A Cross-Sectional, Retrospective, and Comparative Study between Delirium and Non-Delirium Psychiatric Disorders in a Psychogeriatric Inpatient Population Referred to Consultation-Liaison Psychiatry Unit.

Background and objectives: Delirium is the most prevalent psychiatric disorder in inpatient older people. Its presence is associated with higher rates of institutionalization, functional disability and mortality. This study aims to evaluate delirium in a hospitalized psychogeriatric population, focusing on which factors predict the appearance of delirium, the impact it generates and the diagnostic concordance between non-psychiatric physicians and psychiatrists. Material and methods: This is an observational, cross-sectional, retrospective, and comparative study. We obtained data from a sample of 1017 patients (≥65 years) admitted to general hospital and referred from different services to the consultation-liaison psychiatry (CLP) unit. Logistic regression was performed using delirium as the dependent variable. To estimate the concordance of the diagnoses, the Kappa coefficient was used. To assess the impact of delirium, an ordinal regression, Wilcoxon median test and Fisher's test were performed. Results: Delirium is associated with a higher number of visits, OR 3.04 (95% CI 2.38-3.88), longer length of stay and mortality, OR 2.07 (95% CI, 1.05 to 4.10). The model to predict delirium shows that being >75 years old has an OR of 2.1 (95% CI, 1.59-2.79), physical disability has an OR of 1.66 (95% CI, 1.25-2.20), history of delirium has an OR of 10.56 (95% CI, 5.26-21.18) and no use of benzodiazepines has an OR of 4.24 (95% CI, 2.92-6.14). The concordance between the referring physician's psychiatric diagnosis and the psychiatrist CLP unit showed a kappa of 0.30. When analysing depression and delirium, the concordance showed Kappa = 0.46. Conclusions: Delirium is a highly prevalent psychiatric disorder, but it is still underdiagnosed, with low diagnostic concordance between non-psychiatric doctors and psychiatrists from CLP units. There are multiple risk factors associated with the appearance of delirium, which must be managed to reduce its appearance.

Universal healthcare coverage for first episode of schizophrenia-spectrum disorders in Chile: analysis of the administrative database.

Aim of the study was to analyse the Ministry of Health's (MINSAL) administrative database of the Universal Health Coverage (UHC) program for First Episode of Schizophrenia Spectrum Disorders (FEP-SSD). The database included every case registered in the program between 2004 and 2017. According to the timeframes established for permanence in the program, cases were defined as Suspected, FEP in diagnostic observation and FEP-SSD. Only first registers were analysed. We compared gender, age at entry, level of care and region where the case was registered. Denominator data for estimation of incidence rates were obtained from the last census. We adjusted incidence rate ratios by age, gender, and region. During the studied period, 33.207 suspected cases were registered. 27.006 (81%) were confirmed as FEP and after 6-month follow-up, 22.701 (68%) were confirmed as FEP-SSD. The median age at entry was 24 years, males entering at younger age. Male proportion was higher than female in all groups. 46.9% of all cases were detected in primary care. FEP-SSD cases were six years younger and had a higher proportion of males than discarded cases (62.6 vs 53.2%). During 169.4 million person-years at risk, crude incidence for suspected cases was 19.58 per 100.000 person-years; for FEP, 15.92 per 100.000 person-years and for FEP-SSD, 13.38 per 100.000 person-years. Chile has lower incidence of FEP-SSD compared to current world estimations but gender proportions are comparable. This UHC program has allowed early access through the integration of mental health to the health network at all levels of care.

Attachment styles moderate Theory of Mind differences between persons with schizophrenia, first-degree relatives and controls.

OBJECTIVES: Theory of Mind (ToM) plays a role in social functioning and is impaired in patients with schizophrenia and to a lesser degree in first-degree relatives, compared to healthy controls. This study investigates whether attachment styles moderate these observed group differences in ToM. METHODS: This cross-sectional study included a sample of 51 patients, 23 first-degree relatives, and 49 controls who completed assessments of anxious and avoidant attachment (Psychosis Attachment Measure), ToM (Reading the Mind in the Eyes Test), and estimated cognitive ability. Patients' symptoms were assessed with the Positive and Negative Syndrome Scale. RESULTS: Patients differed from controls and relatives in ToM performance but not in attachment avoidance or attachment anxiety. Attachment anxiety showed an interaction with group over ToM. The interaction was significant only between patients and controls but not between patients and relatives or relatives and controls. Post-hoc analysis showed that patients and controls showed differential ToM performance at average and high attachment anxiety. In patients, symptom levels did not moderate the association between attachment and ToM. CONCLUSIONS: Attachment anxiety is related to poorer levels of ToM in patients, suggesting this may have a contributory role in schizophrenia. The findings stress the need for longitudinal research into the directionality of the relationship between ToM and attachment anxiety. PRACTITIONER POINTS: Relationships with significant others might be a factor that influences the way in which social information is processed by persons with a diagnosis of a psychotic disorder. In patients, higher levels of attachment anxiety - that is, low self-worth, fear of abandonment and rejection, continuous vigilance of threat-related cues - were associated with a lower ability to understand the mental states of others. However, at lower levels of attachment anxiety, their ToM performance was comparable to that of relatives and controls. This effect was not influenced by symptom severity. Further research is required to confirm the potential influence of attachment insecurity on ToM ability as the latter is strongly related to patient's functional outcomes.

Clinical Profile and Length of Hospital Stay in a Sample of Psychogeriatric Patients Referred to Consultation Liaison Psychiatric Unit.

Background and objectives: There has been a recent increase in older patients admitted to general hospitals. A significant percentage of hospitalized older patients are ≥75 years old, which differ from the patients aged 65 to 74 years old in terms of functional status at patient discharge. This study aims to compare sociodemographic, clinical features, and factors associated with length of hospital stay in youngest-old and oldest-old populations of inpatients referred to the consultation liaison psychiatry unit. Material and methods: This is an observational, cross-sectional, retrospective, and comparative study. We obtained data from a sample of 1017 patients (≥65 years) admitted to a general hospital and referred from different services (medicine, surgery, etc.) to the consultation liaison psychiatry unit. The sample was divided into two groups of patients: youngest-old (65-74 years) and oldest-old (≥75 years). Psychiatric evaluations were performed while the patients were on wards at the hospital. Psychopharmacs were started as needed. A comparative analysis was carried out and predictive factors related to length of hospital stay were calculated. Results: The reference rate to consultation liaison psychiatry unit was 1.45% of the total older patients hospitalized. Our study demonstrates differences between the groups of older people: the oldest-old group were mainly female (p < 0.001), had more previous psychiatric diagnoses (p < 0.001), physical disabilities (p = 0.02), and neurocognitive disorders (p < 0.001), they used more antipsychotics (p < 0.001), and more frequently had a discharge disposition to a nursing home (p = 0.036). The presence of physical disability (beta = 0.07, p < 0.001) and logtime to referral to consultation liaison psychiatry unit (beta = 0.58, p < 0.001) were associated with increased length of hospital stay. Conclusions: Youngest-old and oldest-old people should be considered as two different types of patients when we consider clinical features. The time to referral to consultation liaison psychiatry unit seems to be a relevant factor associated with length of hospital stay.

Investigaciones sobre envejecimiento realizadas por estudiantes universitarios en el Perú / Research about aging carried out by university students in Peru

Introducción: La promoción de la investigación a nivel universitario ofrece múltiples beneficios para los estudiantes y es considerada reflejo de la calidad educativa de las universidades. Objetivo: Describir las características de la investigación sobre envejecimiento realizada por estudiantes universitarios en el Perú. Métodos: Estudio descriptivo de las tesis de pre y post grado sobre envejecimiento realizadas en el Perú entre los años 1980 al 2013. Se realizó la búsqueda por palabras claves en las bases de datos de universidades del país y en bases de datos electrónicas nacionales y Latinoamericanas con la selección basada en el cumplimiento del proceso metodológico de investigación. Resultados: Se identificaron 500 tesis; la mayoría de pregrado (74,4 por ciento) y relativas al área geriátrica (78 por ciento). El tema social fue el más estudiado (12,8 por ciento) en el área gerontologico y el quirúrgico (8,1 por ciento) en el geriátrico. La mayor proporción de las tesis fueron descriptivas (92 por ciento), de corte transversal (69,6 por ciento) y relativas al área geriátrica (78 por ciento), tanto en pre como en postgrado. Durante el periodo estudiado la proporción de tesis realizadas muestra un aumento progresivo con un incremento significativo en el número de estudios analíticos y de corte prospectivo. Conclusión: La investigación desarrollada por estudiantes universitarios sobre envejecimiento en el Perú es principalmente de tipo transversal, relativa al área geriatrica y muestra un incremento significativo en el periodo estudiado(AU)

Introduction: The promotion of research at the university level offers multiple benefits to students and is indicative of educational quality of universities. Objective: To describe the characteristics of research about aging carried out by university students in Peru. Methods: Descriptive study of the diploma papers and postgraduate theses about aging presented in Peru between 1980 and 2013. The search was carried out by keywords in the databases in the of country's universities and in electronic databases both national and from Latin American, the selection being based on compliance with the research methodological process. Results: We identified 500 works, most of which were diploma papers (74.4 percent) and on the topic of the geriatric field (78 percent). The social issue was the most studied (12.8 percent) in the gerontological field. The surgical topic was the most studied (8.1 percent) in the geriatric field. The majority of the works were descriptive (92 percent), cross-sectional (69.6 percent) and associated with the geriatric field (78 percent), both in the undergraduate and postgraduate levels. During the period under study, the proportion of papers and theses research carried out shows a progressive increase, with a significant increase in the number of analytical and prospective studies. Conclusion: Research developed by university students about aging in Peru is mainly cross-sectional and associated with to the geriatric field. In the period studied, it shows a significant increase(AU)

Effect of multimorbidity on gait speed in well-functioning older people: A population-based study in Peru.

AIM: To determine the association between multimorbidity and gait speed in a population-based sample of older people without functional dependency. METHODS: Data were obtained from a previously made cross-sectional population-based study of individuals aged >60 years carried out in San Martin de Porres, the second most populous district in Lima, Peru. We included well-functioning, independent older people. Exclusion criteria emphasized removing conditions that would impair gait. The exposure of interest was non-communicable chronic disease multimorbidity, and the outcome was gait speed determined by the time required for the participant to walk a distance of 8 m out of a total distance of 10 m. Generalized linear models were used to estimate adjusted gait speed by multimorbidity status. RESULTS: Data from 265 older adults with a median age of 68 years (IQR 63-75 years) and 54% women were analyzed. The median gait speed was 1.06 m/s (SD 0.27) and the mean number of chronic conditions per adult was 1.1 (SD ±1). The difference in mean gait speed between older adults without a chronic condition and those with ≥3 chronic conditions was 0.24 m/s. In crude models, coefficients decreased by a significant exponential factor for every increase in the number of chronic conditions. Further adjustment attenuated these estimates. CONCLUSIONS: Slower speed gaits are observed across the spectrum of multimorbidity in older adults without functional dependency. The role of gait speed as a simple indicator to evaluate and monitor general health status in older populations is expanded to include older adults without dependency. Geriatr Gerontol Int 2018; 18: 293-300.

Factores asociados a velocidad de marcha lenta en adultos mayores de un distrito en Lima, Perú / Factors associated with slow walking speed in older adults of a district in Lima, Peru

RESUMEN Objetivos. Determinar los factores asociados a velocidad de marcha lenta en adultos mayores de la comunidad residentes en un distrito de Lima, Perú. Materiales y métodos. Estudio de análisis de base de datos secundario. Se incluyó a los adultos mayores de 60 años y se excluyó aquellos con condiciones que no garantizaban la evaluación de la marcha. La variable dependiente fue la velocidad de marcha lenta, menor a 1 m/s, y las variables independientes fueron sociodemográficas, clínicas y de valoración geriátrica integral. Se calcularon las razones de prevalencia (RP) crudas y ajustadas con intervalos de confianza al 95% (IC95%). Resultados. Se incluyeron 416 adultos mayores, el rango de edad fue de 60 a 99 años y un 41% presentaba velocidad de marcha lenta. Se encontró que los factores asociados a una velocidad de marcha lenta en adultos mayores de la comunidad son el sexo femenino (RP 1,45, IC95%: 1,13-1,88), la edad mayor de 70 años (RP 1,73, IC95%: 1,30-2,30), un menor grado de instrucción (RP. 2.07, IC95%: 1,20-3,55), la presencia de problema socio familiar (RP 1,66, IC95%: 1,08-2,54), la presencia de diabetes mellitus (RP 1,35, IC95%: 1,01-1,80) y de depresión (RP: 1.41, IC95%: 1,02-1,95). Conclusiones. Los factores modificables asociados a una velocidad de marcha lenta en el adulto mayor en la comunidad son tanto clínicos como sociofamiliares, susceptibles de intervención desde etapas precoces en el curso de la vida.

ABSTRACT Objectives. To determine the factors associated with slow walking speed in older adults living in a district of Lima, Peru. Materials and methods. Analysis of secondary data. Adults older than 60 years were included in the study, while adults with physical conditions who did not allow the evaluation of the walking speed were excluded. The dependent variable was slow walking speed (less than 1 m/s), and the independent variables were sociodemographic, clinical, and geriatric data. Raw and adjusted prevalence ratios (PR) were calculated with 95% confidence intervals (95% CI). Results. The study sample included 416 older adults aged 60 to 99 years, and 41% of the participants met the slow walking speed criterion. The factors associated with slow walking speed in this sample were female gender (PR, 1.45; 95% CI, 1.13-1.88), age > 70 years (PR, 1.73; 95% CI, 1.30- 2.30), lower level of education (PR, 2.07, 95% CI, 1.20-3.55), social-familial problems (PR, 1.66; 95% CI, 1.08-2.54), diabetes mellitus (PR, 1.35; 95% CI, 1.01-1.80), and depression (PR, 1.41; 95% CI, 1.02-1.95). Conclusions. The modifiable factors associated with slow walking speed in older adults included clinical and social-familial problems, and these factors are susceptible to interventions from the early stages of life.

Isobolographic Analyses of Proglumide-Celecoxib Interaction in Rats with Painful Diabetic Neuropathy.

Preclinical Research The aim of the present study was to analyze the antihyperalgesic and antiallodynic interaction between the non-selective cholecystokinin (CCK) antagonist receptor, proglumide, and the selective cyclooxygenase-2 inhibitor, celecoxib in streptozotocin (STZ)-induced diabetic rats. Hyperalgesia was evaluated in the formalin test and tactile allodynia using von Frey filaments. Isobolographic analyses were employed to define the nature of the compound interactions, using a fixed dose ratio (0.5:0.5). Proglumide (20-160 mg/kg) and celecoxib (0.3-30 mg/kg) in these fixed dose ratio combinations induced dose-dependent antihyperalgesia and an antiallodynic effect in diabetic rats. ED40 values were calculated for the treatments and an isobologram was constructed. Theoretical ED40 values for combination proglumide-celecoxib estimated from the isobolograms for antihyperalgesic and antiallodynic activity (30.50 ± 1.90 mg/kg and 45.81 ± 4.55 mg/kg, respectively) were obtained, while experimental ED40 values for this antihyperalgesic and antiallodynic combined effect (13.83 ± 0.65 mg/kg and 17.74 ± 3.57 mg/kg; respectively) were significantly different. Coadministration of proglumide-celecoxib showed an interaction index value of 0.45 ± 0.03 for the antihyperalgesic effect and 0.39 ± 0.08 for the antiallodynic activity, indicating a synergistic interaction. These data suggest that proglumide and celecoxib can interact synergistically to reduce hyperalgesic and allodynic behaviors in diabetic neuropathy. This combination could be useful to treat neuropathic pain in diabetic patients. Drug Dev Res 78 : 116-123, 2017. ©2017 Wiley Periodicals, Inc.

[Factors associated with slow walking speed in older adults of a district in Lima, Peru]. / Factores asociados a velocidad de marcha lenta en adultos mayores de un distrito en Lima, Perú.

OBJECTIVES.: To determine the factors associated with slow walking speed in older adults living in a district of Lima, Peru. MATERIALS AND METHODS.: Analysis of secondary data. Adults older than 60 years were included in the study, while adults with physical conditions who did not allow the evaluation of the walking speed were excluded. The dependent variable was slow walking speed (less than 1 m/s), and the independent variables were sociodemographic, clinical, and geriatric data. Raw and adjusted prevalence ratios (PR) were calculated with 95% confidence intervals (95% CI). RESULTS.: The study sample included 416 older adults aged 60 to 99 years, and 41% of the participants met the slow walking speed criterion. The factors associated with slow walking speed in this sample were female gender (PR, 1.45; 95% CI, 1.13-1.88), age > 70 years (PR, 1.73; 95% CI, 1.30- 2.30), lower level of education (PR, 2.07, 95% CI, 1.20-3.55), social-familial problems (PR, 1.66; 95% CI, 1.08-2.54), diabetes mellitus (PR, 1.35; 95% CI, 1.01-1.80), and depression (PR, 1.41; 95% CI, 1.02-1.95). CONCLUSIONS.: The modifiable factors associated with slow walking speed in older adults included clinical and social-familial problems, and these factors are susceptible to interventions from the early stages of life.

OBJETIVOS.: Determinar los factores asociados a velocidad de marcha lenta en adultos mayores de la comunidad residentes en un distrito de Lima, Perú. MATERIALES Y MÉTODOS.: Estudio de análisis de base de datos secundario. Se incluyó a los adultos mayores de 60 años y se excluyó aquellos con condiciones que no garantizaban la evaluación de la marcha. La variable dependiente fue la velocidad de marcha lenta, menor a 1 m/s, y las variables independientes fueron sociodemográficas, clínicas y de valoración geriátrica integral. Se calcularon las razones de prevalencia (RP) crudas y ajustadas con intervalos de confianza al 95% (IC95%). RESULTADOS.: Se incluyeron 416 adultos mayores, el rango de edad fue de 60 a 99 años y un 41% presentaba velocidad de marcha lenta. Se encontró que los factores asociados a una velocidad de marcha lenta en adultos mayores de la comunidad son el sexo femenino (RP 1,45, IC95%: 1,13-1,88), la edad mayor de 70 años (RP 1,73, IC95%: 1,30-2,30), un menor grado de instrucción (RP. 2.07, IC95%: 1,20-3,55), la presencia de problema socio familiar (RP 1,66, IC95%: 1,08-2,54), la presencia de diabetes mellitus (RP 1,35, IC95%: 1,01-1,80) y de depresión (RP: 1.41, IC95%: 1,02-1,95). CONCLUSIONES.: Los factores modificables asociados a una velocidad de marcha lenta en el adulto mayor en la comunidad son tanto clínicos como sociofamiliares, susceptibles de intervención desde etapas precoces en el curso de la vida.

[Outcomes the Mitrofanoff technique in the management of patients with neurogenic bladder: the experience in the San Vicente de Paul Universitary Hospital]. / Resultados del uso de la técnica de Mitrofanoff en pacientes con disfunción neurógena de la vejiga: análisis de la experiencia en el Hospital Universitario San Vicente de Paul.

INTRODUCTION: The care for children with neurogenic bladder, should be integral, multidisciplinary look to preserve renal function and to accomplish urinary and fecal continence, achieving that the patient becomes self-sufficient and useful to society. METHODS: The result of the use of the Mitrofanoff technique for the treatment of patients with neurogenic dysfunction bladder used in the HUSVP 1998-2003, and the current condition of the patients with respect to their illness and treatment are described in this article. A descriptive retrospective study 1998-2002 and a prospective study during 2003 were done, in which a series of cases were analyzed. RESULTS: 41 patients had surgery. Average age 10.2 years; average follow-up time 27.2 months; the most frequent illness was myelomeningocele (46.3%) and 46.3% had dysinergic bladder. Bladder augmentation was performed on 63.3%, of which 71.4% were constructed with ileum. A surgical intervention of the bladder neck was done on 51.2%. A continent conduct (Mitrofanoff) was performed on 95.1% of the patients with complete continence 70.4%, complete incontinence 14.6% and occasional incontinence 14.6%. 31.7% had Malone surgery with adequate fecal management on 90.2%. 19% of the stomas presented stenosis and 21.9% presented urine leakage. 80% reached appropriate social adaptation. CONCLUSIONS: The continent catheterizable stomas are useful for the treatment of urinary and fecal incontinence. The conducts constructed with ileum had more complications than the conducts done with cecal appendix, which is why the appendix is the choice tissue to perform the continent catheterizable stomas, as long as it is available.

Resultados del uso de la técnica de Mitrofanoff en pacientes con disfunción neurógena de la vejiga: Análisis de la experiencia en el Hospital Universitario San Vicente de Paul / Outcomes the Mitrofanoff technique in the management of patients with neurogenic bladder: the experience in the San Vicente de Paul Universitary Hospital

Introducción: El cuidado de los niños con vejiga neurogénica, debe ser integral, multidisciplinario y busca preservar la función renal, alcanzar continencia urinaria y fecal, logrando que el paciente sea una persona autosuficiente y útil a la sociedad. Métodos: Describimos el resultado del uso de la técnica de Mitrofanoff en el manejo de pacientes con disfunción vesical neurógena, utilizada en el HUSVP desde 1998 al 2003, y las condiciones actuales de los pacientes con respecto a su enfermedad y tratamiento. Se realizó un estudio observacional descriptivo, retrospectivo 1998-2002 y prospectivo durante el 2003, analizando una serie de casos. Resultados: Fueron intervenidos 41 pacientes con vejiga neurogénica. Edad promedio 10.2 años; seguimiento promedio 27,2 meses; enfermedad de base más frecuente mielomeningocele (46,3%); vejiga disinérgica en 46,3%, esfínter hipotónico en 41,5%. Se realizo aumento vesical al 68,3%, utilizándose ileon en 71,4%, y alguna intervención sobre el cuello vesical al 51,2%. Se hizo una derivación tipo Mitrofanoff al 95,1% con continencia completa en 70,8%, incontinencia completa en 14.6% e incontinencia ocasional en 14,6%. En 31,7% se realizó un Malone con adecuada continencia fecal en 90,2%. De los estomas el 19% presentaron estenosis y el 21,9% presentaron escape de orina. Se encuentran socialmente adaptados 80% de los pacientes. Conclusiones: Los estomas continentes cateterizables son útiles para tratar la incontinencia urinaria y fecal. Los conductos realizados con ileon tuvieron mayores complicaciones que los elaborados con apéndice, por lo cual el apéndice debe ser el tejido de elección para realizar las derivaciones, cuando esté disponible (AU)

Introduction: The care for children with neurogenic bladder, should be integral, multidisciplinary look to preserve renal function and to accomplish urinary and fecal continence, achieving that the patient becomes self-sufficient and useful to society. Methods: The result of the use of the Mitrofanoff technique for the treatment of patients with neurogenic dysfunction bladder used in the HUSVP 1998- 2003, and the current condition of the patients with respect to their illness and treatment are described in this article. A descriptive retrospective study 1998- 2002 and a prospective study during 2003 were done, in which a series of cases were analyzed. Results: 41 patients had surgery. Average age 10.2 years; average follow–up time 27.2 months; the most frequent illness was myelomeningocele (46.3%) and 46.3% had dysinergic bladder. Bladder augmentation was performed on 63.3%, of which 71.4% were constructed with ileum. A surgical intervention of the bladder neck was done on 51.2%. A continent conduct (Mitrofanoff) was performed on 95.1% of the patients with complete continence 70.4%, complete incontinence 14.6% and occasional incontinence 14.6%. 31.7% had Malone surgery with adequate fecal management on 90.2%. 19% of the stomas presented stenosis and 21.9% presented urine leakage. 80% reached appropriate social adaptation. Conclusions: The continent catheterizable stomas are useful for the treatment of urinary and fecal incontinence. The conducts constructed with ileum had more complications than the conducts done with cecal appendix, which is why the appendix is the choice tissue to perform the continent catheterizable stomas, as long as it is available (AU)

Isobolographic analyses of the gabapentin-metamizol combination after local peripheral, intrathecal and oral administration in the rat.

This study was designed to evaluate the possible antinociceptive interaction between gabapentin and metamizol on formalin-induced nociception. Gabapentin, metamizol or a fixed dose-ratio combination of both drugs were assessed after local peripheral, intrathecal and oral administration in rats. Isobolographic analyses were employed to define the nature of the interaction between drugs. Gabapentin, metamizol and gabapentin-metamizol combinations yielded a dose-dependent antinociceptive effect when administered by the three different routes. ED30 values were estimated for the individual drugs and isobolograms were constructed. Theoretical ED30 values for the combination estimated from the isobolograms were 21.11 +/- 1.17 microg/paw, 104.6 +/- 5.5 microg/rat and 78.8 +/- 5.5 mg/kg for the local peripheral, intrathecal and oral administration routes, respectively. These values were significantly higher than the experimentally obtained ED30 values which were 11.3 +/- 1.5 microg/paw, 36.8 +/- 3.1 microg/rat and 15 +/- 1.2 mg/kg indicating a synergistic interaction. Systemic administration resulted in the highest synergism. Data confirm that low doses of the gabapentin and metamizol can interact synergistically to reduce formalin-induced nociceptive behavior suggesting that this combination could be useful to treat inflammatory pain in humans.