Medicina antienvelhecimento: notas sobre uma controvérsia sociotécnica / Anti-aging medicine: notes on a socio-technical controversy

Após algumas décadas de batalha, a geriatria e a gerontologia se tornaram as legítimas ciências do envelhecimento. Hoje surge uma contestação a tal condição. Em sua breve história, a medicina antienvelhecimento se afirmou como prática médica que questiona o modo de se endereçar o envelhecimento biológico. Com isso, toda a medicina é questionada. Aqui, exploramos especialmente como essa controvérsia se estrutura em torno dos fundamentos das ciências do envelhecimento. Há bases para esses questionamentos? Como eles foram tratados por aqueles que os receberam? Tendo em vista uma perspectiva sociotécnica, é interessante pensar que, para geriatras e gerontólogos, a necessária crítica à medicina antienvelhecimento também traz uma importante reflexão sobre o modo como as ciências do envelhecimento vêm tratando seu objeto.

After some decades of struggle, geriatrics and gerontology have become the legitimate sciences of aging. Today, their status is being questioned. In its short history, anti-aging medicine has taken root as a medical practice that questions how to address biological aging. In so doing, all medicine is questioned. Here, we explore in particular how this controversy is structured around the founding principles of the sciences of aging. Is there any basis for these questionings? How have they been treated by those who have received them? Taking a socio-technical viewpoint, it is worth considering that for geriatricians and gerontologists, the need to criticize anti-aging medicine also raises some important reflections about how the sciences of aging address their subject.

Evaluation of the application of enemas containing sucralfate in tissue content of neutral and acid mucins in experimental model of diversion colitis

PURPOSE: To evaluate the effects of sucralfate on tissue content of neutral and acids mucins in rats with diversion colitis. METHODS: Thirty-six rats were submitted to a proximal right colostomy and a distal mucous fistula. They were divided into two groups according to sacrifice to be performed two or four weeks after intervention. Each group was divided into three subgroups according daily application of enemas containing saline, sucralfate at 1.0 g/kg/day or 2.0 g/kg/day. Colitis was diagnosed by histological analysis and neutral and acid mucins by Periodic Acid Schiff and Alcian Blue techniques, respectively. The contents of mucins were quantified by computer-assisted image analysis. Student's t paired and ANOVA test were used to compare the contents of both types of mucins among groups, and to verify the variance with time, establishing level of signification of 5% for both (p<0.05). RESULTS: Enemas containing sucralfate improves the inflammation and increases the tissue contents of neutral and acid mucins. The content of neutral mucins does not change with the time or concentration of sucralfate used, while acid mucins increases with concentration and time of intervention. CONCLUSIONS: Sucralfate enemas improve the inflammatory process and increase the tissue content of neutral and acid mucins in colon without fecal stream. .

Comparison between sucralfate and ranitidine effects on gavage tolerance in ICU patients

The absolute rest of Gastrointestinal tract is leading to mucousal destitution and atrophy because of intestinal mucous dependent on luminal feeding for life. The important of prophylactic treatment against stress ulcer in ICU patients was obvious. This study have done to evaluate effects of drugs on gastric feeding tolerance in ICU patients. In this clinical trial study, 50 patients were randomly divided in two groups and received ranitidine or sucralfate for stress ulcer. The demographic variables [age, sex, weight], APACHE II score, TISS, episodes of dairrhea, emesis and gastric retention > 250 CC/6h have been determined in both groups. The data was analyzed by SPSS software using Chi2and T-test and fisher exact test and Mann-Whitney U tests. There were no statistical differences about demographic variables in both groups [P>0.05]. Comparison about the important difference wasn't between APACHE II and TISS scores. The rate of diarrhea and emesis in sacralfate group were lesser than ranitidine group [P<0.05]. Against stress ulcer, prophylaxis with sucralfate has better effect on gastric gavage tolerance than ranitidine

Estudio comparativo de la cicatrización en piel de conejo entre sucralfato y tartrato de ketanserin / Comparative study of wound healing in rabbit skin between sucralfate and ketanserin tartrate

Al sanar una herida se activa un proceso de reepitelización para generar una epidermis. Este proceso de cicatrización debe ocurrir rápido y efectivamente para prevenir los ataques provenientes del medio ambiente. Existe una gran variedad de cremas regeneradoras, dentro de las cuales se encuentran sucralfato (Cicalfate ®), de utilidad en medicina humana, y tartrato de ketanserin (Vulketan ®), utilizado como tratamiento convencional en medicina veterinaria. El objetivo general de este estudio fue comparar el grado de cicatrización y reacción inflamatorio entre sucralfato y tartrato de ketanserin en heridas quirúrgicas en piel del área superior de la pared torácica de conejos (Oryctologus cuniculis), los cuales se utilizaron como modelos animales para medir parámetros cicatriciales que son complicados de evaluar en forma rutinaria en estudios clínicos en el ser humano. Se emplearon 15 conejos machos. Sucralfato y tartrato de ketonserin fueron aplicados simultáneamente en 10 animales. Sucralfato se aplicó en el lado derecho y tartrato de ketanserin, en el lado izquierdo. Cinco conejos fueron tratados con suero fisiológico como grupo control. La evaluación se realizó mediante la Escala de Vancouver durante 19 días. Los resultados revelan que en el caso de ambas cremas regeneradoras no existe diferencia significativa en torno a los signos de vascularidad. Con respecto o los signos de plegabilidad, altura, pigmentación y dolor, sí existe diferencia significativa (P < 0,05) contribuyendo mejor sucralfato, por lo que se concluye que éste presento ventaja comparativa con respecto o tartrato de ketanserin al momento de realizar un tratamiento tópico para heridas en piel.

In healing o process of reepithelialization to generate epidermis start. This process must take place quickly and effectively to prevent attacks from the environment. There is a great variety of regenerative creams available such as sucralfate (Ciclalfate®) in human medicine and ketaserin tartrate (Vulketan®) used as a conventional treatment in veterinary medicine. The main objective of this study was to compare the healing degree and inflammatory reaction between sucralfate and ketanserin tartrate in surgical wounds on skin of the upper thoracic wall of rabbits (Oryctolagus cuniculis), which were used as animal models for measuring cicatricial parameters that are complicated to evaluate routinely in clinical trials in humans. Fifteen male rabbits were used Sucralfate and ketanserin tartrate were used simultaneously in 10 animals. Sucralfate was used on right side and ketanserin trartrate on the left side. Five rabbits were treated with physiological saline solution (control group). Wound evaluation were compared with the Scale of Vancouver during 19 days. The results showed that both regenerative creams had no significant differences in vascularity. In relation to pliability height, pigmentation and pain there was a significant difference (P < 0,05) between the two products in favor of sucralfate in the topical treatment of skin injuries.

Promotion of cutaneous wound healing by famotidine in Wistar rats.

BACKGROUND & OBJECTIVE: Drugs like famotidine, omeprazole and sucralfate which have been reported to promote the healing of gastric ulcers, may have the same effect on cutaneous wounds. Due to paucity of information in this regard, the present study was planned to investigate the effect of these drugs on resutured incision, excision and dead space wounds in Wistar rats. METHODS:Resutured incision, excision and dead space wounds were inflicted under light ether anaesthesia aseptically. Control animals received vehicle and other groups received famotidine, omeprazole and sucralfate orally for a period of 10 days in the incision and dead space wounds, whereas in excision wounds till complete closure. On the 11th day after estimating breaking strength of the resutured incision wounds, animals were sacrificed and granulation tissue removed from dead space wounds to estimate the breaking strength and hydroxyproline content. Quantification of granulation tissue and histological studies were also carried out. Wound closure rate, epithelization time and scar features were studied in the excision wound models from the day of famotidine till complete closure of the wound. RESULTS: Only famotidine significantly promoted the healing process in all the three wound models studied. Histopathological studies revealed increased collagen content and granulation tissue in famotidine treated group compared to control. INTERPRETATION & CONCLUSION: In all the three wound models studied famotidine promoted wound healing whereas omeprazole and sucralfate did not do so. The pro healing effect of famotidine needs to be explored clinically.

Honey potentiates the gastric protection effects of sucralfate against ammonia - induced gastric lesions in rats

Natural honey is widely used all over the world as a complementary and alternative medicine in various disorders including gastrointestinal lesions. To evaluate the effects of combination of low dosage of honey [0.312 g/kg] and sucralafe [0.125 or 0.250 g/kg] on gastric protection and to determine any potentiating interactions between them against ammonia- induced gastric lesions in rats. Material and Twenty-four hours fasted rats were given 1ml of ammonium hydroxide 1% intragastrically and they were killed one hour later under deep ether anesthesia. the gastric lesion index was calculated according to the methods of Takaishi et al 1998.non protein sulfhydryls level was determined spectrophotometrically as described by Sedlak and Lindsay 1968. Administration of ammonium hydroxide produced red and black linear lesions ands significant depletion of gastric nonprotein sulfhydryls level. Oral administration of honey [0.312 g/kg] or sucralfate [0.12 and 0.250 g/kg] 30 min before ammonium hydroxide reduced the severity of gastric mucosal lesions by 11 or 10 and 52% respectively, and has shown the changes in nonprotein sulfhydryls level induced by ammonium hydroxide. Furthermore, pretreatment with a combination of a low dose of honey [0.312 g/kg] and sucralfate [0.125 g or 0.250 g/kg] afforded significantly greater protection [58 and 77%] than that obtained with either of them administered alone. The present results suggest potentiation of gastric protection effect of sucralfate by honey and this may have a clinical value in the treatment of peptic ulcer disease in Helicobacter pylori positive patients

Utilizaçäo de sucralfato para prevençäo de mucosite na radioterapia dos tumores da cabeça e pescoço: um estudo randomizado / Utilization of sucralfate in the prevention of mucositis related to the radiotherapy of head and neck cancer: a randomized study

A mucosite da cavidade oral e faringe causada pela radioterapia nos tumores da cabeça e pescoço determina graus variáveis de dor e desconforto, constituindo um dos maiores fatores dose-limitantes, podendo causar até mesmo interrupçäo do tratamento. Costuma ser mais intensa nos casos que recebem quimioterapia neoadjuvante (QTNA) à radioterapia. Neste estudo foi testado o sucralfato, droga comercialmente disponível e utilizada como antiulcerosa, empregada prospectiva e randomizadamente num grupo de pacientes. Os resultados obtidos indicaram uma nítida reduçäo na incidência de mucosite nos pacientes tratados com QTNA que receberam sulcrafato. Houve também resposta evidente no grupo tratado apenas com radioterapia exclusiva, mas com menor impacto estatístico. Efeitos colaterais e morbidade foram desprezíveis. Estudos mais amplos devem ser desenvolvidos no futuro para identificaçäo mais precisa dos benefícios potenciais desta substância

Sucralfato: uma terapêutica esquecida / Sucralfate: a forgotten therapy

Säo revisados os aspectos farmacológicos do sucralfato e, enfatizados o seu uso clínico no tratamento da esofagite de refluxo, úlceras duodenal e gástrica, e na profilaxia da ulceraçäo de "stress"