX desenvolveram hipertermia (com temperatura retal de 39,8, 39,3 e 38,9° C nos dias 4, 5 e 6, respectivamente) e mostraram sinais clínicos locais de inflamação (edema inguinal e escrotal excessivo) e relutância em andar, bem como marcha rígida dos membros posteriores. As mesmas complicações foram observadas em um cavalo do FX. Não foram observadas complicações entre os animais do FM. Independente do grupo, a castração resultou em alterações significativas nos valores séricos e peritoneais de proteínas totais, ceruloplasmina (Cp), transferrina (Tf), albumina (Alb), haptoglobina (Hp) e glicoproteína ácida 1 (Gp). No entanto, os animais dos grupos MX e FX apresentaram resposta de fase aguda mais intensa quando comparados aos animais do FM. Alterações na resposta de fase aguda deveram-se ao trauma cirúrgico da castração, mas as diferenças entre os grupos foram associadas à capacidade do anti-inflamatório em controlar a inflamação. Em conclusão, baseado da resposta de fase aguda, o flunixin em comparação com o meloxicam e o firocoxib é mais eficiente no controle da inflamação após a castração em equinos.
ABSTRACT
A erupção fixa à droga (EFD) é uma reação de hipersensibilidade tardia a medicamentos caracterizada por máculas ou pápulas eritematosas, violáceas ou acastanhadas, bem demarcadas, que aparecem após uso de uma medicação, e reaparecem na mesma localização após exposições repetidas. A erupção fixa à droga bolhosa generalizada (EFDBG) é uma variante rara da EFD que foi recentemente incluída pelo RegiSCAR no grupo das farmacodermias graves. Apresenta-se através de lesões cutâneas generalizadas características de EFD, com formação de bolhas, geralmente em pacientes com história prévia de EFD. Os principais medicamentos envolvidos na EFDBG são antibióticos e anti-inflamatórios não esteroidais. O diagnóstico é clínico, entretanto, a biópsia cutânea na fase aguda e o teste de contato após a recuperação do paciente, podem auxiliar a investigação. O tratamento requer geralmente apenas a suspensão do fármaco suspeito e medidas de suporte. Relatamos um caso de EFDBG em adolescente após reexposição à dipirona (metamizol) apesar da história prévia de hipersensibilidade a esta medicação. O objetivo deste relato é alertar sobre a importância do diagnóstico da EFDBG e ressaltar os principais pontos para o diagnóstico diferencial com a síndrome de Stevens-Johnson (SSJ)/necrólise epidérmica tóxica (NET).
Fixed drug eruption (FDE) is a delayed drug hypersensitivity reaction characterized by erythematous, violaceous or brownish well-demarcated macules or papules that appear after use of a medication and reappear at the same site after repeated exposures. Generalized bullous fixed drug eruption (GBFDE) is a rare FDE variant that has been recently included by RegiSCAR in the group of severe cutaneous adverse reactions to drugs. GBFDE presents as generalized cutaneous lesions characteristic of FDE, with blistering, usually in patients with a previous history of FDE. The main drugs involved in GBFDE are antibiotics and nonsteroidal anti-inflammatory drugs. The diagnosis is clinical, but some tests can help the investigation, such as skin biopsy in the acute phase and patch testing after patient recovery. Treatment usually requires suspension of the suspected drug and some supportive measures. We report a case of GBFDE after reexposure to dipyrone (metamizole) in an adolescent with a previous history of hypersensitivity to this drug. The aim of this report is to warn about the importance of diagnosing GBFDE and to highlight the main points for differential diagnosis with Stevens- Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN).
Subject(s)
Humans , Male , Adolescent , Dipyrone , Drug Eruptions , Drug Hypersensitivity , Patients , Betamethasone , Prednisolone , Skin Tests , Anti-Inflammatory Agents, Non-Steroidal , Stevens-Johnson Syndrome , Diagnosis, DifferentialABSTRACT
0.05). Mean changes in central macular thickness showed significant differences at 1 and 4 months postoperatively (−1.44 ± 11.72 and 10.44 ± 22.48 µm in bromfenac group vs. 47.19 ± 70.24 and 31.69 ± 48.04 µm in control group, p 0.05).CONCLUSIONS: Treatment with 0.1% bromfenac sodium hydrate ophthalmic solution showed good efficacy for preventing cystoid macular edema early after cataract surgery in patients with diabetes.
Subject(s)
Humans , Anti-Inflammatory Agents, Non-Steroidal , Cataract , Diabetes Mellitus , Macular Edema , Retrospective Studies , Sodium , Visual AcuityABSTRACT
BACKGROUND/AIMS: The association between Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin therapy as a risk factor for peptic ulcer bleeding (PUB) remains unclear. This study investigated the risk of PUB associated with H. pylori infection and NSAID or low-dose aspirin therapy in patients with PUD. MATERIALS AND METHODS: This case-control study investigated 340 patients with PUB between 2012 and 2016. The control group comprised age and sex-matched patients with endoscopically documented non-bleeding ulcers. Using logistic regression analysis, the adjusted odds ratio (AOR) was calculated for the risk of PUB. RESULTS: Of the patients investigated, 57.9% in the study group and 51.8% in the control group were diagnosed with H. pylori infection (P=0.106). Logistic regression analysis showed synergistic interaction between H. pylori infection and low-dose aspirin therapy. Multivariate analysis showed that low-dose aspirin (AOR 3.92, P < 0.001), NSAIDs (AOR 2.98, P=0.001), warfarin (AOR 14.57, P=0.011), gastric ulcer (compared with duodenal ulcer) (AOR 1.65, P=0.01), and smoking (AOR 1.97, P=0.004) increased the risk of PUB compared with the risk of PUD. CONCLUSIONS: Both NSAIDs and aspirin are independent risk factors for bleeding in patients with PUD. Additionally, low-dose aspirin therapy concomitant with H. pylori infection produced a synergistic effect. Therefore, H. pylori eradication may be crucial in aspirin users. Moreover, a proton pump inhibitor should be prescribed in patients with a history of bleeding ulcers who need long-term NSAID treatment.
Subject(s)
Humans , Anti-Inflammatory Agents, Non-Steroidal , Aspirin , Case-Control Studies , Helicobacter pylori , Helicobacter , Hemorrhage , Logistic Models , Multivariate Analysis , Odds Ratio , Peptic Ulcer , Proton Pumps , Risk Factors , Smoke , Smoking , Stomach Ulcer , Ulcer , WarfarinABSTRACT
Non-Helicobacter pylori, non-NSAID peptic ulcer disease (PUD), termed idiopathic PUD, is increasing in Korea. Diagnosis is based on exclusion of common causes such as H. pylori infection, infection with other pathogens, surreptitious ulcerogenic drugs, malignancy, and uncommon systemic diseases with upper gastrointestinal manifestations. The clinical course of idiopathic PUD is delayed ulcer healing, higher recurrence, higher re-bleeding after initial ulcer healing, and higher mortality than the other types of PUD. Genetic predisposition, older age, chronic mesenteric ischemia, cigarette smoking, concomitant systemic diseases, and psychological stress are considered risk factors for idiopathic PUD. Diagnosis of idiopathic PUD should systematically explore all possible causes. Management of this disease is to treat underlying disease followed by regular endoscopic surveillance to confirm ulcer healing. Continuous proton pump inhibitor therapy is an option for patients who respond poorly to the standard ulcer regimen.
Subject(s)
Humans , Diagnosis , Genetic Predisposition to Disease , Korea , Mesenteric Ischemia , Mortality , Peptic Ulcer , Proton Pump Inhibitors , Proton Pumps , Recurrence , Risk Factors , Smoking , Stress, Psychological , UlcerABSTRACT
PURPOSE: Advanced cancer may accompany cold sweat as paraneoplastic symptom. Few studies have been performed on the efficacy of non-steroid anti-inflammatory drug (NSAID) in advanced cancer patients who sweated without fever. METHODS: To select study participants, medical records were retrospectively reviewed for patients who satisfied the following criteria: 1) incurable, advanced solid cancer; 2) Cold sweating of 4 or higher on the numeric rating scale (NRS) 4; 3) No evidence of infection or hypoglycemia; 4) No newly started opioid or anti-hormonal agents within one month; 5) NSAID prescription for the management of cold sweating and 6) Documented NRS information before and after NSAID administration. RESULTS: A total of 13 patients were selected after excluding four patients due to lack of NRS information or fever. The mean age was 59 years old (range: 50~71), and nine patients (69%) were male. Bile duct cancer was the most common primary tumor followed by pancreatic cancer, gastric cancer and prostate cancer. The mean NRS of cold sweating dropped from baseline 6.5 (min-max: 4~10) to 1.9 at the follow-up assessment (min-max: 0~5). The mean follow-up period was 9.1 days (range: 2~30 days) from NSAID treatment to assessment. CONCLUSION: NSAID was effective medication for management of sweating without fever in patients with advanced cancer.
Subject(s)
Humans , Male , Anti-Inflammatory Agents , Anti-Inflammatory Agents, Non-Steroidal , Bile Duct Neoplasms , Fever , Follow-Up Studies , Hospices , Hypoglycemia , Medical Records , Pancreatic Neoplasms , Prescriptions , Prostatic Neoplasms , Retrospective Studies , Stomach Neoplasms , Sweat , SweatingABSTRACT
BACKGROUND/AIMS: The prevalence of peptic ulcer disease has not decreased mainly due to an increase in the use of NSAIDs. This study was conducted in order to determine whether a chronic NSAID-induced gastric inflammation model could be established by repeated administration of NSAID. METHODS: Indomethacin (10 mg/kg) was administered once per week for six weeks in 8- and 26-week rats and animals were sacrificed every week after administration. Gross ulcer index, histologic damage index, myeloperoxidase (MPO) activity, and mucus (glucosamine) levels were measured. Small bowel damage was also evaluated. RESULTS: Gross gastric damage index showed a peak level at three weeks and then decreased slowly in the 26-week indomethacin group. Gastric mucosal glucosamine level increased in both the 8-week (p=0.038) and 26-week groups (p=0.007). In addition, gastric mucosal MPO level decreased in the 8-week group (p=0.018) but did not show a decrease in the 26-week group. Small bowel damage began to occur at three weeks during the schedule and eight of 36 rats (22.2%) died due to perforation or peritonitis of the small bowel in the 8- and 26-week indomethacin groups, respectively. CONCLUSIONS: Due to gastric adaptation and small bowel damage, repeated administration of NSAID to experimental animals may not be an adequate method for establishment of the chronic gastric inflammation model.
Subject(s)
Animals , Male , Rats , Anti-Inflammatory Agents, Non-Steroidal/toxicity , Disease Models, Animal , Gastric Mucosa/drug effects , Glucosamine/metabolism , Indomethacin/toxicity , Intestine, Small/drug effects , Peroxidase/metabolism , Rats, Sprague-Dawley , Time FactorsABSTRACT
BACKGROUND/AIMS: The prevalence of peptic ulcer disease has not decreased mainly due to an increase in the use of NSAIDs. This study was conducted in order to determine whether a chronic NSAID-induced gastric inflammation model could be established by repeated administration of NSAID. METHODS: Indomethacin (10 mg/kg) was administered once per week for six weeks in 8- and 26-week rats and animals were sacrificed every week after administration. Gross ulcer index, histologic damage index, myeloperoxidase (MPO) activity, and mucus (glucosamine) levels were measured. Small bowel damage was also evaluated. RESULTS: Gross gastric damage index showed a peak level at three weeks and then decreased slowly in the 26-week indomethacin group. Gastric mucosal glucosamine level increased in both the 8-week (p=0.038) and 26-week groups (p=0.007). In addition, gastric mucosal MPO level decreased in the 8-week group (p=0.018) but did not show a decrease in the 26-week group. Small bowel damage began to occur at three weeks during the schedule and eight of 36 rats (22.2%) died due to perforation or peritonitis of the small bowel in the 8- and 26-week indomethacin groups, respectively. CONCLUSIONS: Due to gastric adaptation and small bowel damage, repeated administration of NSAID to experimental animals may not be an adequate method for establishment of the chronic gastric inflammation model.
Subject(s)
Animals , Male , Rats , Anti-Inflammatory Agents, Non-Steroidal/toxicity , Disease Models, Animal , Gastric Mucosa/drug effects , Glucosamine/metabolism , Indomethacin/toxicity , Intestine, Small/drug effects , Peroxidase/metabolism , Rats, Sprague-Dawley , Time FactorsABSTRACT
Introducción: el manejo del dolor debe ser adaptado y optimizado de acuerdo con las condiciones de cada hospital, tipo de cirugía y paciente. Objetivos: ealuar la percepción del dolor de los pacientes intervenidos en el postoperatorio del Hospital Universitario San Jorge de Pereira. Materiales y métodos: Se realizó un estudio de corte, prospectivo en pacientes mayores de 18 años entre 2 de septiembre y 28 de octubre de 2011. La valoración de intensidad del dolor postoperatorio se realizó mediante Escala Visual Analógica a las 24 horas del postquirúrgico. Se consideraron variables sociodemográficas, clínicas (tipo de cirugía, anestesia, riesgo) y farmacológicas (medicamentos empleados, dosis, intervalos dosificación). El análisis se hizo con SPSS 20.0 para Windows. Resultados: Se evaluaron 153 pacientes en postoperatorio, 80 (52,3%) mujeres y 73 (47,7%) hombres, con edad promedio de 47,6 ± 20,2 años. El 38,8% de los pacientes no tenía controlado el dolor. Las variables de cirugía ortopédica, el empleo de anestesia general por vía intravenosa, y el incumplimiento de los intervalos recomendados de dosificación de los analgésicos, se asociaron de manera estadísticamente significativa con la falta de control. Discusión: El control del dolor fue inadecuado haciendo evidente la necesidad de replantear su manejo ajustado a guías de práctica clínica, formalizando el uso de medicamentos, en dosis e intervalos adecuados que garanticen una analgesia efectiva.
Introduction: Pain management should be adapted and optimized according to the conditions of each hospital, type of surgery and patient. Objectives: To evaluate the perception of pain in postoperative patients at Hospital Universitario San Jorge of Pereira. Materials and methods: A descriptive observational study in patients older than 18 years, between September 2nd to October 28, 2011. The assessment of postoperative pain intensity was performed by visual analogue scale 24 hours after surgery. We considered socio-demographic, clinical (type of surgery, anesthesia, risk) and pharmacological variables (drugs used, dosage, dosage intervals). The analysis was done with SPSS 20.0 for Windows. Results: We evaluated 153 patients in the postoperative period, 80 (52.3%) women and 73 (47.7%) males, mean age 47.6 ± 20.2 years. 38.8% of patients did not obtain pain control. The variables of orthopedic surgery, the use of intravenous general anesthesia, and suboptimal dosage was statistically significantly associated with lack of control. Conclusions: Pain control was inadequate thus showing the need to redefine its management by following clinical practice guidelines, through the use of analgesics in doses and appropriate intervals.
Introdução: o manejo da dor deve ser adaptado e otimizado de acordo com as condições de cada hospital, tipo de cirurgia e paciente. Objetivos: avaliar a percepção da dor dos pacientes intervindos no pós operatório do Hospital Universitário San Jorge de Pereira. Materiais e métodos: Realizou-se um estudo de corte, prospectivo em pacientes maiores de 18 anos entre 2 de setembro e 28 de outubro de 2011. A valoração de intensidade da dor pós-operatória se realizou mediante Escala Visual Analógica às 24 horas do pós-cirúrgico. Consideraram-se variáveis sociodemográficas, clínicas (tipo de cirurgia, anestesia, risco) e farmacológicas (medicamentos empregados, doses, intervalos, dosagem). A análise se fez com SPSS 20.0 para Windows. Resultados: Se avaliaram 153 pacientes em pós-operatório, 80 (52,3%) mulheres e 73 (47,7%) homens, com idade média de 47,6 ± 20,2 anos. O 38,8% dos pacientes não tinha controlada a dor. As variáveis de cirurgia ortopédica, o emprego de anestesia geral por via intravenosa, e o descumprimento dos intervalos recomendados de dosagem dos analgésicos, se associaram de maneira estatisticamente significativa com a falta de controle. Discussão: O controle da dor foi inadequado fazendo evidente a necessidade de repensar o seu manejo ajustado a guias de prática clínica, formalizando o uso de medicamentos, em doses e intervalos adequados que garantam uma analgesia efetiva.
Subject(s)
Humans , Adult , Pain, Postoperative , Practice Guideline , Colombia , Analgesics, Opioid , Anti-Inflammatory AgentsABSTRACT
BACKGROUND AND OBJECTIVES: Our previous study showed that nonsteroidal anti-inflammatory drug-activated gene (NAG-1) induced apoptosis in tongue cancer cells. However, the NAG-1 expression in tongue cancer and normal tissues was not studied. The aim of this study was to investigate the expression of NAG-1 in oral tongue cancer and normal tissues and to identify the relationship between NAG-1 expression and the prognosis of tongue cancer patients to determine whether NAG-1 can be used as a valuable prognostic marker in tongue cancer. SUBJECTS AND METHOD: The medical records and pathologic reports of 42 tongue cancer patients who received surgery as primary treatment were surveyed. Tongue cancer and normal tissues, which were obtained during the operation, were stained with anti-NAG-1 antibody using the immunohistochemical method and the H-score was calculated. RESULTS: As a result, the higher expression of NAG-1 was observed in the cancer tissues than in the normal tissues. NAG-1 expression was noted to be higher in cases of tongue cancers with more invasion, positive lymph node metastasis, and poor prognosis. A 5-year survival rate was significantly decreased in cases showing higher NAG-1 expression in the cancer tissues than in the normal tissues. CONCLUSION: The higher NAG-1 expression in the cancer tissue suggests malignant changes in cancer tissue and poor prognosis. Therefore, NAG-1 may be a useful prognostic marker in tongue squamous cell carcinoma.