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Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most frequently prescribed classes of drugs worldwide. Due to their excellent effects for analgesic, anti-inflammatory and antipyretic, most elder population used frequently for osteoarthritis. Gastrointestinal symptoms and ulceration associated with NSAIDs are common. Such ulcers may cause pain, bleeding, or perforation. It leads to other medical problems. The aim of this study was to examine the utilizations of medical resources associated with inpatients with NSAID related peptic ulcer disease and compared to non-NSAID related peptic ulcer disease. The study used the database from a teaching hospital in southern Taiwan. Inpatients who were identified ICD-9 CM codes as peptic ulcer diseases from January 1st of 2008 to December 31 of 2008 were included in this study. We also examined the indications for usage of NSAIDs, the date of prescription before the index date. The results showed 17.6% of inpatients with peptic ulcer disease related to NSAIDs. Inpatients with NSAIDs related peptic ulcer disease compared with inpatients with non-NSAIDs related peptic ulcer disease had significant difference in age and comorbidity. Although rapid urease test positive rate for Helicobacter pylori was higher in group of non-NSAID related peptic ulcer disease, it seemed underestimate because of the test number of patients was low. The average total direct medical cost of inpatients with NSAID related peptic ulcer was NT$ 36,491 and non-NSAID related peptic ulcer was NT$ 37,266.1. There were no significant difference in medical costs of standard care , intensive care , blood products,endoscopy, endoscopic hemostasis, surgery, CT scan , ultrasound, laboratory tests,medications, doctor¡¦s service between the two groups. Diagnostic and therapeutic procedures were no statistically significant difference, including blood transfusion,CT scan, endoscopic hemostasis, surgery, symptoms presentations, and intensive care. In this study, the duration for using NSAID was within 30 days for inpatients associated with NSAID related peptic ulcer, which had a substantial excess numbers of ulcer hospitalization. Since the common disease for using NSAID is osteoarthritis,which is very popular in elderly, therefore, we suggested that the policy makers of the National Health Insurance should be aware that preventive usage of proton pump inhibitors for the elder population who need frequent use of NSAIDs might decrease NSAID related ulcer complications.

No description available.

No description available.

Colorectal carcinoma is an important, feasible and attractive target for chemoprevention because a) it is a major cause of mortality in the United States and in other developed countries worldwide, b) there is a high mortality associated with advanced disease, c) there is a well described molecular carcinogenesis pathway and d) recent advances in molecular genetics will improve the ability to identify high-risk subjects. Epidemiological data, colonoscopic screening and advances in molecular genetics has made possible the identification and selection of subjects at increased risk of developing colorectal cancer. Due to this new information it may be possible to impede malignant cellular transformation with drugs. Such intervention with relatively simple maneuvers, such as a low daily dose of aspirin, can potentially reduce mortality from colorectal cancer. Prospective trials need to confirm experimental and epidemiological data supporting the efficacy of aspirin and other NSAID as chemopreventive agents before they can be used in the general population at risk. To use cancer chemopreventives effectively and safely in an asymptomatic population, the risks should be minimized and the benefits maximized by determination of optimal dose, schedule and chemopreventive mechanism of the NSAID. By linking the putative mechanism of drug action to effect endpoints, we expect to know whether the chemopreventive intervention is likely to be effective in a given individual.

in Hradec Králové Student: Johana Urbanová Supervisor: PharmDr. Jana Mandíková, Ph.D. = 38.02 μM), lowest indometacin μM

Inhibition of cyclooxygenase (COX)-2 increases cardiovascular deaths. Identifying a biomarker of COX-2 is desirable but difficult, since COX-1 and COX-2 ordinarily catalyze formation of an identical product, prostaglandin H2. When acetylated by aspirin, however, COX-2 (but not COX-1) can form 15(R)-HETE, which is metabolized to aspirin-triggered lipoxin (ATL), 15-epi-lipoxin A4. Here we have used COX-1- and COX-2-knockout mice to establish whether plasma ATL could be used as a biomarker of vascular COX-2 in vivo. Vascular COX-2 was low but increased by LPS (10 mg/kg; i.p). Aspirin (10 mg/kg; i.v.) inhibited COX-1, measured as blood thromboxane and COX-2, measured as lung PGE2. Aspirin also increased the levels of ATL in the lungs of LPS-treated wild-type C57Bl6 mice (vehicle: 25.5±9.3 ng/ml; 100 mg/kg: 112.0±7.4 ng/ml; P<0.05). Despite this, ATL was unchanged in plasma after LPS and aspirin. This was true in wild-type as well as COX-1−/− and COX-2−/− mice. Thus, in mice in which COX-2 has been induced by LPS treatment, aspirin triggers detectable 15-epi-lipoxin A4 in lung tissue, but not in plasma. This important study is the first to demonstrate that while ATL can be measured in tissue, plasma ATL is not a biomarker of vascular COX-2 expression.—Kirkby, N. S., Chan, M. V., Lundberg, M. H., Massey, K. A., Edmands, W. M. B., MacKenzie, L. S., Holmes, E., Nicolaou, A., Warner, T. D., Mitchell, J. A. Aspirin-triggered 15-epi-lipoxin A4 predicts cyclooxygenase-2 in the lungs of LPS-treated mice but not in the circulation: implications for a clinical test.

Made available in DSpace on 2016-05-02T13:54:42Z (GMT). No. of bitstreams: 1 DISSERTACAO COMPLETA ERICA SILVA BIANCHETTI.pdf: 401322 bytes, checksum: d859a5d12a9b16ecd28ee0fecfa86d09 (MD5) Previous issue date: 2006-06-01 / Conselho Nacional de Desenvolvimento Cientifico e Tecnologico / Etoricoxib is a new medicine expected to lead the next generation of selective inhibitors of COX-2 Presently the focus of many clinical assays it is a potent fast-action second generation coxib and the most selective of all The purpose of this study was to evaluate the interference of different nutritional diets in the anti-inflammatory and analgesic actions of etoricoxib and also the interactions of this NSAID plus different diets and their gastric and hematological side effects The following assays were carried out a) paw edema induced by carrageenin b) granuloma test c) dermatitis induced by croton oil d) vascular permeability in rats e) writhing test in mice f) formalin test g) gastric ulcers by stress and h) evaluation of the hematological parameters after sub-chronic treatment With regard to edema by carrageenin the etoricoxib-treated group showed a maximum peak of edema 49.04% (1.061 +- 0.1886) the other groups showed the following percentages of inhibiton etoricoxib + hyperproteic diet 30.2% (1.4537 +- 0.0955) etoricoxib + hyperlipidic diet 35.96% (64.04 +- 0.0578) etoricoxib + hyperglicidic diet 35.35% (1.346 +-0.0423) etoricoxib + standardized diet 33% (1.2968+-0.047) all of them in relation to the control group (2.0825+-0.1886) and the results were statistically significant (p < 0.01) However when the groups treated with etoricoxib associated to different diets were compared there was no statistically significant difference In the granuloma test the daily oral administration of 1 mg/kg of etoricoxib during 6 days significantly (p < 0.01) inhibited the formation of granulomatous tissue 57.02% (153.2 +- 21.908) the other groups showed the following percentages of inhibition etoricoxib + hyperlipidic diet 59% (144.98 +- 9.632) etoricoxib + hyperproteic diet 47.5% (185.575 +- 26.043) etoricoxib + hyperglicidic diet 38.5% (217.4 +- 21.318) etoricoxib + standardized diet 47.13% (166.583 2 +- 2.229) all of them in relation to the control group (353.475 +- 37.692) In the croton oil-induced dermatitis the edema of the control group had 10.33 mg The treatment with etoricoxib (1 mg/kg) associated with different nutritional diets showed inhibition of the edema but not significantly when compared to the control group The inhibition percentages were etoricoxib-treated group 7.86% (9.525 +- 1.345) etoricoxib + hyperproteic diet 31.43% (7.0875 +- 1.160) etoricoxib + hyperlipidic diet 35.6% (6.6625 +- 1.523) etoricoxib + hyperglicidic diet 39.5% (6.2571 +- 1.362) etoricoxib + standardized diet 30.7% (7.1875 +- 1.130) *p < 0.05 (Student s t test) when compared to the control group (10.3375 +- 1.462) In the vascular permeability by histamine etoricoxib (1 mg/kg) etoricoxib + hyperproteic diet etoricoxib + hyperlipidic diet etoricoxib + hyperglicidic diet and etoricoxib + standardized diet exhibited the following inhibition percentages 5.29% -31.4% -31.3% 4.05% and 15.82 respectively These results were not significant when compared to the control group (527.862 +- 66.869) In the writhing test the administration of etoricoxib (1mg/kg) inhibited the algogenic process in 9.32% (49.86 +- 4.166) When associated with different nutritional diets the inhibition percentages were hyperproteic diet 29.27% (38.9 +- 6.166) hyperlipidic diet 11.36% (48.75 +- 5.384) hyperglicidic diet 9.81% (49.6 +- 6.775) standardized diet -7.3% (59 +- 4.946) In the formalin test both in the acute and late phase all the treatments caused significant (p < 0.05) inhibitions of the hyperalgesic process etoricoxib (1mg/kg) 47.74% (62.71 +- 8.462) etoricoxib + hyperproteic diet 74.64% (30.428 +- 5.163) etoricoxib + hyperglicidic diet 68.61% (37.67 +- 5.308) etoricoxib + hyperlipidic diet 46.46% (64.25 +- 5.662) etoricoxib + standardized diet 68.2% (38.17 +- 5.528) when compared to the control group (120 +- 5.021) In the late phase the percentages of inhibition were 84.4% (10.142 +- 2.98) for etoricoxib 82.65% (11.28 +- 2.705) for etoricoxib + hyperproteic diet 66.16% (22 +- 11.781) for etoricoxib + hyperlipidic diet 98.72% (0.18 +- 0.0) for etoricoxib + hyperglicidic diet and 99.74% (0.16 +- 0.1667) for etoricoxib + standardized diet in comparison with the control group (65 +- 4.167) In the test of stress-induced ulcer the animals treated with etoricoxib (1mg/kg) + standardized diet showed the highest lesion index when compared to the other groups The lowest lesion index was shown by the group treated with etoricoxib + hyperlipidic diet whose significance was p < 0.01 (Student s t test) when compared to the control group The hematological parameters in the groups treated with etoricoxib (1mg/kg) + hyperlipidic diet (19.637 +- 3.879) and etoricoxib + hyperglicidic diet (19.3 +- 4.562) showed statistically significant differences in the hematocrit (HCT) in relation to the group treated only with etoricoxib (40.5375 +- 2.410) for p < 0.01 (Student s t test) There was a significant difference in the group treated with etoricoxib + hyperglicidic diet (8.9 +- 1.940) in relation to the group treated with etoricoxib (19.9 +- 2.134) (Student s t test) In the erythrocyte dosage the group etoricoxib + hyperglicidic diet (3.82125 +- 0.893) showed a significant difference when compared to the group treated with etoricoxib (9.4037 +- 1.027) (p < 0.01 Student s t test) No statistically significant differences were observed in the other hematological parameters The evaluation of the ponderal development of the animals treated with etoricoxib (1mg/kg) and etoricoxib assiciated with different kinds of nutritional diets showed no significant differences between the treated and control groups however the group treated with etoricoxib + hyperglicidic diet revealed lower ponderal development than the other groups With regard to diuresis there were variations in all the groups For water and feed consumption variations were practically similar in all the experimental groups The weight of the organs from different groups of animals treated with etoricoxib (1mg/kg) and etoricoxib associated with different nutritional diets showed no significant differences when compared to the control group The mean weight of the organs are within the normal parameters for rats The results suggest that a) the association of etoricoxib to different kinds of diets did not change the anti-inflammatory effect in the present assays b) the association of different types of diets potentialized the analgesic effect mainly when associated to hyperproteic diet for peripheral pain and hyperglicidic diet for central pain c) the association of etoricoxib to hyperglicidic diet decreases the gastric lesion index d) the use of etoricoxib alone did not interfere with the hematological parameters e) the association of etoricoxib to hyperglicidic diet interfered with the hemoglobin and erythrocyte index f) the treatment of the sub-chronic phase (30 days) with etoricoxib alone and etoricoxib associated to different nutritional diets caused no changes on the ponderal development diuresis and water and feed consumption / O etoricoxib (Arcóxia®) um medicamento novo posicionado para liderar a próxima geração de inibidores seletivos de COX-2 é um coxib de segunda geração potente e de ação rápida sendo motivo atualmente de muitos ensaios clínicos É o mais seletivo de COX-2 de todos os coxibs O objetivo deste estudo foi estudar em modelos in vivo a interferência sobre a atividade antiinflamatória e analgésica do etoricoxib antiinflamatório inibidor seletivo de COX-2 associado a diferentes tipos de dietas nutricionais observando as possíveis interações entre este AINE com as dietas empregadas e observar possíveis efeitos adversos ao nível gástrico e hematológico com o uso da associação do etoricoxib com as dietas nutricionais Para tanto foram utilizados os seguintes ensaios a) edema de pata por carragenina b) teste do granuloma c) dermatite induzida por óleo de croton d) permeabilidade vascular em ratos e) contorções em camundongos f) teste da formalina g) úlcera por estresse e h) avaliação dos parâmetros hematológicos após tratamento sub-crônico No edema por carragenina o grupo tratado com etoricoxib produziu inibição no pico máximo do edema de 49,04% (1.061 +- 0.1886) no tratado com etoricoxib + dieta hiperprotéica a inibição foi de 30,2% (1.4537 +- 0.0955) no tratado com etoricoxib + dieta hiperlipídica a inibição foi de 35,96% (64.04 +- 0.0578) no tratado com etoricoxib + dieta hiperglicidica a inibição foi de 35,36% (1.346 +- 0.0423) e no grupo tratado com etoricoxib + dieta padrão a inibição foi de 33% (1.3968 +- 0.047) todos em relação ao grupo controle (2.0825 +- 0.1886) apresentando resultados significativos estatisticamente (p < 0,01) Entretanto quando comparados entre si os grupos tratados com etoricoxib associado às diferentes dietas não houve diferença estatística significativa No teste do granuloma a administração diária de 1 mg/kg/v.o de etoricoxib durante 6 dias inibiu de forma significativa a formação do tecido granulomatoso (p < 0,01) em 57,02% (153.2 +- 21.908) e 59% (144.98 +- 9.632) pelo grupo tratado com etoricoxib + dieta hiperlipídica respectivamente no grupo tratado com etoricoxib + dieta hiperprotéica a inibição foi de 47,5% (185.575 +- 26.043) no tratado com etoricoxib + dieta hiperglicídica a inibição foi de 38,5% (217.4 +- 21.318) e no tratado com etoricoxib + dieta padrão foi 47,13% (166.583 2 +- 2.229) todas em relação ao grupo controle (353.475 +- 37.692) Na dermatite por óleo de cróton o edema no grupo controle foi de 10,33 mg Neste experimento observou-se que o tratamento dos animais com etoricoxib (1mg/kg) associado aos diferentes tipos de dietas nutricionais apresentou inibição do processo edematogênico mas não de forma significativa quando comparado com o grupo controle Para o grupo tratado com etoricoxib a inibição foi de 7,86% (9.525 +- 1.354) etoricoxib + dieta hiperprotéica foi de 31,43% (7.0875 +- 1.160) etoricoxib + dieta hiperlipídica foi de 35,6% (6.6625 +- 1.523) etoricoxib + dieta hiperglicídica foi de 39,5% (6.2571 +- 1.362) e etoricoxib + dieta padrão foi de 30.7% (7.1875 +- 1.130) *p < 0.05 ( teste t de Student) quando comparado ao grupo controle (10.3375 +- 1.462) Na permeabilidade vascular por histamina o etoricoxib (1mg/kg) etoricoxib + dieta hiperprotéica etoricoxib + dieta hiperlipídica etoricoxib + dieta hiperglicídica e etoricoxib + dieta padrão apresentaram inibições de 5,29% -18.4% -31.3% 4,05% e 15,82% respectivamente não sendo significativas quando comparados ao grupo controle (527.862 +- 66.869) No teste de contorções a administração de etoricoxib (1mg/kg) produziu 9,32% (49.86 +- 4.166) de inibição do processo algogênico e quando associado as diferentes dietas nutricionais a inibição foi de dieta hiperprotéica 29,27% (38.9 +- 6.166) dieta hiperlipídica 11,36% (48.75 +- 5.384) hiperglicídica 9,81% (49.6 +- 6.775) e dieta padrão 7,3% (59 +- 4.946) No teste da formalina tanto na fase aguda quanto na fase tardia todos os tratamentos produziram inibições significativas do processo hiperalgésico (p < 0.05) cujas percentagens de inibições foram de 47,74% para etoricoxib (1mg/kg) (62.71 +- 8.462) 74,64% para etoricoxib (1mg/kg) + dieta hiperprotéica (30.428 +- 5.163) 68,61% para etoricoxib (1mg/kg) + dieta hiperglicídica (37.67 +- 5.308) 46,46% para etoricoxib (1mg/kg) + dieta hiperlipídica (64.25 +- 5.662) e 68,2% para etoricoxib (1mg/kg) + dieta padrão (38.17 +- 5.528) quando comparados ao grupo controle (120 +- 5.021) Na fase tardia as percentagens de inibições foram de 84,4% (10.142 +- 2.98) para etoricoxib 82,65% (11.28 +- 2.705) para etoricoxib + dieta hiperprotéica 66,16% (22 +- 11.781) para etoricoxib + dieta hiperlipídica 98,72% (0,18 +- 0.0) para etoricoxib + dieta hiperglicídica e 99,74% (0.16 +- 0.1667) para etoricoxib + dieta padrão em comparação com o grupo controle (65 +- 4.167) No teste de úlcera por estresse observou-se que o tratamento dos animais com etoricoxib (1mg/kg) + dieta padrão foi o grupo que apresentou maior índice de lesão comparado aos outros grupos de tratamentos Já o grupo tratado com etoricoxib (1mg/kg) + dieta hiperglicídica foi o que apresentou menor índice de lesão cuja significância quando comparado ao grupo controle foi de p < 0.01 (teste t de Student) Os parâmetros hematológicos nos grupos tratados com etoricoxib (1mg/kg) + dieta hiperlipídica (19.637 +- 3.879) e etoricoxib + dieta hiperglicídica (19.3 +- 4.562) apresentaram diferenças estatisticamente significativas para o hematócrito (HCT) em relação ao grupo tratado apenas com etoricoxib (40.5375 +- 2.410) para p < 0.01 (teste t de student) Quanto à hemoglobina (HGB) foi significativa a diferença para o grupo tratado com etoricoxib + dieta hiperglicídica (8.9 +- 1.940) em relação ao grupo tratado com etoricoxib (19.9 +- 2.134) (p < 0.05, teste t de Student) Na dosagem de hemácias o grupo etoricoxib + dieta hiperglicídica (3.82125+- 0.893) apresentou diferença significativa quando comparada com o grupo tratado com etoricoxib (9.4037 +- 1.027) (p < 0.01, teste t de Student) Em relação aos outros parâmetros hematológicos não foram observadas diferenças significativas estatisticamente Na avaliação do desenvolvimento ponderal dos animais tratados com etoricoxib (1mg/kg) e etoricoxib associado aos diferentes tipos de dietas nutricionais não foram observadas diferenças significativas entre os grupos tratados e o controle entretanto o grupo tratado com etoricoxib + dieta hiperglicidica apresentou desenvolvimento ponderal menor que os outros grupos Em relação à diurese pôde-se observar ocorrência de variações em todos os grupos Para os consumos de água e ração houve variações praticamente semelhantes em todos os grupos experimentais Quanto ao peso dos órgãos dos diferentes grupos de animais tratados com etoricoxib (1mg/kg) e etoricoxib associado a diferentes dietas nutricionais não apresentaram diferenças significativas quando comparados ao grupo controle O peso médio dos órgãos encontram-se dentro dos parâmetros normais para a espécie animal (ratos) A partir dos resultados obtidos pode-se sugerir que a) A associação do etoricoxib aos diferentes tipos de dietas empregadas não alterou o efeito antiinflamatório nos ensaios empregados b) A associação do etoricoxib aos diferentes tipos de dietas empregadas potencializou o efeito analgésico principalmente quando associado à dieta hiperprotéica para dor periférica e dieta hiperglicídica para dor central c) A associação do etoricoxib à dieta hiperglicídica diminui o índice de lesão gástrica d) O tratamento com etoricoxib isolado não interferiu sobre os parâmetros hematológicos avaliados e) A associação do etoricoxib à dieta hiperglicídica provocou interferência sobre a taxa de hemoglobina e hemácias f) O tratamento em fase sub-crônica (30 dias) com etoricoxib e etoricoxib associado às diferentes dietas nutricionais não produziu alterações sobre o desenvolvimento ponderal diurese consumo de água e ração

Submitted by Adriana Martinez (amartinez@unoeste.br) on 2017-12-18T11:39:51Z No. of bitstreams: 1 Rivaldo Marini Filho.pdf: 197818 bytes, checksum: ae8b3afee2f83011a3937b0b0a8b0124 (MD5) / Made available in DSpace on 2017-12-18T11:39:51Z (GMT). No. of bitstreams: 1 Rivaldo Marini Filho.pdf: 197818 bytes, checksum: ae8b3afee2f83011a3937b0b0a8b0124 (MD5) Previous issue date: 2011-09-26 / This study aimed to evaluate hematological and hemostatic parameters, cardiac and hepatic biomarkers in healthy dogs submitted to therapy with non-selective (NSAID) and COX-2 preferential nonsteroidal anti-inflammatory drugs. Were used 24 healthy dogs, randomly divided into 4 groups (G) submitted to therapy with ketoprofen, nimesulide, meloxicam and etodolac. The blood count, hemostatic profile (clotting time (CT), prothrombin time (PT), activated partial thromboplastin time (APTT), platelets and fibrinogen), cardiac biomarkers (CK, CKMB) and liver function (ALT, AST and albumin) were evaluate before, at 5 and 10 days (T0, T5, T10) of treatment. Were observed increase in CT in the ketoprofen and nimesulide groups at T5 and T10, respectivelly, when compared to T0. The etodolac group showed reduction in TP in T5 compared to T0. The platelet count increased at T10 compared to T0 and T5 in the ketoprofen group. The red blood cells and hematocrit decreased in at T10 in the ketoprofen group. Reduction of serum albumin occurred in the ketoprofen (T5 and T10) and nimesulide (T10) groups. In conclusion, meloxican was the safest drug to NSAID therapy in dogs. The NSAIDs ketoprofen, nimesulide and etodolac should be used judiciously in patients with dysfunction of coagulation profile, once that promote increase in coagulation parameters. Ketoprofen therapy requires attention for use in anemic dogs because they are able to reduce the red series, and in patients with hypoalbuminemia is contraindicated. / O presente estudo teve como objetivo avaliar a hemograma, hemostasia, biomarcadores cardíacos e função hepática de cães saudáveis tratados com anti-inflamatórios não-esteroidais (AINEs) não seletivos e COX-2 preferenciais. Foram utilizados 24 cães clinicamente sadios, divididos em 4 grupos (G), que receberam as seguintes terapias: cetoprofeno, nimesulida, meloxicam, e etodolaco, durante 10 dias. O hemograma, perfil hemostático (tempo de coagulação (TC), tempo de protrombina (TP), tempo de tromboplastina parcial ativada (TTPA), plaquetas e fibrinogênio), biomarcadores cardíacos (creatinofosfoquinase (CK) e sua fração MB- CKMB) e função hepática (alanina aminotransferase (ALT), aspartato aminotransferase (AST) e albumina foram avaliados antes, aos 5 e 10 dias (T0, T5 e T10) de tratamento. O TC revelou aumento significativo nos grupos cetoprofeno e nimesulida no T5 e T10, respectivamente, em relação ao T0. O grupo etodolaco revelou redução do TP no T5 em relação ao T0. A contagem de plaquetas aumentou no T10 em relação ao T0 e T5 no grupo cetoprofeno. As hemáceas e o Ht diminuiram no T10 no grupo cetoprofeno. Redução da albumina sérica ocorreu nos grupos cetoprofeno (T5 e T10) e nimesulida (T10). Em conclusão, o meloxican foi o fármaco que se revelou mais seguro para uso em cães, em relação aos aspectos avaliados. Os AINEs cetoprofeno, nimesulida e etodolaco devem ser usados criteriosamente em pacientes com disfunções do perfil de coagulação, uma vez que prolongam do mesmo. O cetoprofeno exige atenção para uso em cães anêmicos, pois é capaz de reduzir a série vermelha, e em pacientes com hipoalbuminemia é contra-indicado.

No description available.