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1.
J. oral res. (Impresa) ; 10(2): 1-10, abr. 30, 2021. ilus, tab
Article in English | LILACS | ID: biblio-1382212

ABSTRACT

Objetive: The degenerative diseases of the tempo-romandibular joint (TMJ) are characterized by a progressive destruction of the articular tissues of the condyle and the glenoid fossa. The main aim of this review is to describe the effectiveness of the hyaluronic acid (HA) in the treatment of degenerative diseases of the TMJ in accordance with the available scientific evidence. Material and Methods: A literature search was made in the following databases EBSCO, Pubmed, Cochraneand Trip Database, using the keywords hyaluronic, hyaluronan, NaH, hyaluronate, TMJ, TMD, CMD, craniomandibular, orofacial pain and temporomandibular. There were no date or language restrictions applied. Results: After applying inclusion and exclusion criteria, 14 studies were included in this review (11 randomized controlled clinical trials and 3 non-randomized clinical trials). Conclusion: The studies reported a decrease in pain and improvement in functional parameters after treatment of TMJ osteoarthritis with HA . The use of arthrocentesis associated with the administration of HA provides effects synergistic, reaching a superiority the protocols with multiple injections with respect to those of a single session. The adverse effects related to the injection of HA with or without associated arthrocentesis were minor and transitory.


Resumen: Objetivo: Las enfermedades degenerativas de la articulación temporomandibular (ATM) se caracterizan por una destrucción progresiva de tejidos articulares en el cóndilo y la fosa glenoidea. El objetivo principal de esta revisión es describir la efectividad del uso de ácido hialurónico en el tratamiento de enfermedades degenerativas de la articulación temporomandibular de acuerdo con la evidencia científica disponible. Material y Métodos: Se realizó una búsqueda de la literatura en las bases de datos electrónicas EBSCO, PubMed, Cochrane y Trip Database, utilizando las palabras claves hyaluronic, hyaluronan, NaH, hyaluronate, tmj, tmd, cmd, craniomandibular, orofacial pain y temporomandibular, sin límite de fecha ni de idioma hasta Mayo del año 2020, complementada con una búsqueda retrógrada. Resultados: Con base en los criterios de inclusión y exclusión, 14 estudios fueron incluidos en esta revisión (11 ensayos clínicos controlados aleatorizados y 3 ensayos clínicos controlados no aleatorizados). Conclusión: Los estudios reportaron una disminución del dolor y mejora en los parámetros funcionales luego del tratamiento de osteoartritis de la ATM con AH. El uso de artrocentesis asociada a la administración del AH provee efectos sinérgicos, alcanzando una superioridad los protocolos con múltiples inyecciones con respecto a aquellos de una sola sesión. Los efectos adversos relacionados con la inyección de AH con o sin artrocentesis asociada fueron menores y transitorios.


Subject(s)
Humans , Osteoarthritis/drug therapy , Temporomandibular Joint Disorders/drug therapy , Hyaluronic Acid/administration & dosage , Facial Pain , Viscosupplementation , Arthrocentesis
2.
Article in Chinese | WPRIM | ID: wpr-878892

ABSTRACT

The rat osteoarthritis model was replicated by injection of sodium iodoacetate into the knee joint cavity, and the effects of Gancao Fuzi Decoction on rat osteoarthritis and the proteome of articular cartilage were investigated. Sixty SD rats weighing 230-250 g were randomly divided into normal group, model group, glucosamine sulfate group, and Gancao Fuzi Decoction high, medium and low dose groups. Osteoarthritis model was induced by intra-articular injection of sodium iodoacetate(3 mg on each leg) in all groups except the normal group. After modeling, each administration group was given intragastric administration for 1 month. During the administration period, joint pain test and joint width measurement were performed every week to observe the autonomous behavior of rats. Enzyme linked immunosorbent assay(ELISA) method was used to detect the contents of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), matrix metalloproteinase-3(MMP-3), and matrix metalloproteinase tissue inhibitor(TIMP-1) in rat joint lavage fluid. Hematoxylin-eosin(HE) staining was used to observe bone and joint morphology. Nano-LC-LTQ-Orbitrap system was used to detect arti-cular cartilage proteins. The results showed that, compared with the model group, Gancao Fuzi Decoction could significantly improve joint pain and joint swelling in osteoarthritis rats, significantly reduce the contents of TNF-α, IL-1β and MMP-3 in the joint cavity la-vage fluid, increase the content of TIMP-1, and relieve inflammatory diseases such as enlarged joint space, rough cartilage edge, different thickness of cartilage layer, and disordered arrangement of chondrocytes. After comparing the proteins between the groups, 273 differential proteins were screened out. KEGG analysis found that the above differential proteins involved 43 signaling pathways such as systemic lupus erythematosus, among which 11 signaling pathways were related to osteoarthritis. The above results indicated that Gancao Fuzi Decoction had a preventive effect on osteoarthritis, and its mechanism of action may be accomplished by regulating the protein expression of osteoarthritis-related signal pathways.


Subject(s)
Animals , Cartilage, Articular , Drugs, Chinese Herbal , Osteoarthritis/drug therapy , Plant Extracts , Proteomics , Rats , Rats, Sprague-Dawley
3.
Salud colect ; 17: e3246, 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1290035

ABSTRACT

RESUMEN En abril de 2016, el Instituto Nacional de Servicios Sociales para Jubilados y Pensionados excluyó del subsidio social la cobertura al 100% de 159 fármacos, entre ellos, los antiartrósicos sintomáticos de acción lenta o symptomatic slow-acting drugs for osteoarthritis (SySADOA), por insuficiente evidencia de beneficio clínico significativo. Evaluamos el efecto de esta medida sobre la utilización de SySADOA y de los antiinflamatorios no esteroides (AINE), no afectados por la medida. Se compararon las dispensas ambulatorias de los SySADOA y los AINE de 2015 a 2017, midiendo unidades dispensadas, precio de venta al público y gasto de bolsillo del beneficiario para cada mes. Luego de la medida, descendieron un 61,6% los envases de SySADOA dispensados y un 63,4% el monto total del precio de venta al público, medido en valores constantes. La dispensa no se reorientó hacia los AINE, que descendieron un 6,1%. Disminuyó tanto la incidencia de nuevos tratamientos (de 6,4 a 3,3 tratamientos por 1.000 beneficiarios por mes) como su continuidad. El gasto de bolsillo de los beneficiarios en SySADOA aumentó un 75,8% (a valores constantes). La desinversión en intervenciones de valor terapéutico cuestionable es una herramienta valiosa para la sustentabilidad de los sistemas de salud.


ABSTRACT In April 2016, the National Institute of Social Services for Retirees and Pensioners discontinued its policy of 100% coverage for 159 drugs (the "social subsidy"), including symptomatic slow-acting drugs for osteoarthritis (SYSADOAs), due to insufficient evidence of significant clinical benefit. We evaluated the effect of this measure on the use of SYSADOAs as well as non-steroidal anti-inflammatory drugs (NSAIDs), which were unaffected by this policy change. We compared outpatient dispensations of SYSADOAs and NSAIDs from 2015 to 2017, measuring dispensed units, retail price, and out-of-pocket expenses for beneficiaries each month. After the change in coverage, there was a 61.6% total decrease in SYSADOA units dispensed, and a 63.4% decrease in the final sales price to the public, measured in constant values. Dispensation was not reoriented towards NSAIDs, which fell by 6.1%. The incidence of new treatments decreased (from 6.4 to 3.3 treatments per 1,000 beneficiaries per month), as did their continuity. Beneficiaries' out-of-pocket spending on SYSADOAs increased by 75.8% (at constant values). Disinvestment in interventions with questionable therapeutic value is an important tool in working toward the sustainability of health systems.


Subject(s)
Humans , Osteoarthritis/drug therapy , Pharmaceutical Preparations , Argentina , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Glucosamine/therapeutic use
4.
J. appl. oral sci ; 29: e20210329, 2021. tab, graf
Article in English | LILACS | ID: biblio-1346398

ABSTRACT

Abstract Objectives To investigate the effect of a standardized extract of Centella asiatica (ECa 233), which has anti-inflammatory properties, on the local expression of the transient receptor potential vanilloid 1 (TRPV1), the acid-sensing ion channel subunit 3 (ASIC3), and the calcitonin gene-related peptide (CGRP) in the temporomandibular joint (TMJ) structure 21 days after injecting the TMJ with complete Freund's adjuvant (CFA). Methodology A mouse model was induced by analyzing the CFA-injected TMJ on days 7, 14, and 21. We assessed TMJ histology by the osteoarthritis cartilage grade score. Then, we observed the effect of different ECa 233 concentrations (30, 100, and 300 mg/kg) and of 140 mg/kg ibuprofen doses on TRPV1, ASIC3, and CGRP local expression on day 21. Results Osteoarthritis cartilage scores were 1.17±0.37 and 3.83±0.68 on days 14 and 21, respectively, in the CFA group (n=5). On day 21, TRPV1, ASIC3, and CGRP expression significantly increased in the CFA group. In the ibuprofen-treated group, TRPV1 expression significantly decreased, but ASIC3 and CGRP showed no significant difference. All ECa 233 doses reduced TRPV1 expression, but the 100 mg/kg ECa 233 dose significantly decreased ASIC3 expression. Conclusions TRPV1, ASIC3, and CGRP expression increased in mice with TMJ-OA on day 21. All ECa 233 and ibuprofen doses inhibited pathogenesis by modulating the local expression of TRPV1 and ASIC3. Therefore, ECa 233 was more effective than ibuprofen.


Subject(s)
Animals , Rabbits , Osteoarthritis/drug therapy , Centella , Temporomandibular Joint , Plant Extracts/pharmacology , Inflammation Mediators
6.
Clinics ; 74: e722, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001822

ABSTRACT

OBJECTIVES: This study aimed to provide evidence for understanding how to treat osteoarthritis (OA) in our country. Therefore, it was necessary to match information and investigations related to the treatment of the disease from the three main types of specialists involved: physiatrists, orthopedists and rheumatologists. METHODS: The authors acted as a scientific advisory committee. From the initial discussions, a structured questionnaire was developed for use with a group of specialists on OA using the Delphi technique. The questionnaire was sent to 21 experts appointed by the authors, and the results obtained were critically analyzed and validated. RESULTS: The prevalence of OA was 33% in Brazil, corresponding to one-third of the individuals in the reference population, which included individuals over 25 years of age. Another significant finding was that most patients did not receive any form of treatment in the early stages of OA. CONCLUSION: The committee pointed to the need for early intervention and that the available medicinal resources can fulfil this important role, as is the case with SYSADOA treatments. Glucosamine-based medicinal products with or without chondroitin could also fulfill this need for early treatment. The other generated evidence and included investigations were then grouped together and are the subject of this publication.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Osteoarthritis/therapy , Delphi Technique , Clinical Competence/standards , Evidence-Based Medicine/standards , Orthopedics/standards , Osteoarthritis/drug therapy , Physical and Rehabilitation Medicine/standards , Severity of Illness Index , Brazil , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Chondroitin Sulfates/therapeutic use , Treatment Outcome , Osteoarthritis, Knee/therapy , Consensus , Drug Therapy, Combination , Glucosamine/therapeutic use
7.
Rio de Janeiro; s.n; 2019. 77 p.
Thesis in Portuguese | LILACS, ColecionaSUS | ID: biblio-1151977

ABSTRACT

A artroplastia total de joelho (ATJ) é um procedimento cirúrgico bem estabelecido, com altas taxas de sucesso para o tratamento da osteoartrite avançada do joelho que resulta, na maioria dos pacientes, em alívio da dor e melhora funcional da articulação. Embora a ATJ seja uma cirurgia eletiva segura, podem ocorrer complicações que resultam em maior tempo de internação e necessidade de readmissão hospitalar. Uma forma de reduzir o impacto das intercorrências é a identificação de possíveis fatores de risco para desenvolver complicações. A adoção de estratégias preventivas voltadas para controlar os fatores de risco potencialmente reduz a morbidade, a mortalidade e os custos diretos e indiretos com a ATJ. O objetivo do presente estudo foi determinar os fatores de risco para a ocorrência de complicações até trinta dias após realização de artroplastia total primária do joelho, a prevalência e o impacto das complicações sobre o tempo de internação e a necessidade de readmissão hospitalar. Foram incluídos no estudo 1.035 procedimentos de ATJ primária unilateral realizados no Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad, no período de setembro de 2011 até fevereiro de 2016. Os parâmetros préoperatórios (idade, gênero, índice de massa corporal, ASA e comorbidades) e a ocorrência de complicações sistêmicas e locais até o 30º dia de pós-operatório foram obtidos por busca ativa nos prontuários. A identificação dos possíveis fatores de risco para ocorrência de qualquer complicação e a relação entre a ocorrência de complicação com o tempo de internação e com a necessidade de readmissão foi feita através de análise univariada. Em 4,3% dos procedimentos houve associação com algum tipo de complicação pósoperatória, sendo 2,8% complicações sistêmicas e 1,5% locais. Do total das complicações apresentadas pelos pacientes, 1,8% foram classificadas como graves e 2,5% como de baixa gravidade. Não foi registrado nenhum óbito no período pós-operatório de 30 dias. Diabetes e história de evento cardíaco prévio foram identificados como fatores de risco para complicação pós-operatória. Os pacientes que complicaram, permaneceram mais de 10 dias internados e/ou necessitaram de reinternação hospitalar. O baixo índice de complicações até trinta dias após a realização de ATJ, incluindo ausência de óbito, pode ser atribuído à estruturação multidisciplinar do atendimento médico realizado na instituição, a adoção de protocolos eficazes de anticoagulação e de reabilitação e o rastreamento de infecção no pré-operatório. Apesar dos baixos índices de complicações, nossos resultados mostram a importância de considerar a associação de fatores de risco com complicações pós-operatórias em pacientes que serão submetidos a ATJ. A adoção de estratégias preventivas voltadas para controlar os fatores de risco terá um impacto direto sobre o tempo de internação e readmissão hospitalar e, consequentemente, sobre os custos do procedimento para o sistema de saúde


Total knee arthroplasty (TKA) is a well-established surgical procedure with high success rates for the treatment of advanced knee osteoarthritis that results in pain relief and functional joint improvement in most patients. Although TKA is safe elective surgery, complications may occur that result in longer hospital stays and the need for hospital readmission. A way to reduce the impact of complications is to identify possible risk factors associated with complications. The adoption of prevention strategies designed to control risk factors potentially reduces morbidity, mortality, and direct and indirect costs regarding TKA. The aims of the present study were to determine the risk factors for complications occurring within 30 days of primary total knee arthroplasty (TKA), the prevalence and impact of complications on length of stay, and the need for hospital readmission. The study included 1,035 procedures of unilateral primary TKA at the Jamil Haddad National Institute of Traumatology and Orthopedics, from September 2011 to February 2016. Preoperative parameters (age, gender, body mass index, ASA and comorbidities) and the occurrence of systemic and local complications up to the 30th postoperative day were obtained by an active search of patients' medical records. The identification of possible risk factors for the occurrence of any complication and the relationship between the occurrence of complication with the length of stay and the need for readmission was performed through univariate analysis. In 4.3% of the procedures, there was an association with some type of postoperative complication of which 2.8% were systemic and 1.5% local. Of the total complications presented by patients, 1.8% were classified as severe whereas 2.5% were classified as low severity. No deaths were recorded in the 30-day postoperative period. Diabetes and history of the previous cardiac events were significantly associated with the risk of postoperative complications. Affected patients remained in the hospital for more than 10 days and/or required hospital readmission. The low complication rate up to 30 days after TKA, including the absence of death, can be attributed to the multidisciplinary structure of medical care provided at the institution, the adoption of effective anticoagulation and rehabilitation protocols and preoperative infection screening. Despite the low complication rates, our results show the importance of considering the association of risk factors with postoperative complications in patients undergoing TKA. The adoption of prevention strategies for the control of risk factors will have a direct impact on the length of hospital stay and readmission and, consequently, on the health system costs


Subject(s)
Osteoarthritis/drug therapy , Postoperative Complications/surgery , Arthroplasty, Replacement, Knee
8.
Rev. Círc. Argent. Odontol ; 77(227): 13-17, dic. 2018. ilus, tab
Article in Spanish | LILACS | ID: biblio-1122775

ABSTRACT

La osteoartrosis es una enfermedad degenerativa que, instalada en la articulación temporomandibular, genera efectos deletéreos en los tejidos blandos y óseos que la constituyen. En los tejidos duros se destaca la aparición de procesos osteolíticos a nivel condilar y de la cavidad glenoidea con cambios morfológicos importantes. Estas modificaciones están íntimamente relacionadas con el debilitamiento y/o destrucción de los tejidos blandos que ocurren previamente. Los síntomas que se presentan con mayor frecuencia en esta afección son la alteración del rango de movimiento, el dolor y, el más característico, la crepitación durante el examen con estetoscopio. La frecuencia de aparición alcanza entre un 8% y un 18%. Las causas para su documentación son variables y están vinculadas al desplazamiento discal, el trauma, hormonales y la inestabilidad oclusal, siendo el aumento de carga (bruxismo) la de mayor significación. El examen imagenológico puede documentar aplanamiento de los componentes óseos, disminución del espacio articular, discontinuidad de las corticales, esclerosis subcondral, osteofitos, quistes subcondrales y cuerpos libres periarticulares. En ocasiones la radiografía panorámica puede ser poco demostrativa para la documentación de esas particularidades; por el contrario, la tomografía computada es un excelente procedimiento diagnóstico. El aporte de la IRM es relevante en la ubicación del disco articular; asimismo, posibilita la observación de colección de fluido en los espacios articulares, generando una señal hiperintensa. Tratamiento: actuar principalmente para disminuir la carga sobre la ATM y,`por lo tanto, concientizar al paciente de la presencia del bruxismo, instalar un dispositivo oclusal miorrelajante (DOM) y suplementar con analgésicos, antiinflamatorios y antiartrósicos. Cuando la OA está asociada al desplazamiento discal, debe indicarse un dispositivo oclusal de desplazamiento anterior mandibular (DODAM) (AU)


Osteoarthrosis is a degenerative disease. When is located in the TMJ produces deleterious effects in its soft and hard tissues, osteolytic processes on condyle and glenoid cavity in the latter, with significant morphological changes, closely related to weakening and destruction of the tissues that had happened previously. Symptoms most frequent are alteration of the range of movement, pain and,the most characterystic, cracking while examination through stethoscope. Its frequency is between 8 and 18%.Causes for its documentation are variable and related to disc displacement, trauma, hormones and occlusal unsteadiness, being de increase of charge (clenching) the most relevant. Imaging can show flattening on osseusparts,, the articular space, discontinuation of cortexes, subchondral sclerosis, osteophytes, subchondral cysts,and loose particular bodies. Sometimes orthopantomograph may be barely demonstrative to document these phenomena, conversely CT is an excellent diagnostic procedure. The contribution of MRI is relevant to locate articular disc, and facilitate visualize fluid collection within the articular spaces, producing a hiperintense signal. Treatment: to act mainly for diminishing charge on the TMJ, so to raise patients conscience of the presence of clenching, install a myorelaxant occlusal device (DOM) and additionally analgesics, antiinflamatories and antiarthrosis When osteoarthrosis is associated with disc displacement and occlusal device for anterior mandibular displacement (DODAM) is suitable(AU)


Subject(s)
Humans , Male , Female , Osteoarthritis/pathology , Temporomandibular Joint Disorders/diagnostic imaging , Osteoarthritis/drug therapy , Signs and Symptoms , Bruxism , Magnetic Resonance Imaging , Radiography, Panoramic , Tomography Scanners, X-Ray Computed , Chronic Disease , Chondroitin Sulfates/therapeutic use , Occlusal Splints , Age and Sex Distribution , Analgesics/therapeutic use , Anti-Inflammatory Agents
9.
Braz. J. Pharm. Sci. (Online) ; 54(4): e17534, 2018. tab, graf
Article in English | LILACS | ID: biblio-1001576

ABSTRACT

Diacerein (DCN) was obtained by diacetylation of an anthraquinone derivative rhein and was approved by FDA in 2008, in the treatment of osteoarthritis due to its inhibitory effect on proinflammatory cytokines, including IL-6 and IL-1ß. It was synthesized in 1980s and marketed as a tablet in some European Union and Asian countries from 1994. Along with its great potential in the treatment of osteoarthritis, its other applications are also being explored day by day, such as in the treatment of psoriasis, epidermolysis bullosa, breast cancer, type 2 diabetes and periodontitis. The main aim of this review is to explore mechanism of action, various applications and side effects associated with DCN. This has been reviewed that apart from the risk of diarrhea on long-term administration of DCN, various clinical studies has also shown its modest benefits in treatment of various pathological conditions. Hence, DCN is emerging as a new and potentially safe derivative with maximum therapeutic efficacies and minimum side effects which can results in improving the living status of patients suffering from various inflammatory diseases


Subject(s)
Osteoarthritis/drug therapy , Pharmaceutical Preparations/analysis , Pharmacologic Actions , Chondrocytes/drug effects
11.
Braz. j. med. biol. res ; 51(8): e7440, 2018. graf
Article in English | LILACS | ID: biblio-951737

ABSTRACT

Considering that osteoarthritis (OA) is the most prevalent joint disease worldwide, multiple pharmacological treatments have been proposed to alter the articular structure with potential benefit in the progression of the disease. The so-called disease-modifying OA drugs have been frequently investigated but conclusive findings are rare. Strontium ranelate (SrRan) is a drug usually prescribed to treat osteoporosis, with proven effects in decreasing the risk of fractures and possible effect in reducing the progression of OA. The objective of this review was to demonstrate the current panorama of knowledge on the use of SrRan in clinical and experimental models, clarifying its mechanisms of action and describing possible anti-nociceptive and anti-inflammatory effects. The systematic review was based on the PRISMA statement and included articles that are indexed in scientific databases. Fifteen studies were included: seven pre-clinical and eight clinical studies. Despite the limited number of studies, the results suggest a positive effect of SrRan in patients with OA, through changes in functional capacity and reduction of progression of morphological parameters and joint degradation, with moderate quality of evidence for those clinical outcomes. Novel studies are necessary to elucidate the molecular targets of SrRan, focusing on anti-inflammatory effects and histological changes promoted by SrRan, which seemed to reduce the progression of OA in the experimental and clinical studies.


Subject(s)
Humans , Animals , Osteoarthritis/drug therapy , Thiophenes/therapeutic use , Bone Density Conservation Agents/therapeutic use , Thiophenes/pharmacology , Bone Resorption/drug therapy , Cartilage, Articular/drug effects , Bone Remodeling/drug effects , Disease Progression , Arthralgia/drug therapy , Bone Density Conservation Agents/pharmacology
12.
Int. j. morphol ; 35(3): 870-876, Sept. 2017. ilus
Article in English | LILACS | ID: biblio-893066

ABSTRACT

The aim of this study was to perform a literature review regarding the role of hyaluronic acid (HA) in the homeostasis and therapeutics of temporomandibular joint (TMJ) osteoarthritis (OA). The TMJ has characteristics that give it special adaptation and recovery abilities, where HA plays a fundamental role in helping to maintain joint homeostasis, which is affected in pathological processes like OA. OA is a chronic degenerative multi-factor disease that can affect all the components of the synovial joints, causing degradation of the articular cartilage, extracellular matrix and breakage in the HA molecules. HA is a non-branched linear polysaccharide with viscosupplementation, anti-inflammatory, lubrication and pain relief effects; it also activates the intrinsic repair processes of the cartilage and normalizes the endogenous production of HA by the synoviocytes. In recent years, the therapeutic use of HA has shown evidence that supports its application in TMJ OA, improving viscosupplementation capacity, acting at the cellular and molecular levels, reducing various inflammatory mediators and improving the reparative characteristics. Its use has been studied in animal models and in humans. However, no consensus has been reached in terms of concentrations, dose, application frequency or molecular weight to be used.


El objetivo de este estudio fue realizar una revisión de la literatura respecto del rol del ácido hialurónico (AH) en la homeostasis y terapéutica de la osteoartritis (OA) de la articulación temporomandibular (ATM). La ATM presenta características que le confieren propiedades de adaptación y recuperación especiales, donde el AH juega un rol fundamental ayudando a mantener la homeostasis articular, la cual se ve afectada en procesos patológicos como la OA. La OA es una enfermedad multifactorial crónica degenerativa que puede afectar a todos los componentes de las articulaciones sinoviales, generando degradación del cartílago articular, matriz extracelular y quiebre de las moléculas de AH. El AH es un polisacárido lineal no ramificado que presenta efectos de viscosuplementación, antiinflamatorios, lubricantes, en el alivio del dolor, permite además, activar procesos intrínsecos de reparación del cartílago y normalizar la producción endógena de AH por parte de los sinoviositos. En los últimos años el uso terapéutico del AH ha presentado evidencia que sustenta su aplicación en OA de ATM mejorando la capacidad de viscosuplementación, actuando a nivel celular y molecular, disminuyendo diversos mediadores inflamatorios y mejorando las características reparativas. Su uso se ha estudiado en modelos animales y en humanos, sin embargo no existe consenso en cuanto a concentraciones, dosis, frecuencias de aplicación y peso molecular a utilizar.


Subject(s)
Osteoarthritis/drug therapy , Temporomandibular Joint Disorders/drug therapy , Viscosupplementation/methods , Hyaluronic Acid/administration & dosage , Temporomandibular Joint/drug effects , Homeostasis/drug effects
13.
Rio de Janeiro; s.n; 2017. 69 p.
Thesis in Portuguese | LILACS, ColecionaSUS | ID: biblio-1151754

ABSTRACT

A artroplastia total de joelho (ATJ) está associada a sangramento per operatório significativo, que é causa potencial de complicações. Por isso, medidas que possam minimizá-lo devem ser constantemente investigadas. Os agentes hemostáticos, tipo selantes de fibrina humano, têm se mostrado como alternativas para alcançar este objetivo, porém alguns componentes de suas formulações como o ácido tranexâmico e a aprotinina têm se associado a complicações alérgicas e irritativas ao sistema nervoso central, surgindo então um selante de fibrina humano livre de tais substâncias. O objetivo desse estudo foi avaliar os resultados do uso tópico intraoperatório do selante de fibrina humano Evicel® em pacientes com osteoartrite submetidos à ATJ, buscando diferenças entre os grupos em relação à perda sanguínea, necessidade transfusional, tempo de internação hospitalar, amplitude de movimento, percepção de dor e incidência de complicações de cicatrização de feridas, infecciosas e tromboembólicas. Foram analisados prospectivamente um grupo de intervenção com 32 pacientes e um grupo controle com 31 pacientes, com osteoartrite sintomática dos joelhos, submetidos à ATJ. Os resultados foram semelhantes entre os grupos, em relação à perda sanguínea visível no dreno em 24h (Controle 276,5 mL ± 46,24 vs. Evicel 365,9 mL ± 45,73), à perda sanguínea total em 24h (Controle 930 mL ± 78 vs. Evicel 890 mL ± 67) e em 60h de pós-operatório (Controle 1250 mL ± 120 vs. Evicel 1190 mL ± 96;), à necessidade de hemotransfusão (ocorreu em apenas um controle), ao tempo de permanência hospitalar (Controle 5,61 ± 0,50 n=31 vs. Evicel 4,81 ± 0,36), dor pósoperatória e amplitude de movimento. O uso do agente selante de fibrina não se relacionou à ocorrência de complicações da cicatrização de ferida, infecção ou à trombose venosa profunda. Concluímos que o agente hemostático de fibrina humana não foi eficaz em reduzir o volume de sangramento e a necessidade de hemotransfusão ou interferir sobre o tempo de internação hospitalar, percepção de dor e amplitude de movimento. Seu uso não se relacionou a nenhuma complicação


Total knee arthroplasty is associated with significant per operative bleeding, which is a potential cause of complications. So, measures that may minimize it should be constantly investigated. Hemostatic agents, such as human fibrin sealants, have been shown as alternatives to achieve this goal, but some components of their formulations (tranexamic acid and aprotinin), have been associated with complications like allergy and irritative central nervous system reactions, and a fibrin sealant has emerged, free of these substances. The goal of this study was to evaluate the results of the intraoperative topical use of the Evicel® human fibrin sealant in total knee arthroplasties, looking for differences between groups in relation to blood loss, transfusional need, length of hospital stay, range of motion, pain perception and incidence of complications. We analyzed prospectively an intervention group with 32 patients and a control group with 31 patients with symptomatic knee osteoarthritis who underwent arthroplasty. The results were similar between the groups, in relation to the visible blood loss in the drain in 24h (Control 276.5 mL ± 46.24 vs. Evicel 365.9 mL ± 45.73), the total blood loss in 24h (Control 930 mL ± 78 vs. Evicel 890 mL ± 67) and in the postoperative 60h (Control 1250 mL ± 120 vs. Evicel 1190 mL ± 96), the need for blood transfusion (occurred in only one control), the length of hospital stay (Control 5.61 ± 0.50 n=31 vs. Evicel 4.81 ± 0.36), postoperative pain and range of motion. Its use was not related to the occurrence of wound healing complications, infection or to deep venous thrombosis. We conclude that the new hemostatic agent of human fibrin was not effective in reducing bleeding volume and the need for blood transfusion or interfering with hospital length of stay, pain perception and range of motion. Its use was not related to any complications.


Subject(s)
Humans , Osteoarthritis/drug therapy , Fibrin Tissue Adhesive/therapeutic use , Arthroplasty, Replacement, Knee
14.
Int. j. med. surg. sci. (Print) ; 3(3): 959-962, sept. 2016.
Article in Spanish | LILACS | ID: biblio-1088105

ABSTRACT

La osteoartritis es un tipo de trastorno temporomadibular de origen articular, siendo uno de los procesos degenerativos óseos que más comúnmente afectan a la articulación temporomandibular. Se caracteriza por remodelación del hueso subcondral subyacente, deterioro y abrasión del tejido articular. Las infiltraciones intraarticulares de ácido hialurónico se consideran beneficiosas para el tratamiento del dolor y la recuperación de propiedades de los tejidos articulares. El objetivo de éste artículo es describir el uso de ácido hialurónico en el manejo de osteoartritis de articulación temporomandibular en un paciente adolescente. Paciente de sexo femenino, 15 años de edad, presenta dolor de un año de evolución en la región preauricularbilateral, con aumento de dolor en apertura máxima. Considerando el examen clínico e imagenológico se diagnostica una luxación discal con reducción con componente osteoartritico e inflamatorio bilateral. Se indica reposo mandibular, dieta líquida, AINEs y se realiza la aplicación intraarticular de ácido hialurónico(Suprahyalâ 25 mg/2,5 ml) bilateral. Se cita a control a las 2, 3 y 16 semanas donde la paciente se encuentra sin dolor espontaneo y a la palpación. El uso de ácido hialurónico es una de las alternativas terapeúticas más utilizadas para el manejo de la osteoartritis de articulación temporomandibular, sin embargo es necesario que la evidencia de su aplicación intraarticular en adolescentes y niños se consolide.


Osteoarthritis is a type of articular origin Temporomandibular disorders, being one of themost common degenerative processes affecting thetemporomandibular joint. It is characterized byremodeling of the underlying subchondral bone,deterioration and abrasion of articular tissue. Intra-articular injections of hyaluronic acid are considered beneficial for treatment of pain and recovery of joint tissues properties. The aim of this article is to describe the use of hyaluronic acid in the management of osteoarthritis of temporomandibular joint in an adolescent patient. Female patient, 15 years old,presented pain with a year of progress in the bilateral preauricular region, with increased pain at maximum aperture. Considering the clinical and imaging tests the patient was diagnosed with disk displacement with reduction with bilateral osteoarthritic and inflammatory component. Mandibular rest, liquid diet, NSAIDs were indicated and the application of intra-articular hyaluronicacid (Suprahyalâ 25 mg / 2.5 ml) bilaterally. Control was quoted at 2, 3 and 16 weeks where the patient has no spontaneous pain and tenderness. The use of hyaluronic acid is one of the most commonly usedtherapeutic alternatives for the management ofosteoarthritis of temporomandibular joint. However,further evidence of its use in intra-articular application in adolescents and children should be incorporated.


Subject(s)
Humans , Female , Adolescent , Osteoarthritis/drug therapy , Temporomandibular Joint/drug effects , Viscosupplements/administration & dosage , Hyaluronic Acid/administration & dosage , Temporomandibular Joint Disorders/drug therapy , Viscosupplements/therapeutic use , Musculoskeletal Pain/etiology , Hyaluronic Acid/therapeutic use , Injections, Intra-Articular
15.
Int. j. morphol ; 34(1): 291-297, Mar. 2016. ilus
Article in English | LILACS | ID: lil-780508

ABSTRACT

This study aims to observe the 3-D structural changes in subchondral bone and the effects of bisphosphonate intervention in the early unsteady stage of the knee joint. Sixty healthy male New Zealand white rabbits were divided into the model group (n= 24), the bisphosphonate (Bis) group (n= 24), and the control group (n= 12). The rabbits' right knees were used to evaluate the structural changes. The Bis group received subcutaneous injections of bisphosphonate, while the model and control groups received subcutaneous injections of isotonic saline solution. After surgical preparation, the knee joint was dissected for Micro-CT examination, and the Micro-CT results were compared using ANOVA. In the fourth postoperative week, the bone volume fraction (BVF), trabecular number (Tb.N), and trabecular thickness (Tb.Th) of the model group were significantly lower than those of the control group (P<0.01). There was no significant difference between the Bis and control groups. In the twelfth postoperative week, BVF, Tb.Th, and Tb.N of the model group were significantly higher than those of the control and Bis groups (P <0.05). Similarly, bone mineral density was higher in the model group (P <0.01), while the trabecular spacing was significantly lower (P <0.05). In the early unsteady stage of the knee joint, the subchondral bone had markedly decreased, while obvious bone formation was visible in the late stage. Bisphosphonates could protect the subchondral bone structure by inhibiting bone absorption.


El objetivo fue observar los cambios estructurales en 3-D del hueso subcondral y los efectos de la intervención con bifosfonatos en la etapa temprana de la inestabilidad de la articulación de la rodilla. Sesenta conejos blancos New Zealand machos sanos se dividieron en tres grupos: modelo (n= 24), bisfosfonato (Bis) (n= 24) y control (n= 12). Las rodillas derechas de los conejos se utilizaron para evaluar los cambios estructurales. El grupo Bis recibió inyecciones subcutáneas de bisfosfonato, mientras que los grupos modelo y control recibieron inyecciones subcutáneas de solución salina isotónica. Después de la preparación quirúrgica, la articulación de la rodilla fue disecada para su análisis mediante micro-TC, y los resultados se compararon mediante ANOVA. En la cuarta semana postoperatoria, la fracción del volumen óseo (GVF), el número trabecular (Tb.N) y el espesor trabecular (Tb.Th) del grupo modelo fueron significativamente más bajos que los del grupo control (P <0,01). No hubo diferencia significativa entre los grupos control y Bis. En la semana 12 postoperatoria, BVF, Tb.Th, y Tb.N del grupo modelo fueron significativamente mayores que los del grupo control y Bis (P <0,05). Del mismo modo, la densidad mineral ósea fue mayor en el grupo modelo (P <0,01), mientras que la separación trabecular fue significativamente menor (<0,05 P). En la etapa inestable temprana de la articulación de la rodilla, el hueso subcondral disminuyó notablemente, mientras que la formación ósea obvia fue visible en la etapa tardía. Los bisfosfonatos podrían proteger la estructura ósea subcondral mediante la inhibición de la absorción ósea.


Subject(s)
Animals , Male , Rabbits , Bone and Bones/diagnostic imaging , Bone and Bones/drug effects , Diphosphonates/administration & dosage , Osteoarthritis/diagnostic imaging , Osteoarthritis/drug therapy , X-Ray Microtomography/methods , Bone and Bones/pathology , Imaging, Three-Dimensional , Osteoarthritis/pathology
16.
Actual. osteol ; 12(3): 197-214, 2016. graf, ilus
Article in English | LILACS, BINACIS, UNISALUD | ID: biblio-1371338

ABSTRACT

Treatment of osteoarthritis (OA) with antiremodeling agents has had a mixed record of results. It is likely that remodeling suppression is only effective when used in the early phases of OA, before significant progression. Animal and human studies largely bear this out. Treatment of young mice with a RANKL inhibitor suppresses bone resorption and prevents OA progression. Likewise, bisphosphonate treatments in rodents and rabbits with induced injury or inflammatory arthritis, reduced cartilage degeneration when administered preemptively, but later administration did not. The increased prevalence of OA in women after the menopause, and presence of estrogen receptors in joint tissues, suggests that treatment with estrogens or Selective Estrogen Receptor Modulators may be effective. However, in clinical trials of knee and hip, results show decreased or increased risk for OA, or no effect. Raloxifene had positive effects in animal models, but no effect in human studies. More recent potential treatments such as strontium ranelate or cathepsin-K inhibitors may be effective, but may work directly on the cartilage rather than through their well-known effects on bone. The conclusion from these studies is that anti-remodeling agents must be administered pre-emptively or in the very early stages of disease to be effective. This means that better imaging techniques or identification of early structural changes in bone that occur before progressive cartilage destruction must be developed. (AU)


Subject(s)
Humans , Animals , Female , Mice , Rabbits , Osteoarthritis/prevention & control , Osteoarthritis/drug therapy , Bone Remodeling/drug effects , Raloxifene Hydrochloride/therapeutic use , Diphosphonates/therapeutic use , Cathepsin K/therapeutic use , Osteoarthritis/pathology , Rodentia , Postmenopause , Disease Progression , Raloxifene Hydrochloride/pharmacology , Selective Estrogen Receptor Modulators/therapeutic use , Selective Estrogen Receptor Modulators/pharmacology , Models, Animal , Diphosphonates/pharmacology , Estrogens/therapeutic use , RANK Ligand/antagonists & inhibitors , Cathepsin K/antagonists & inhibitors , Cathepsin K/pharmacology
17.
Braz. j. med. biol. res ; 48(10): 863-870, Oct. 2015. tab, ilus
Article in English | LILACS | ID: lil-761606

ABSTRACT

We aimed to investigate the effects of an anti-tumor necrosis factor-α antibody (ATNF) on cartilage and subchondral bone in a rat model of osteoarthritis. Twenty-four rats were randomly divided into three groups: sham-operated group (n=8); anterior cruciate ligament transection (ACLT)+normal saline (NS) group (n=8); and ACLT+ATNF group (n=8). The rats in the ACLT+ATNF group received subcutaneous injections of ATNF (20 μg/kg) for 12 weeks, while those in the ACLT+NS group received NS at the same dose for 12 weeks. All rats were euthanized at 12 weeks after surgery and specimens from the affected knees were harvested. Hematoxylin and eosin staining, Masson's trichrome staining, and Mankin score assessment were carried out to evaluate the cartilage status and cartilage matrix degradation. Matrix metalloproteinase (MMP)-13 immunohistochemistry was performed to assess the cartilage molecular metabolism. Bone histomorphometry was used to observe the subchondral trabecular microstructure. Compared with the rats in the ACLT+NS group, histological and Mankin score analyses showed that ATNF treatment reduced the severity of the cartilage lesions and led to a lower Mankin score. Immunohistochemical and histomorphometric analyses revealed that ATNF treatment reduced the ACLT-induced destruction of the subchondral trabecular microstructure, and decreased MMP-13 expression. ATNF treatment may delay degradation of the extracellular matrix via a decrease in MMP-13 expression. ATNF treatment probably protects articular cartilage by improving the structure of the subchondral bone and reducing the degradation of the cartilage matrix.


Subject(s)
Animals , Female , Adalimumab/pharmacology , Antirheumatic Agents/pharmacology , Bone and Bones/drug effects , Cartilage, Articular/drug effects , Osteoarthritis/drug therapy , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Arthroplasty, Subchondral , Anterior Cruciate Ligament/surgery , Arthritis, Experimental/drug therapy , Bone and Bones/metabolism , Cartilage, Articular/metabolism , Extracellular Matrix/drug effects , Hindlimb/pathology , Hindlimb/surgery , Immunohistochemistry , Injury Severity Score , /drug effects , /metabolism , Osteoarthritis/surgery , Protective Factors , Random Allocation , Rats, Sprague-Dawley
18.
Rev. bras. anestesiol ; 65(3): 217-221, May-Jun/2015. tab, graf
Article in English | LILACS | ID: lil-748919

ABSTRACT

RATIONALE: The changes in body position can cause changes in lung function, and it is necessary to understand them, especially in the postoperative upper abdominal surgery, since these patients are susceptible to postoperative pulmonary complications. OBJECTIVE: To assess the vital capacity in the supine position (head at 0° and 45°), sitting and standing positions in patients in the postoperative upper abdominal surgery. METHODS: A cross-sectional study conducted between August 2008 and January 2009 in a hospital in Salvador/BA. The instrument used to measure vital capacity was analogic spirometer, the choice of the sequence of positions followed a random order obtained from the draw of the four positions. Secondary data were collected from the medical records of each patient. RESULTS: The sample consisted of 30 subjects with a mean age of 45.2 ± 11.2 years, BMI 20.2 ± 1.0 kg/m2. The position on orthostasis showed higher values of vital capacity regarding standing (mean change: 0.15 ± 0.03 L; p = 0.001), the supine to 45 (average difference: 0.32 ± 0.04 L; p = 0.001) and 0° (0.50 ± 0.05 L; p = 0.001). There was a positive trend between the values of forced vital capacity supine to upright posture (1.68 ± 0.47; 1.86 ± 0.48; 2.02 ± 0.48 and 2.18 ± 0.52 L; respectively). CONCLUSION: Body position affects the values of vital capacity in patients in the postoperative upper abdominal surgery, increasing in postures where the chest is vertical. .


JUSTIFICATIVA: As alterações no posicionamento corporal podem ocasionar mudanças na função respiratória e é necessário compreendê-las, principalmente no pós-operatório abdominal superior, já que os pacientes estão suscetíveis a complicações pulmonares pós-operatórias. OBJETIVO: Verificar a capacidade vital nas posições de decúbito dorsal (cabeceira a 0° e 45°), sentado e em ortostase em pacientes no pós-operatório de cirurgia abdominal superior. MÉTODOS: Estudo transversal, feito entre agosto de 2008 e janeiro de 2009, em um hospital na cidade de Salvador (BA). O instrumento usado para mensuração da capacidade vital (CV) foi o ventilômetro analógico e a escolha da sequência das posições seguiu uma ordem aleatória obtida a partir de sorteio das quatro posições. Os dados secundários foram colhidos nos prontuários de cada paciente. RESULTADOS: A amostra foi composta por 30 indivíduos com idade média de 45,2 ± 11,2 anos e IMC 20,2 ± 1,0 kg/m2. A posição em ortostase apresentou valores maiores da CV em relação à sedestração (média das diferenças: 0,15 ± 0,03 litros; p = 0,001), ao decúbito dorsal a 45° (média das diferenças: 0,32 ± 0,04 litros; p = 0,001) e 0° (0,50 ± 0,05 litros; p = 0,001). Houve um aumento positivo entre os valores de CVF do decúbito dorsal para a postura ortostática (1,68 ± 0,47; 1,86 ± 0,48; 2,02 ± 0,48 e 2,18 ± 0,52 litros; respectivamente). CONCLUSÃO: A posição do corpo afeta os valores da CV em pacientes no pós-operatório de cirurgia abdominal superior, com aumento nas posturas em que o tórax encontra-se verticalizado. .


JUSTIFICACIÓN: Las alteraciones en el posicionamiento corporal pueden ocasionar cambios en la función respiratoria y es necesario comprenderlas, principalmente en el postoperatorio abdominal superior, ya que los pacientes son susceptibles a complicaciones pulmonares postoperatorias. OBJETIVO: Verificar la capacidad vital en las posiciones de decúbito dorsal (cabeza a 0° y 45°), sentado y en ortostasis en pacientes en el postoperatorio de cirugía abdominal superior. MÉTODOS: Estudio transversal realizado entre agosto de 2008 y enero de 2009, en un hospital en la ciudad de Salvador (BA). El instrumento usado para la medición de la capacidad vital (CV) fue el espirómetro analógico y la elección de la secuencia de las posiciones siguió un orden aleatorio que se obtuvo a partir de un sorteo de las 4 posiciones. Los datos secundarios fueron extraídos de las historias clínicas de cada paciente. RESULTADOS: La muestra se compuso de 30 individuos con edades medias de 45,2 ± 11,2 años e IMC de 20,2 ± 1 kg/m2. La posición en ortostasis presentó valores mayores de CV con relación a la posición sedente (media de las diferencias: 0,15 ± 0,03 L; p = 0,001), al decúbito dorsal a 45° (media de las diferencias: 0,32 ± 0,04 L; p = 0,001) y a 0° (0,50 ± 0,05 L; p = 0,001). Hubo un aumento positivo entre los valores de CV forzada del decúbito dorsal para la postura ortostática (1,68 ± 0,47; 1,86 ± 0,48; 2,02 ± 0,48 y 2,18 ± 0,52 L, respectivamente). CONCLUSIÓN: La posición del cuerpo afecta los valores de la CV en pacientes durante el postoperatorio de cirugía abdominal superior, con aumento en las posturas en las que el tórax está verticalizado. .


Subject(s)
Humans , Arthritis, Rheumatoid/drug therapy , Computer Simulation , Cartilage, Articular/drug effects , Extracellular Matrix/drug effects , Models, Biological , Osteoarthritis/drug therapy , Arthritis, Rheumatoid/metabolism , Arthritis, Rheumatoid/pathology , Cartilage, Articular/metabolism , Cartilage, Articular/pathology , Extracellular Matrix/metabolism , Extracellular Matrix/pathology , Interleukin-1/pharmacology , Interleukin-1/therapeutic use , Oncostatin M/pharmacology , Oncostatin M/therapeutic use , Osteoarthritis/metabolism , Osteoarthritis/pathology , Signal Transduction
19.
Bogotá; IETS; dic. 2014. tab, ilus.
Monography in Spanish | LILACS, BRISA | ID: biblio-847020

ABSTRACT

Introducción: la OA es la forma más común de enfermedad de las articulaciones y la principal causa de discapacidad de las personas de la tercera edad. Su alta prevalencia en una población que usualmente tiene comorbilidades asociadas que requieren otros medicamentos obliga a buscar otras alternativas terapéuticas con mínimos eventos adversos y pocas interacciones medicamentosas. Condroitín es un medicamento regenerador de cartílago que se ha usado en el manejo de estos pacientes. Esta evaluación tecnológica se desarrolló en el marco de la actualización integral del Plan Obligatorio de Salud para el año 2015. Objetivo: evaluar la efectividad y seguridad del uso de condroitín comparado con acetaminofén, antiinflamatorios no esteroideos, glucosamina, condroitín más glucosamina, diacereina, ácido hialurónico ó fitoterapéuticos, en pacientes osteoartrosis. Metodología: la evaluación fue realizada de acuerdo con un protocolo definido a priori por el grupo desarrollador. Se realizó una búsqueda sistemática en MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects y LILACS, con restricción al idioma inglés y español y limitada a revisiones sistemáticas publicadas en los últimos cinco años y ensayos clínicos sin restricción de tiempo. Las búsquedas electrónicas fueron hechas entre octubre y diciembre de 2014 y se complementaron mediante búsqueda manual en bola de nieve y una consulta con expertos temáticos. La tamización de referencias se realizó por un revisor. La selección de estudios fue realizada mediante la revisión en texto completo de las referencias preseleccionadas, verificando los criterios de elegibilidad. La calidad de los estudios fue valorada con la herramienta de riesgo de sesgo de la Colaboración Cochrane. Las características de los estudios fueron extraídas a partir de las publicaciones originales. Se realizó una síntesis narrativa de las estimaciones del efecto para las comparaciones y desenlaces de interés a partir de los estudios de mejor calidad. Se estimaron medidas combinadas del efecto a través de un metanálisis con el método de Mantel-Haenszel y un modelo de efectos aleatorios, empleando el programa RevMan 5.2. Resultados: condroitín es semejante a los AINEs, glucosamina y glucosamina más condroitín en mejorar los desenlaces como dolor y funcionalidad a los seis meses y el desenlace radiológico proporción de pacientes con progresión de la disminución de la amplitud del espacio articular. Los AINEs, glucosamina y glucosamina más condroitín son superiores en los desenlaces rigidez a los seis meses según puntaje en la escala WOMAC (RR=5.97 IC 95% 1.45, 10.49). Condroitín sulfato es no inferior a pascledina en estos mismos desenlaces. Además en relación a seguridad no se reportó ningún evento adverso serio a ninguno de los medicamentos evaluados, incluyendo condroitín. La adherencia al tratamiento fue muy buena tanto a los seis meses como a los 24 meses y la percepción de tolerancia fue superior al 94%. Conclusiones: condroitín es semejante en efectividad y seguridad a glucosamina, glucosamina más condroitín, AINEs y pascledina en pacientes con osteoartrosis.(AU)


Subject(s)
Humans , Osteoarthritis/drug therapy , Acetaminophen/administration & dosage , Anthraquinones/administration & dosage , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Biomedical Technology , Chondroitin/administration & dosage , Colombia , Cost-Benefit Analysis , Drug Therapy, Combination , Glucosamine/administration & dosage , Hyaluronic Acid/administration & dosage , Phytotherapeutic Drugs
20.
J. bras. med ; 102(5)set.-out. 2014. graf
Article in Portuguese | LILACS | ID: lil-730202

ABSTRACT

Os anti-inflamatórios não esteroides (AINEs) estão entre os medicamentos mais comumente prescritos em todo o mundo e são responsáveis por cerca de um quarto de todas as notificações de reações adversas. Têm sido amplamente indicados em pacientes com doença reumática e outras doenças musculoesqueléticas - população de maior risco de graves complicações gastrintestinais (GI). Os AINEs tópicos são administrados para o tratamento de diversas condições: lesões musculoesqueléticas, dor pós-operatória, neuralgia pós-herpética, periodontite, úlceras aftosas e ceratoses actínicas. Dados mostram que metade dos AINEs é indicada para osteoartrite (OA). Sua administração tópica oferece como benefício menor incidência de efeitos adversos sistêmicos, como úlcera péptica e hemorragia GI, na metabolização do medicamento nos tecidos afetados...


Nonsteroidal anti-inflammatory are among the drugs more usually prescribed in all over the world which is responsible for about a fourth of all notifications of adverse reactions. It has been widely indicated in patients with rheumatic disease and others musculoskeletal disease - high risk population of severe gastrointestinal complications (GI). The topic AINEs are managed for the treatment of many conditions: musculoskeletal injury, postoperative pain, postherpetic neuralgy, periodontic, mouth ulcer and actinic keratosis. Data show that half of AINEs are indicated for osteoarthritis (OA). Its topic administration provides benefits like less incidence of systemic adverse effects like peptic ulcer and GI bleeding in drug-metabolizing in affected tissues...


Subject(s)
Humans , Male , Female , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Musculoskeletal Pain/drug therapy , Administration, Topical , Diclofenac/therapeutic use , Rheumatic Diseases/drug therapy , Pain, Postoperative/drug therapy , Stomatitis, Aphthous/drug therapy , /therapeutic use , Neuralgia, Postherpetic/drug therapy , Osteoarthritis/drug therapy , Musculoskeletal System/injuries
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