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Id: biblio-959894
Autor: Ceballos, Mauricio; González, César A; Holguín, Héctor A; Amariles, Pedro.
Título: Relevancia clínica de la interacción de la warfarina y del acetaminofén: estudio de cohortes retrospective / Clinical relevance of the interaction of warfarin and acetaminophen: retrospective cohort study
Fonte: Rev. colomb. cardiol;23(5):351-360, sep.-oct. 2016. tab, graf.
Idioma: es.
Resumo: Resumen Objetivo: Evaluar el uso concomitante de la warfarina y el acetaminofén en una población ambulatoria de pacientes anticoagulados, como posible factor de riesgo en el aumento de la Relación Normalizada Internacional (INR). Métodos: Estudio de cohortes retrospectivo. Se analizó la información de 1.458 pacientes anticoagulados con la warfarina. El factor de riesgo fue la utilización conjunta de warfarina- acetaminofén; el tiempo de seguimiento fue de 1 mes y como evento final se consideró un incremento del INR igual o mayor a 0,5 unidades. La asociación del factor de riesgo con el evento final se estableció con el riesgo relativo (RR) y el riesgo atribuible poblacional (RAP). Resultados: 63 pacientes cumplieron criterios de inclusión, 21 pacientes expuestos y 42 pacientes no expuestos. En los individuos expuestos se observó un aumento estadísticamente significativo en el INR al mes siguiente de haber iniciado el tratamiento con el acetaminofén comparado con el momento de ingreso al estudio (mes 1: mediana 3,06 vs. mes 0: mediana 2,63), (valor p = 0,003). En contraste, en los sujetos no expuestos no se observaron diferencias estadísticamente significativas en los valores del INR (mes 0: mediana 2,63 vs. mes 1: mediana 2,75), (valor p = 0,115). El uso de la warfarina y el acetaminofén representó un RR de 2,5 veces mayor de incrementar el INR mayor o igual de 0,5 unidades. Conclusión: El uso concomitante de la warfarina y el acetaminofén está asociado a un aumento del INR igual o mayor de 0,5 unidades, lo cual podría generar un mayor efecto anticoagulante y, por tanto, un mayor riesgo potencial de sangrado.

Abstract Motivation: To assess concomitant use of warfarin and acetaminophen in an outpatient population of patients receiving blood-thinning drugs as a possible risk factor for the increase of International Normalised Ratio (INR). Methods: Retrospective cohort study. The information pertaining 1,458 patients receiving blood-thinning drugs with warfarin was analysed. The risk factor was the joint intake of warfarin and acetaminophen; follow-up time was 1 month and the final event considered was a INR increase of or higher than 0.5 units. The association of the risk factor with the final event was establish with the Relative Risk (RR) and the Population Attributable Risk (PAR). Results: 63 patients met the inclusion criteria, of whom 21 were exposed patients and 42 were unexposed patients. In the exposed patients a statistically significant increase of INR on the month following the onset of treatment with acetaminophen was observed, compared to the baseline values (month 1: median 3.06 vs. month 0: median 2.63), (p = 0.003). In contrast, no statistically significant differences of INR values were observed in unexposed individuals (month 0: median 2.63 vs. month 1: median 2.75) (p = 0.115). The combination of warfarin and acetaminophen represented a RR 2.5 times higher to increase INR greater than or equal to 0.5 units. Conclusion: Concomitant use of warfarin and acetaminophen is associated to an increase of INR equal to or greater than 0.5 units, which could generate a higher blood-thinning effect and, thus, cause a potentially higher risk of bleeding.
Descritores: Varfarina
Acetaminofen
Anticoagulantes/administração & dosagem
-Preparações Farmacêuticas
Fatores de Risco
Hemorragia
Limites: Humanos
Masculino
Idoso
Tipo de Publ: Estudo Observacional
Responsável: CO369.9 - SCC - Sociedad Colombiana de Cardiologia y Cirugía Cardiovascular


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Id: biblio-962724
Autor: Cidon, Esther Una.
Título: Myalgia-arthralgia syndrome induced by docetaxel in oncology: the wolf disguised as a sheep
Fonte: Säo Paulo med. j;136(3):270-271, May-June 2018.
Idioma: en.
Descritores: Artralgia/induzido quimicamente
Taxoides/efeitos adversos
Mialgia/induzido quimicamente
Antineoplásicos/efeitos adversos
-Síndrome
Codeína/uso terapêutico
Artralgia/tratamento farmacológico
Mialgia/tratamento farmacológico
Docetaxel
Analgésicos/uso terapêutico
Acetaminofen/uso terapêutico
Limites: Humanos
Tipo de Publ: Carta
Responsável: BR1.1 - BIREME


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Id: biblio-1019609
Autor: Lino, Patrícia Azevedo; Sohn, Woosung; Singhal, Astha; Martins, Maria Auxiliadora Parreiras; Silva, Maria Elisa de Souza e; Abreu, Mauro Henrique Nogueira Guimarães de.
Título: A national study on the use of opioid analgesics in dentistry
Fonte: Braz. oral res. (Online);33:e076, 2019. tab, graf.
Idioma: en.
Projeto: CAPES; . CNPq.
Resumo: Abstract The aim of this study was to assess the frequency of opioid analgesics prescribed by Brazilian dentists, potential regional differences and their association with socioeconomic and health-related factors. Data for all opioid prescriptions by dentists was obtained from the 2012 database of the National Controlled Substances Management System, regulated by the Brazilian Health Surveillance Agency. The number of defined daily doses (DDD) and DDDs per 1,000 inhabitants per day for each Brazilian state were calculated as the primary outcomes. DDDs were compared by regions and Brazilian states. Spearman's rho correlation coefficient was used to determine the influence of the states' characteristics, such as the Human Development Index; poverty; education; number of dentists per 100,000 inhabitants; visit to the dentist; dental care plan; good or very good oral health; number of pharmaceutical establishments per 100,000/inhabitants; and ability to get all prescribed medications. Data analysis was performed using IBM SPSS Statistics 25.0. A total of 141,161 prescriptions for opioids analgesics by 36,929 dentists were recorded, corresponding to 658,855 doses of opioids dispensed in 2012. The most commonly dispensed opioids were codeine associated with paracetamol (83.2%; n = 117,493). The national DDDs per 1,000 inhabitants per day was 0.0093 (range: 0.0002-0.0216). DDD per 1,000 inhabitants per day was positively associated to visits to dentists (rs = 0.630; P < 0.001) and inversely associated to poverty (rs = -0.624; p = 0.001). There are significant differences in opioid prescriptions in dentistry among the Brazilian states. These differences may be associated with non-clinical factors.
Descritores: Prescrições de Medicamentos/estatística & dados numéricos
Assistência Odontológica/estatística & dados numéricos
Padrões de Prática Odontológica/estatística & dados numéricos
Analgésicos Opioides/uso terapêutico
-Farmácias/estatística & dados numéricos
Valores de Referência
Fatores Socioeconômicos
Tramadol/uso terapêutico
Brasil
Estudos Transversais
Codeína/uso terapêutico
Estatísticas não Paramétricas
Uso de Medicamentos/estatística & dados numéricos
Acetaminofen/uso terapêutico
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: lil-677356
Autor: Ceballos, Mauricio; Holguín, Héctor; González, César; Amariles, Pedro.
Título: Interacción warfarina y acetaminofén Evaluación para establecer su relevancia clínica / Warfarin and acetaminophen interaction Assessment to establish its clinical relevance
Fonte: Acta méd. colomb;38(1):22-25, ene.-mar. 2013. ilus, tab.
Idioma: es.
Resumo: Objetivo: realizar una revisión estructurada de la interacción warfarina y acetaminofén, buscando establecer su relevancia clínica y profundizar en el mecanismo de dicha interacción. Método: revisión estructurada en PubMed/Medline, de artículos en inglés y español, buscando los términos warfarin AND (acetaminophen OR paracetamol) en el título o resumen. La búsqueda se complementó con las referencias de artículos valorados como importantes. Los trabajos se agruparon en: relacionados con el aumento de sangrado por la interacción warfarina-acetaminofén, o relacionados con el mecanismo de la interacción. Resultados: se identificaron 45 artículos, de los cuales se incluyeron 15 en la revisión: 11 relacionados con el aumento del riesgo de sangrado por la interacción y cuatro con el mecanismo de la interacción. La gravedad del efecto (aumento de la probabilidad de sangrado) se consideró moderada; mientras que la probabilidad de aparición fue valorada como definida. Además, se identificó una relación entre la dosis de acetaminofén y el riesgo de sangrado. Por su parte, el N-acetil-para-benzoquinona-imina (metabolito del acetaminofén) inhibe enzimas del ciclo de la vitamina K y tiene un efecto sinérgico con el efecto anticoagulante de la warfarina. Conclusiones: la relevancia clínica de la interacción warfarina - acetaminofén es de riesgo alto, debido a que la gravedad del efecto (aumento del riesgo de sangrado) es moderada y su probabilidad de presentación es definida. Por tanto, estos dos medicamentos pueden ser utilizados conjuntamente, pero se debe realizar una estricta monitorización. El metabolito N-acetil-para-benzoquinona-imina es el responsable del aumento del efecto anticoagulante de la warfarina. (Acta Med Colomb 2013; 38: 22-27).

Objective: to make a structured review of the interaction between warfarin and acetaminophen, seeking to establish its clinical relevance and deepen in the mechanism of this interaction. Method: structured review of PubMed/Medline of articles in English and Spanish, looking warfarin and acetaminophen or paracetamol in the title or abstract. The search was complemented with references of articles rated as important. The papers were grouped in: related to increased bleeding due to warfarin-acetaminophen interaction, or related to the mechanism of the interaction. Results: we identified 45 articles, of which 15 were included in the review: 11 related to increased risk of bleeding due to the interaction and 4 with the mechanism of the interaction. The severity of the effect (increased likelihood of bleeding) was considered moderate, whereas the probability of appearance was rated as definite. In addition, we identified a relationship between the dose of acetaminophen and the risk of bleeding. In turn, the N-acetyl-para-benzoquinone-imine (metabolite of acetaminophen) inhibits enzymes of the vitamin K cycle and has a synergistic effect with the anticoagulant effect of warfarin. Conclusions: the clinical relevance of the interaction warfarin-acetaminophen is of high risk due to the fact that the severity of the effect (increased risk of bleeding) is moderate and the probability of its presentation is definite. Therefore, these two drugs can be used together, but a strict monitoring should be conducted. The metabolite N-acetyl-para-benzoquinone-imine is responsible for the increase in the anticoagulant effect of warfarin. (Acta Med Colomb 2013; 38: 22-27).
Descritores: Interações Medicamentosas
-Varfarina
Prática Clínica Baseada em Evidências
Acetaminofen
Tipo de Publ: Revisão
Responsável: CO70 - Asociación Colombiana de Medicina Interna


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Id: biblio-1002303
Autor: Burgos-Quiróz, Karen Mishell; Asmat-Abanto, Angel S; Espejo-Carrera, Rosita Elena.
Título: Efectividad Analgésica de Paracetamol Post-Cirugía Mucogingival: Ensayo Clínico Aleatorizado Paralelo / Analgesic Effectiveness of Paracetamol Post-Mucogingival Surgery: Parallel Randomized Clinical Trial
Fonte: Int. j. odontostomatol. (Print);13(2):184-188, jun. 2019. tab.
Idioma: es.
Resumo: RESUMEN: El objetivo de este trabajo fue determinar la efectividad analgésica de paracetamol post-cirugía mucogingival. El estudio, prospectivo, longitudinal, comparativo y experimental, se desarrolló en la Clínica Odontológica de la Universidad Privada Antenor Orrego (Trujillo, Perú) con los pacientes de la asignatura Periodoncia II. Se incluyeron 39 pacientes, quienes fueron distribuidos de manera aleatoria en 2 grupos de 19 y 20 cada uno, según los criterios establecidos. La medicación se inició 20 minutos después de concluida la cirugía, y se mantuvo por 24 horas. Para determinar la efectividad analgésica se usó la escala visual analógica (0-100 mm) y se recogió la información que fue procesada, utilizando la prueba de U Mann-Whitney con un nivel de significancia del 5 %. No existe diferencia en cuanto a la efectividad analgésica post-cirugías mucogingivales entre paracetamol y el control a las 2 horas (p=0.415), 8 horas (p=0.279) y 24 horas (p=0.736). Paracetamol es efectivo como analgésico post-cirugía mucogingival.

ABSTRACT: The objective of this study was to determine the analgesic effectiveness of paracetamol after mucogingival surgery. This prospective, longitudinal, comparative and experimental study was developed in the Stomatology Clinic of the Universidad Privada Antenor Orrego (Trujillo, Perú) with the patients of the Periodontics II subject. We included 39 patients, who were randomly distributed into 2 groups of 19 and 20 each, according to the established criteria. The medication was started 20 minutes after the surgery was completed, and was maintained for 24 hours. To determine the analgesic effectiveness, the analogue visual scale (0-100 mm) was used and the information that was processed was collected, using the U Mann-Whitney test with a level of significance of 5 %. There is no difference in terms of analgesic effectiveness post-mucogingival surgery between paracetamol and control at 2 hours (p = 0.415), 8 hours (p = 0.279) and 24 hours (p = 0.736). Paracetamol is effective as a mucogingival post-surgery analgesic.
Descritores: Analgésicos não Narcóticos/administração & dosagem
Retração Gengival/cirurgia
Acetaminofen/administração & dosagem
-Peru
Efetividade
Gengiva
Limites: Humanos
Adolescente
Adulto
Pessoa de Meia-Idade
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Ensaio Clínico Fase IV
Responsável: CL1.1 - Biblioteca Central


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Id: lil-480751
Autor: Rowensztein, Hérnan.
Título: ¿Son eficaces los antipiréticos alternados para el tratamiento de la fiebre en pediatría? / Are alternating antipiretics efficacious to treat fever in pediatrics?
Fonte: Med. infant;14(1):79-81, mar. 2007. tab.
Idioma: es.
Descritores: Acetaminofen/farmacologia
Acetaminofen/uso terapêutico
Analgésicos não Narcóticos/farmacologia
Analgésicos não Narcóticos/uso terapêutico
Eficácia
Febre/diagnóstico
Ibuprofeno/farmacologia
Ibuprofeno/uso terapêutico
Limites: Lactente
Pré-Escolar
Criança
Adolescente
Responsável: AR94.1 - Centro de Información Pediatrica


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Id: biblio-1153105
Autor: Pereira, Vinicius B. P; Torriceli, André A; Garcia, Renato; Bechara, Samir J; Alves, Milton R.
Título: Codeine plus acetaminophen improve sleep quality, daily activity level, and food intake in the early postoperative period after photorefractive keratectomy: a secondary analysis / Melhora da qualidade do sono e das atividades diárias pós PRK imediato utilizando codeína com paracetamol: análise secundária de um ensaio clínico randomizado, duplo-cego e placebo-controlado
Fonte: Arq. bras. oftalmol;84(1):45-50, Jan.-Feb. 2021. tab.
Idioma: en.
Resumo: ABSTRACT Purpose: To determine whether codeine plus acetaminophen after photorefractive keratectomy (PRK) have beneficial effects on sleep quality, activity levels, and food intake, beyond their effect of pain relief. Methods: We enrolled 40 patients (80 eyes) in this randomized, double-blind, paired-eye, placebo-controlled, add-on trial. Each eye was treated 2 weeks apart, and the patients were randomly allocated to receive either the placebo or the intervention (30 mg codeine and 500 mg acetaminophen) (4 times a day for 4 days). Outcomes were sleep quality, daily activity level, and food intake within 24-72 h post-photorefractive keratectomy, as measured by the McGill Pain Questionnaire. Results: Sleep quality and daily activity level were inversely associated with pain scores within the first 48 h post-photorefractive keratectomy. During the intervention, patients were significantly more likely to score their sleep quality as good at 24 h (relative risk=2.5; 95% confidence interval 1.48-4.21, p<0.001) and 48 h compared to during placebo (relative risk=1.37; 95% confidence interval: 1.03-1.84, p=0.023). The probability of reporting good daily activity level at 24 and 72 hours post-photorefractive keratectomy was three times higher when patients received the intervention compared to the placebo (relative risk=3.0; 95% confidence interval: 1.49-6.15, p=0.006 and relative risk=1.31; 95% confidence interval: 1.02-1.67, p=0.021, respectively). No difference was observed in food intake. Conclusion: The oral combination of codeine and acetaminophen significantly improves sleep quality and daily activity level within the first 24-72 h post-photorefractive keratectomy compared to a placebo.

RESUMO Objetivo: Determinar se codeína (30 mg) mais pa­racetamol (500 mg) após ceratectomia fotorrefrativa fornece efeitos benéficos sobre a qualidade do sono, níveis de atividade e ingestão de alimentos além de seu efeito analgésico. Métodos: Quarenta pacientes (80 olhos) foram incluídos neste estudo randomizado, duplo-cego, pareado, placebo-controlado, add-on. Cada olho foi tratado com 2 semanas de intervalo, sendo aleatoriamente alocado para placebo ou intervenção (4x/dia durante 4 dias). Os resultados incluíram a qualidade do sono, atividade diária e ingestão de alimentos dentro de 24-72 horas de pós-operatório, conforme medido pelo McGill Pain Questionnaire. Resultados: A qualidade do sono e os níveis de atividade foram inversamente associados aos escores de dor nas primeiras 48 horas após o ceratectomia fotorrefrativa. Durante a intervenção, os pacientes foram significativamente mais propensos a classificar seu sono como bom em 24 horas (risco relativo=2,5, intervalo de confiança de 95%: 1,48-4,21, p<0,001) e 48 horas comparado ao placebo (risco relativo=1,37, intervalo de confiança de 95%: 1,03-1,84, p=0,023). A probabilidade de relatar bons níveis de atividade em 24 e 72 horas após ceratectomia fotorrefrativa também foi significativamente maior durante a intervenção em comparação com placebo (risco relativo=3,0, intervalo de confiança de 95%: 1,49-6,15, p=0,006 e risco relativo=1,31, intervalo de confiança de 95%: 1,02 -1,67, p=0,021, respectivamente). Nenhuma diferença foi observada entre a intervenção e placebo em relação à alimentação oral. Conclusão: A combinação de codeína e paracetamol melhorou significativamente a qualidade do sono e atividades diárias nas primeiras 24-72 horas após o ceratectomia fotorrefrativa em comparação com placebo.
Descritores: Método Duplo-Cego
Codeína/uso terapêutico
Ceratectomia Fotorrefrativa
Ingestão de Alimentos
Acetaminofen/uso terapêutico
-Dor Pós-Operatória/prevenção & controle
Dor Pós-Operatória/tratamento farmacológico
Período Pós-Operatório
Sono
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-1134461
Autor: Al-Doaiss, Amin A.
Título: Hepatotoxicity-induced by the therapeutic dose of acetaminophen and the ameliorative effect of oral co-administration of selenium/Tribulus terrestris extract in rats / Hepatotoxicidad inducida por la dosis terapéutica de acetaminofén y el efecto de mejora de la administración conjunta de extracto de selenio Tribulus terrestris en ratas
Fonte: Int. j. morphol;38(5):1444-1454, oct. 2020. tab, graf.
Idioma: en.
Projeto: King Khalid University.
Resumo: SUMMARY: Over dose or long-term clinical use of therapeutic doses of acetaminophen (APAP) causes hepatotoxicity. Various strategies attempted to ameliorate APAP-hepatotoxicity have been found to be unsuitable for clinical practice. This study was aimed to illustrate the histopathological changes induced by therapeutic dose of APAP and investigate the hepatoprotective role of oral co-administration of selenium/ Tribulus terrestris (TT) extract concurrently against hepatotoxicity induced by APAP in rats. Fifty-four healthy male albino Wistar rats were randomized into nine groups (G1-G9) of six rats each, and administered with APAP and TT orally for 30 days as follows: Control (2ml normal saline), APAP (470 mg/kg), APAP (470 mg/kg) + selenium (2 mg/kg), APAP (470 mg/kg) + TT (98 mg/kg), APAP (470 mg/kg) + selenium (2mg/kg) + TT (98 mg/kg), APAP (470 mg/kg) + silymarin (200 mg/kg), selenium (2 mg/ kg), TT (98 mg/kg) and silymarin (200 mg/kg) groups. The results demonstrated that exposure of rats to therapeutic dose of APAP for 30 days caused significant histopathological changes parallel to elevated blood chemistry parameters. Co-administration of selenium/TT extract showed significantly reduced histopathological lesions and, restored or decreased levels of the examined blood chemistry parameters. Liver histology in selenium/TT extract showed normal hepatic architecture with mild changes and silymarin treated rats showed no histopathological changes. Histochemically PAS staining, showed that APAP-induced hepatotoxicity was characterized by hepatocytes glycogen depletion. Selenium/TT co-supplementation plays a potential role in preventing APAP-induced glycogen depletion by increasing detoxification and scavenging the reactive metabolites. Selenium/TT extract oral co-administration possesses a significant hepatoprotective property and mitigates APAP-induced hepatotoxicity by enhancing its antioxidant role and improving tissue integrity. Selenium/TT supplementation could represent an effective treatment against APAP-induced hepatotoxicity. Further studies are needed to elucidate the exact mechanism underlying the protective role of TT extract.

RESUMEN: La dosis excesiva o el uso clínico a largo plazo de dosis terapéuticas de acetaminofeno (APAP) causa hepatotoxicidad. Se ha descubierto que varias estrategias que intentaron mejorar la hepatotoxicidad por APAP no son adecuadas para la práctica clínica. Este estudio tuvo como objetivo ilustrar los cambios histopatológicos inducidos por la dosis terapéutica de APAP e investigar el papel hepatoprotector de la administración conjunta de extracto de selenio / Tribulus terrestris (TT) simultá- neamente contra la hepatotoxicidad inducida por APAP en ratas. Cincuenta y cuatro ratas Wistar albino machos sanas se aleatorizaron en nueve grupos (G1 - G9) de seis ratas cada una, y se administraron con APAP y TT por vía oral durante 30 días de la siguiente manera: Control (2 ml de solución salina normal), APAP (470 mg / kg), APAP (470 mg / kg) + selenio (2 mg / kg), APAP (470 mg / kg) + TT (98 mg / kg), APAP (470 mg / kg) + selenio (2 mg / kg) + TT (98 mg / kg), APAP (470 mg / kg) + silimarina (200 mg / kg), selenio (2 mg / kg), TT (98 mg / kg) y silimarina (200 mg / kg). Los resultados demostraron que la exposición de las ratas a la dosis terapéutica de APAP durante 30 días causó cambios histopatológicos significativos paralelos a parámetros elevados de química sanguínea. La administración conjunta de extracto de selenio / TT mostró lesiones histopatológicas significativamente reducidas y niveles restaurados o disminuidos de los parámetros de química sanguínea. La histología hepática en el extracto de selenio / TT mostró una arquitectura hepática normal con cambios leves y las ratas tratadas con silimarina no mostraron cambios histopatológicos. La tinción histoquímica de PAS mostró que la hepatotoxicidad inducida por APAP se caracterizó por la pérdida de glucógeno de los hepatocitos. La suplementación con selenio / TT juega un papel potencial en la prevención de la pérdida de glucógeno inducido por APAP al aumentar la desintoxicación y eliminar los metabolitos reactivos. La administración conjunta de extracto de selenio / TT posee una propiedad hepatoprotectora significativa y mitiga la hepatotoxicidad inducida por APAP al mejorar su papel antioxidante y la integridad del tejido. La suplementación con selenio / TT podría representar un tratamiento efectivo contra la hepatotoxicidad inducida por APAP. Se necesitan más estudios para dilucidar el mecanismo exacto que subyace a la función protectora del extracto TT.
Descritores: Selênio/administração & dosagem
Extratos Vegetais/administração & dosagem
Tribulus/química
Doença Hepática Induzida por Substâncias e Drogas/tratamento farmacológico
Acetaminofen/toxicidade
-Administração Oral
Ratos Wistar
Glicogênio
Fígado/efeitos dos fármacos
Limites: Animais
Masculino
Ratos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-958409
Autor: Geldi, Onur; Kubat, Emre; Ünal, Celal Selçuk; Canbaz, Suat.
Título: Acetaminophen mitigates myocardial injury induced by lower extremity ischemia-reperfusion in rat model
Fonte: Rev. bras. cir. cardiovasc = Braz. j. cardiovasc. surg. (impr.);33(3):258-264, May-June 2018. tab, graf.
Idioma: en.
Resumo: Abstract Objective: The injury-reducing effect of acetaminophen, an effective analgesic and antipyretic on ischemia-reperfusion continues to attract great attention. This study analyzed the protective effect of acetaminophen on myocardial injury induced by ischemia-reperfusion in an experimental animal model from lower extremity ischemia-reperfusion. Methods: Twenty-four Sprague-Dawley female rats were randomized into three groups (n=8) as (i) control group (only laparotomy), (ii) aortic ischemia-reperfusion group (60 min of ischemia and 120 min of reperfusion) and (iii) ischemia-reperfusion + acetaminophen group (15 mg/kg/h intravenous acetaminophen infusion starting 15 minutes before the end of the ischemic period and lasting till the end of the reperfusion period). Sternotomy was performed in all groups at the end of the reperfusion period and the heart was removed for histopathological examination. The removed hearts were histopathologically investigated for myocytolysis, polymorphonuclear leukocyte (PMNL) infiltration, myofibrillar edema and focal hemorrhage. Results: The results of histopathological examination showed that acetaminophen was detected to particularly diminish focal hemorrhage and myofibrillar edema in the ischemia-reperfusion + acetaminophen group (P<0.001, P=0.011), while there were no effects on myocytolysis and PMNL infiltration between the groups (P=1.000, P=0.124). Conclusion: Acetaminophen is considered to have cardioprotective effect in rats, by reducing myocardial injury induced by abdominal aortic ischemia-reperfusion.
Descritores: Cardiotônicos/farmacologia
Traumatismo por Reperfusão Miocárdica/prevenção & controle
Extremidade Inferior/irrigação sanguínea
Acetaminofen/farmacologia
-Aorta Abdominal/patologia
Valores de Referência
Fatores de Tempo
Traumatismo por Reperfusão Miocárdica/patologia
Distribuição Aleatória
Ratos Sprague-Dawley
Constrição
Modelos Animais de Doenças
Edema Cardíaco/patologia
Isquemia/prevenção & controle
Isquemia/sangue
Miofibrilas/patologia
Limites: Humanos
Animais
Feminino
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME


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Id: biblio-1010313
Autor: Soria Garcés, Ximena.
Título: Factores predisponentes para administrar un segundo ciclo de paracetamol o el cierre quirúrgico del ductus arterioso persistente en los recién nacidos pretérmino / Predisposing factors for administering a second paracetamol cycle or surgical closure of the persistent arterial ductus in preterm infants
Fonte: Rev. ecuat. pediatr;20(1):45-56, Agosto2019.
Idioma: es.
Resumo: Contexto: el conducto arterioso es una estructura que forma parte de la circulación fetal normal; en condiciones normales, se cierra espontáneamente en las primeras 24 a 36 horas de vida. En algunas condiciones patológicas, como la prematuridad, sigue siendo permeable. El tratamiento incluye terapia farmacológica y, en casos extremos, asistencia quirúrgica. Propósito: determinar si los factores demográficos, la edad en el momento del diagnóstico, los parámetros antropométricos, las patologías asociadas, la sobrehidratación, la fototerapia, las transfusiones sanguíneas, el uso de drogas inotrópicas y la ventilación mecánica influyen en la respuesta del tratamiento farmacológico con un ciclo de paracetamol en los pacientes con conducto arterioso persistente y en aquellos que requieren un segundo ciclo o el cierre quirúrgico. Sujetos y métodos: Este es un estudio descriptivo, analítico, epidemiológico, transversal, retrospectivo. Muestra: 205 pacientes pretérminos, nacidos en Quito entre noviembre del 2016 y noviembre del 2018 que tuvieron ductus arterioso persistente. Resultados: 103 casos de ducto arterioso persistente con respuesta al tratamiento con un solo ciclo de paracetamol y 102 que no cerraron el ductus; en el momento del diagnóstico la edad fue menor o igual a 72 horas (n = 110; 53,73 %); predominó el sexo masculino (n = 111; 54,14 %), así como la raza mestiza (200; 97.73 %); los diagnósticos al ingreso fueron: riesgo metabólico (n = 147; 71.7 %) y riesgo de sepsis (n = 108; 52.9 %); la edad gestacional promedio fue de 32-37 semanas ; la mayoría de los pacientes presentaron perímetro cefálico, talla y temperatura adecuados; y no requirieron inotrópicos (n = 132; 64,39 %); la mayoría recibió antibióticos (n = 170; 82,71 %); muchos no recibieron alimentación (n = 126; 61,76 %); algunos requirieron Ventilación Mecánica Intermitente (n = 131; 63,7 %). Las patologías asociadas más frecuentes fueron las respiratorias (n = 179; 87.31 %), las metabólicas (n = 160; 78,36 %) y las infecciosas (n = 152; 74,63 %); en cuanto a los hallazgos ecocardiográficos, se encontró un tamaño del ductus mayor a 1,4mm/kg (n = 110; 53,62 %), un patrón de flujo en cierre (n = 99; 48,55 %), sin inversión de flujo (n = 157; 76,81 %), una fracción de acortamiento mayor o igual a 35 % (n = 162; 78.99 %), sin dilatación de las cavidades izquierdas (n = 184; 89,86 %); los cofactores asociados fueron: fototerapia (n = 113; 55,07 %), transfusión sanguínea (n = 83; 40,58 %), uso de furosemida (n = 58; 28,26 %) y sobrehidratación (n = 55; 26,81 %). Conclusiones: las variables asociadas a una no respuesta a un solo ciclo de paracetamol fueron la edad en el momento del diagnóstico, mayor a 72 horas; la temperatura al nacer menor a 36,5° C; las transfusiones, el uso de furosemida y la sobrehidratación.

Context: The ductus arteriosus is part of the normal fetal circulation, that normally closes spontaneously in the first 24 to 36 hours of life. In some pathological conditions, such as prematurity, it continues to be permeable. Treatment includes pharmacological therapy and in extreme cases surgical assistance. Purpose: To determine if demographic factors, age of diagnosis, anthropometric parameters, associated pathologies, overhydration, phototherapy, blood transfusions, use of inotropic drugs, mechanical ventilation influence the response of pharmacological treatment with a paracetamol cycle in patients with persistent ductus arteriosus and those that require a second cycle or surgical closure. Subjects and methods: This is a descriptive, analytical, epidemiological, cross-sectional, retrospective study. Sample: 205 preterm patients born from November 2016 to November 2018 in Quito with persistent ductus arteriosus. Results: 103 patients responded to treatment with a single cycle of paracetamol and 102 did not, age at diagnosis less than or equal to 72 hours (n = 110, 53.73%), male sex (n = 111 54.14%), mestizo (200, 97.73%), diagnosis at admission: metabolic risk (n = 147, 71.7%), risk of sepsis (n = 108, 52.9%), gestational age 32-37 SG (n = 85, 41.67%), the majority of the patients presented adequate head circunference, height and temperature, did not require inotropics (n = 132, 64.39), used antibiotics (n = 170, 82.71%), did not receive food (n = 126, 61.76%), required Intermittent Mandatory Ventilation(n = 131, 63.7%), among the associated pathologies the most frequent were: respiratory (n = 179, 87.31%), metabolic (n = 160, 78.36%), infectious (n = 152, 74.63%), echocardiographic findings: ductus size greater than 1.4mm / kg (n = 110, 53.62%), flow pattern at closure ( n = 99; 48.55%), without flow reversal (n = 157; 76.81%), shortening fraction greater than or equal to 35% ( n = 162; 78.99%), without dilatation of left cavities (n = 184; 89.86%), associated cofactors: phototherapy (n = 113, 55.07%), blood transfusion (n = 83, 40.58%), use of furosemide (n = 58, 28.26%) and overhydration ( n = 55, 26.81%) Conclusions: The variables associated with non-response to a single cycle of paracetamol were age at diagnosis greater than 72 hours, temperature at birth less than 36.5 ° C, transfusions, use of furosemide and overhydration.
Descritores: Recém-Nascido Prematuro
Canal Arterial
Acetaminofen
-Síndrome da Persistência do Padrão de Circulação Fetal
Ecocardiografia
Conduta do Tratamento Medicamentoso
Limites: Humanos
Recém-Nascido
Tipo de Publ: Artigo Clássico
Responsável: EC150



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