Combined acetaminophen and ibuprofen for pain relief after oral surgery in adults: a randomized controlled trial.

BACKGROUND: Acetaminophen is often used with a non-steriodal anti-inflammatory drug for acute pain. Hitherto, these drugs have had to be given separately, typically at different time intervals. Maxigesic tablets combine acetaminophen and ibuprofen in clinically appropriate doses to simplify administration and dosage regimen. We compared this combination with each of the constituent drugs for the relief of pain after extraction of third molar teeth. METHODS: Adults (more than 16 yr) having one or more wisdom teeth removed under general or local anaesthesia were instructed to take two tablets before operation, then two tablets every 6 h for up to 48 h of: (i) a combination of acetaminophen 500 mg and ibuprofen 150 mg per tablet (Maxigesic); (ii) acetaminophen 500 mg per tablet alone; or (iii) ibuprofen 150 mg per tablet alone. The primary outcome measure was the area under the curve (AUC) of the 100 mm visual analogue scale pain measurements taken for up to 48 h after surgery, divided by time, at rest and on activity. Pharmacokinetic data were collected in a subset of patients. RESULTS: The mean (sem) time-corrected AUC on rest and activity, respectively, were: combination group 22.3 (3.2) and 28.4 (3.4); acetaminophen group 33.0 (3.1) and 40.4 (3.3); and ibuprofen group 34.8 (3.2) and 40.2 (3.4); P<0.01 for each of the four comparisons of combination vs constituent drug. There was no pharmacokinetic interaction between acetaminophen and ibuprofen administered together. CONCLUSIONS: Maxigesic tablets provide superior pain relief after oral surgery to acetaminophen or ibuprofen alone.

Temporal changes to uterine collagen types I, III and V in relation to early pregnancy in the rat.

Uterine tissues of pregnant rats were extracted to define any changes to the proportions of collagens types I, III and V. The total concentration of extracted collagen was determined in tissue samples from implant and adjacent non-implant (NI) sites. Extracts were also subjected to polyacrylamide gel electrophoresis (PAGE), immunoblotting and gel densitometry to define the collagen types and to determine their relative proportions. By relating the proportions to the collagen concentrations in the extracts, type I was found to be the predominant collagen in both tissue regions although the concentration in the implant sites was lower than that in the NI sites. The concentration of Type I collagen decreased significantly over the period of observation in both implant and NI sites. Although the concentrations of collagen type III and type V also decreased in the implant sites, they did not alter in the NI sites. The results demonstrate that shortly after the initiation of implantation the uterus responds to the presence of the implanting embryo by decreasing the concentration of all three types of collagen. This indicates that their metabolism may, in part, be regulated by similar mechanisms. Furthermore, it was evident that a decrease in the concentration of collagen type I was initiated in uterine areas that, at the time of sampling, were not directly involved with implantation. During the study, it was found that the alpha 1 chain of collagen type V separated into two distinct bands when run on gels containing 3.8 M urea.(ABSTRACT TRUNCATED AT 250 WORDS)

Intradermal hepatitis B virus vaccine: immunogenicity and side-effects in adults.

Fourteen adult volunteers were given a series of three 0.1 ml (2.0 micrograms of antigen protein) intradermal doses of hepatitis B virus vaccine (Merck). An antibody (anti-HBs) response was induced in 10 of 12 (83%) who were antibody negative at the start of the study. Two participants who had anti-HBs before vaccination had a significant increase in serum antibody. The two participants with no antibody response were the oldest members of the study group. Side-effects of the vaccine were limited to local reactions at the site of administration.

Loiasis: report of three cases and literature review.

Loiasis is a tropical infection caused by the microfilarial nematode Loa loa. Increased numbers of cases of loiasis have been diagnosed outside of the endemic areas in Western and Central Africa because of widespread international travel. The author presents three cases of loiasis discovered at Howard University followed by a review of the literature.