Administration Of Nonsteroidal Anti-inflammatory Drugs Research Articles

Relative Expression of Mouse Udp-glucuronosyl Transferase 2b1 Gene in the Livers, Kidneys, and Hearts: The Influence of Nonsteroidal Anti-inflammatory Drug Treatment.

Mouse Udp-glucuronosyl Transferase (UGT) 2b1 is equivalent to the human UGT2B7 enzyme, which is a phase II drug-metabolising enzyme and plays a major role in the metabolism of xenobiotic and endogenous compounds. This study aimed to find the relative expression of the mouse ugt2b1 gene in the liver, kidney, and heart organs and the influence of Nonsteroidal Anti-inflammatory Drug (NSAID) administration. Thirty-five Blab/c mice were divided into 5 groups and treated with different commonly-used NSAIDs; diclofenac, ibuprofen, meloxicam, and mefenamic acid for 14 days. The livers, kidneys, and hearts were isolated, while the expression of ugt2b1 gene was analysed with a quantitative real-time polymerase chain reaction technique. It was found that the ugt2b1 gene is highly expressed in the liver, and then in the heart and the kidneys. NSAIDs significantly upregulated (ANOVA, p < 0.05) the expression of ugt2b1 in the heart, while they downregulated its expression (ANOVA, p < 0.05) in the liver and kidneys. The level of NSAIDs' effect on ugt2b1 gene expression was strongly correlated (Spearman's Rho correlation, p < 0.05) with NSAID's lipophilicity in the liver and its elimination half-life in the heart. This study concluded that the mouse ugt2b1 gene was mainly expressed in the liver, as 14-day administration of different NSAIDs caused alterations in the expression of this gene, which may influence the metabolism of xenobiotic and endogenous compounds.

Low-dose rectal diclofenac does not prevent post-ERCP pancreatitis in low- or high-risk patients.

The most common adverse event following an endoscopic retrograde cholangiopancreatography (ERCP) procedure is post-ERCP pancreatitis (PEP). Rectal nonsteroidal anti-inflammatory drug (NSAID) administration has shown promise to reduce the risk of PEP in high-risk patients. However, in contrast to high-risk patients, the role of NSAID administration in patients with low risk remains controversial. We performed a prospective, single-center, single-blinded, two-arm parallel group, randomized controlled trial to clarify the efficacy of low dose (50mg) rectal NSAID administration for preventing PEP in at-risk patients. Patients scheduled to undergo ERCP were randomized into two groups, those with and without rectal administration of diclofenac. Patients in the diclofenac group received 50mg of rectal diclofenac 30min before undergoing ERCP. The primary endpoint was rate of PEP. A total of 303 were randomized into the study groups. Four patients declined participation following randomization, and another two were withdrawn. As a result, a total of 147 patients were assigned to the diclofenac group and 150 to the control group. The baseline and procedural characteristics were similar in both groups. The primary endpoint of PEP occurrence was seen in 13 of 297 patients (4.4%), including eight (5.4%) in the diclofenac group and five (3.3%) in the control group (P=0.286). Additionally, those results were not significantly different when patients were classified as low or high risk. Prophylactic low-dose rectal diclofenac did not reduce the incidence of PEP following ERCP in patients classified as low or high risk.

Uterine inflammatory conditions in dairy cows: Diagnosis and treatment

The diagnosis of inflammatory conditions in the uterus depends primarily on the severity of the inflammation process and associated clinical symptoms. Because of the period of occurrence and characteristic signs, severe lesions in the uterus, such as metritis puerperalis, are not difficult to diagnose and do not require the use of diagnostic methods other than clinical examinations and, if necessary, additional tests to determine the general condition of the animals. However, in this case, it is important to precisely identify the pathogenic factor and to determine its susceptibility to antibiotics in order to define further treatment. Endometritis is the biggest diagnostic problem, especially its subclinical form, which can be diagnosed only by additional cytological or histopathological tests. These tests, although available, are not routinely performed in Poland at this time. The latest diagnostic methods, such as immunohistochemical tests or flow cytometry, have provided many previously unknown data, for example, on the action of the local resistance mechanisms in the uterus. Since the immune system of the uterus is not fully known, the above tests may improve the understanding of its activity or may help modulate its functions in the future as a potential preventative measure or treatment for inflammatory conditions of the uterus. The treatment of inflammatory conditions in dairy cows is currently based on two basic methods: intrauterine administration of antibiotics and intramuscular injections of prostaglandin-based preparations. The main goal of the treatment is to improve the fertility of cows in the herd, and since these methods are often ineffective, there have been attempts to treat endometritis with iodine-based preparations and preparations containing enzymes (trypsin, chymotrypsin and papain). They did not, however, improve the fertility of cows. The administration of non-steroid anti-inflammatory drugs to eliminate the inflammatory condition of the uterus and to prevent early deaths of embryos at the time of the greatest risk of embryo loss did not increase the number of pregnancies in cows either. Literature data suggest that immunomodulation and the use of probiotics may be useful in the prevention and treatment of endometritis.

PSIII-4 Infrared thermography as a method for detecting pain in dairy calves in response to disbudding on-farm

Abstract Measured using infrared thermography (IRT), changes in eye temperature, can be used to non-invasively measure pain in response to husbandry procedures such as disbudding in calves. Previous studies have manually recorded IRT in controlled studies, however, it would be of interest to determine if IRT could be used to measure changes in eye temperature in response to pain in an automated on-farm system. Therefore, the objective of this study was to determine if IRT could be used to detect pain in dairy calves in response to disbudding on-farm. At 3 wk of age, 51 Friesian calves were allocated to 1 of 5 treatment groups: 1) sham handling (SHAM, n = 10), 2) cautery disbudding (DB, n = 11), 3) administration of local anesthetic (LA) and DB (LA+DB, n = 11), 4) administration of a non-steroidal anti-inflammatory drug (NSAID) and DB (NSAID+DB, n = 9) and 5) administration of LA, NSAID and DB (LA+NSAID+DB, n = 10). Eye temperature was measured using an IRT camera located next to an automatic calf milk feeder for 3 days before and after disbudding. During each calf’s visit to the feeder, IRT images were automatically recorded for the duration of the feeding bout. A mixed model analysis with splines was used to determine the effect of treatment on eye temperature over time. There was no overall effect of disbudding treatment on eye temperature (P = 0.22), but temperature appeared to increase in calves after disbudding or sham handling (P = 0.036). On average, calves visited the calf feeder 4 times/day, which may have been too infrequent to collect sufficient IRT images to detect a difference in eye temperature in response to disbudding. However, the increase in eye temperature after disbudding and handling may reflect a general stress response. Therefore, the automated use of IRT to measure eye temperature may be a useful non-invasive method to measure stress in calves.

Nonsteroidal Anti-Inflammatory Drugs Impact on the Outcomes of Hospitalized Patients with Clostridium difficile Infection.

PurposeMouse model experiments have demonstrated an increased Clostridium difficile infection (CDI) severity with Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) use. We aim to evaluate the impact of NSAIDs in humans after a diagnosis of CDI on primary outcomes defined as I) all-cause mortality and II) toxic mega-colon attributable to CDI.Patients and methodsAll hospitalized patients with a diagnosis of CDI were divided into two groups; those with NSAIDs administered up to 10 days after onset of CDI versus no NSAIDs use. The primary outcomes were analyzed between the groups, while controlling for severity of CDI. A logistic regression analysis was performed to identify the predictors of worse outcomes.ResultsNSAIDs were administered in 14% (n=80) of the 568 hospitalized visits for an average of 2.5 days after the CDI diagnosis. All-cause mortality was high in patients who did not receive NSAIDs as compared to those who did receive NSAIDs (16.6% vs 12.5%, p 0.354). Patients who were prescribed NSAIDs were more likely to have toxic mega-colon as compared to those who were not prescribed NSAIDs (2.5% vs 0.6%, p 0.094). Results were not statistically significant, even after controlling for CDI severity. Logistic regression analysis did not identify NSAIDs administration as a significant factor for all-cause mortality in CDI patients.ConclusionThis retrospective study results, contrary to mouse model, did not show association between NSAID use and CDI related mortality and toxic mega-colon. Shorter duration of NSAIDs use, younger people in study group, and timely CDI treatment may have resulted in contrasting results.

Effects of NSAID use on bone healing: A meta-analysis of retrospective case–control and cohort studies within clinical settings

IntroductionThis meta-analysis aims to determine whether non-steroidal anti-inflammatory drug (NSAID) use is significantly associated with adverse bone healing outcomes within clinical settings, including trauma and elective spine settings. It will also explore bone healing outcomes with the type, route, dosage and duration of NSAID exposure and aims to demonstrate the effects of various other confounding factors on bone healing outcomes.MethodsElectronic databases including MedLine, Embase and Cochrane were searched from January 1975 to December 2017. A distinct analysis of observational long bone and spine studies in adult populations was performed, assessing the effects of NSAID exposure on bone healing. Studies from paediatric population and randomised trials also underwent separate assessment in the synthesis. Meta-analysis was conducted in compliance with QUORUM and PRISMA guidelines.ResultsQuantitative assessment of observational studies suggested a significant risk of bone healing complications with NSAID exposure across each clinical group: long bone (p = 0.0004) and spine (p = 0.02). Analysis of paediatric studies revealed a non-significant association of poor outcomes with NSAID use (p = 0.36), while assessment of randomised trials demonstrated a statistically significant risk of complications following NSAID administration (p = 0.04). Meta-regression further suggested smoking to be a substantial confounder associated with adverse bone healing outcomes (p &lt; 0.00001).ConclusionInclusion of only fair and moderate-quality retrospective cohort and case–control studies in the current synthesis limits the clinical application of its findings and therefore warrants the need for further research. Thus, attempts to conduct high-quality prospective cohort and randomised trials to study the effects of NSAID use on bone healing would be very helpful and will provide a basis for more extensive research in future.

Impact of the Type of Analgesic Therapy on Postsurgical Complications of Patients with Kidney Cancer Undergoing Nephrectomy

Background: The treatment of kidney cancer usually involves surgery, and in some cases systemic therapy. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to control postsurgical pain in patients undergoing nephrectomy for renal cancer. Nevertheless, the association between these drugs and adverse postsurgical outcomes, including deterioration of renal function, is not fully established. Methods: This retrospective cohort study included patients >18 years old with kidney cancer undergoing nephrectomy between January 2006 and January 2018. The primary endpoint was to determine the impact of postsurgical analgesic therapy (NSAIDs vs. acetaminophen) on renal function and postsurgical complications. This study was approved by our scientific and bioethical committee. Results: One hundred patients were included in the final analysis. Clear-cell renal-cell carcinoma was the most frequent histologic subtype. Adequate acute pain control was accomplished in 91% of the patients during hospitalization. Twenty percent of the patients presented postsurgical complications. Bleeding-related complications were the most frequent (9%), followed by surgical-site infection (6%) and acute renal injury (6%). The administration of NSAIDs was not related to any postsurgical complication in comparison with the use of acetaminophen (21.3 vs. 17.9%, respectively). The length of hospital stay did not differ between patients treated with NSAIDs and those treated with acetaminophen (the average stay was 4 days for both groups, p = 0.32). Conclusion: The use of NSAIDs was not related to acute kidney injury, postsurgical complications, or prolonged hospital stay in patients with renal cancer undergoing nephrectomy.

Vibration treatment modulates macrophage polarisation and enhances early inflammatory response in oestrogen-deficient osteoporotic-fracture healing.

Fracture healing is a well-orchestrated and coordinated process and begins with the inflammatory stage involving the infiltration of immune cells and the release of cytokines, including tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10). Low-magnitude high-frequency vibration (LMHFV) stimulation is effective in promoting fracture healing. The study hypothesis was that the innate immune response was impaired in osteoporotic fracture and LMHFV could positively modulate it. 9-month-old ovariectomy (OVX)-induced osteoporotic rats were randomised into sham (SHAM), OVX control (OVX), OVX-vibration (OVX-VT) or OVX vibration plus administration of COX-2 specific non-steroid anti-inflammatory drugs (OVX-VT-NSAID). LMHFV (35 Hz, 0.3 g) was given 20 min/d and 5 d/week to the treatment groups. Healing and innate immune response were evaluated by weekly radiographs, endpoint micro-computed tomography (µCT), enzyme-linked immunosorbent assay (ELISA) and histomorphometry at weeks 1, 2, 4 and 8 post-treatment. Results showed that OVX slightly elevated systemic inflammation but impaired the innate immune response locally at the fracture site, with significantly lower expressions of TNF-α and IL-6 but higher IL-10 expression during the early stage of healing. LMHFV was effective in accelerating the delayed fracture healing in OVX bones by partly restoring the impaired innate immune response at the fracture site, accompanied by promoted progression of macrophage polarisation from M1 (pro-inflammatory) to M2 (anti-inflammatory) phenotype. In conclusion, vibration treatment could positively modulate the impaired innate immune response and promote macrophage polarisation in osteoporotic-fracture healing.

Decreasing Opioid Use Postpartum: A Quality Improvement Initiative.

To estimate the effects of an inpatient initiative to decrease opioid use among women admitted to labor and delivery. We created a multimodal pain power plan with standard therapeutic postpartum activity goals rather than pain goals, tiered order sets with scheduled administration of nonsteroidal antiinflammatory drugs (NSAIDs), and embedded changes into the electronic health record. Before the multimodal pain power plan launch, pain was assessed on a 10-point scale; women received NSAIDs for pain levels of 3 or less and opioids for pain levels higher than 3. For this analysis, we included women who delivered at 5 hospitals in the 10 months before and 12 months after the multimodal pain power plan launch. Women with prior substance use disorder or complicated deliveries were excluded and we stratified analyses into women who delivered vaginally compared with by cesarean. Opioid use was converted to morphine milligram equivalent (MME). Women rated pain control in 24-hour blocks using individually ascertained cutoffs. A multivariable regression analysis was performed, and adjusted odds ratios are reported. We compared the 6,892 women who delivered 10 months before the pain power plan launch to the 7,527 who delivered in the 12 months after the launch. The mean cohort age was 29.6±6.0 years; the majority (75%) were white. Risk of opioid use decreased by 26% among women who delivered vaginally (risk ratio [RR] 0.74; 95% CI [0.68, 0.81]) and 18% among women who delivered by cesarean (RR 0.82; 95% CI [0.72, 0.92]). Among women who received opioids, mean MME use decreased 21% (RR 0.79; 95% CI [0.70, 0.88]) and 54% (RR 0.46; 95% CI [0.35, 0.61]) in the vaginal and cesarean delivery groups, respectively. Fewer women reported acceptable pain levels, with decreases of 82-69% (P<.01) and 82-74% (P<.01) in the vaginal and cesarean delivery groups, respectively. Within the postlaunch cesarean delivery group, women also reported that they were less likely to have their pain well controlled on the Hospital Consumer Assessment of Healthcare Providers and Systems questionnaires (82% vs 62%, P <.01). A standardized multimodal pain power plan reduced opioid use among a large cohort of women admitted to labor and delivery in Central Texas. Despite meeting functional goals, some women reported increased pain during their hospital stay.

State of intestinal microbiome in patients with osteoarthritis

Objective — to study the composition of intestinal microflora (CM) in patients with osteoarthritis (OA) against the background of administration of non-steroidal anti-inflammatory drugs (NSAIDs) and without them, as well as define difference in the CM of patients and healthy subjects.Materials and methods. The study involved 26 OA patients, who were divided into two groups: 16 subjects on NSAIDs (NSAID group) and 10 patients who did not take NSAIDs (non-NSAID group). Control group consisted of 23 healthy individuals. The state of intestinal microbiome was studied by real-time PCR, with the determination of the content of Bacteroides, Firmicutes, Actinobacteria, «other» types (total bacterial RNA with the exception of the above types) and the ratio of Firmicutes/Bacteroides.Results. It following significant differences have been established in QA patients in comparison with the healthy controls: Bacteroides levels was significantly higher, the median 19 % (interquartile range 8.05 — 27.39) % versus 7.36 (3.69 — 9.22) %, p &lt; 0.001; the Firmicutes and Actinobacteria levels were lower (51.47 (45.05 — 56.13) % versus 71.53 (58.57 — 74.098) %, p &lt; 0.01) and (6.95 (4.71 — 9.25) % versus 10.56 (7.07 — 14.64) %, p &lt; 0.05), respectively. The Firmicutes/Bacteroides ratio was almost five times lower in the OA group than in healthy control (2.81 (1.73 — 6.48) versus 9.898 (6.37 — 18.81), p &lt; 0.001), which makes it a very important diagnostic criterion. No significant difference was reveled in the CM compositions between the patients of NSAID group and non-NSAID group, as well as in the Firmicutes/Bacteroides ratio. However, Bacteroides levels differed form healthy controls in a higher extent in the group of OA patients from non-NSAID group, and they demonstrated more low Actinobacteria levels than healthy controls. Moreover, a middle-strength correlation has been established between the age and fecal Bacteroides content (positive, ρ = 0.595, p &lt; 0.001) and between age and fecal Firmicutes content (negative, ρ = –0.523, p &lt; 0.001). A positive correlation of the average strength was established between the «other» types of flora and age (ρ = 0.325, p &lt; 0.05)and body mass index (ρ = 0.464, p &lt; 0.05), which is consistent with the previous literature data.Conclusions. The significant difference has been established in the intestinal microflora composition between the group of OA patients and healthy subjects, and absence of such difference in case of subgroups comparison. The most significant difference was reveled in the levels of Bacteroides and Firmicutes: an increase of Bacteroides level and decrease in Firmicutes and Actinobacteria levels. The Firmicutes/Bacteroides ratio was the most sensitive indicator. In terms of Bacteroides levels, the non-NSAID group differed from the control group in more extension than the NSAID group, and they had the low Actinobacteria level.

Impact of transversus abdominis plane blocks versus non-steroidal anti-inflammatory on post-operative opioid use in ERAS ovarian cancer surgery

BackgroundTreatment of ovarian cancer often requires extensive surgical resection. The transversus abdominis plane (TAP) block has been utilized in benign gynecologic surgery to decrease post-operative pain and opioid use. We...

Celecoxib, ibuprofen, and indomethacin alleviate depression-like behavior induced by interferon-alfa in mice

Background Interferon-α (IFNα) therapy causes psychiatric side effects, including depression that may result in poor compliance of therapy. It is important to find alternative therapies for the prevention of IFNα induced depression. Non-steroidal anti-inflammatory drugs (NSAIDs) have been useful in depressive disorder. Therefore the effects of celecoxib, ibuprofen, and indomethacin were evaluated following IFNα-induced depression in mice. Methods Male albino mice weighing 26 ± 2 g were used. Depression was induced by IFNα (16 × 105 IU/kg, SC) for six consecutive days. Animals were first subject to the locomotor test, then the splash test and finally the forced swimming test (FST) on the 7th day. The NSAIDs were administered (IP) either one single dose before the test, or simultaneously with IFNα. Results locomotor activity was only impaired by ibuprofen high dose (75 mg/kg), thus it was not further evaluated. Following IFNα therapy depression-like behaviors were observed; significant changes during the splash test (grooming time 24 ± 7 sec vs. control 63 ± 7 sec), the FST (immobility time 166 ± 15 sec vs. control 128 ± 6 sec), and sucrose preference reduced to 64 ± 0.8%. The NSAIDs noticeably reduced the immobility time in FST, while grooming time was increased. Celecoxib and indomethacin single doses were effective while ibuprofen showed better antidepressant effects when it was administered along with IFNα. Conclusions The NSAIDs were able to prevent IFNα induced depression in mice. NSAIDs administration with IFNα does not interfere with clinical benefit effects of IFNα and they could also be useful to prevent IFNα psychiatric side effects, thus further clinical trials are suggested.

Acute calcific retropharyngeal tendinitis

A 44-year-old man with a 3-day history of limited range of motion of the bilateral shoulders, neck pain, dysphagia and mild fever presented to our emergency department. He had no...

Targeting the Canonical WNT/β-Catenin Pathway in Cancer Treatment Using Non-Steroidal Anti-Inflammatory Drugs

Chronic inflammation and oxidative stress are common and co-substantial pathological processes accompanying and contributing to cancers. Numerous epidemiological studies have indicated that non-steroidal anti-inflammatory drugs (NSAIDs) could have a positive effect on both the prevention of cancer and tumor therapy. Numerous hypotheses have postulated that NSAIDs could slow tumor growth by acting on both chronic inflammation and oxidative stress. This review takes a closer look at these hypotheses. In the cancer process, one of the major signaling pathways involved is the WNT/β-catenin pathway, which appears to be upregulated. This pathway is closely associated with both chronic inflammation and oxidative stress in cancers. The administration of NSAIDs has been observed to help in the downregulation of the WNT/β-catenin pathway and thus in the control of tumor growth. NSAIDs act as PPARγ agonists. The WNT/β-catenin pathway and PPARγ act in opposing manners. PPARγ agonists can promote cell cycle arrest, cell differentiation, and apoptosis, and can reduce inflammation, oxidative stress, proliferation, invasion, and cell migration. In parallel, the dysregulation of circadian rhythms (CRs) contributes to cancer development through the upregulation of the canonical WNT/β-catenin pathway. By stimulating PPARγ expression, NSAIDs can control CRs through the regulation of many key circadian genes. The administration of NSAIDs in cancer treatment would thus appear to be an interesting therapeutic strategy, which acts through their role in regulating WNT/β-catenin pathway and PPARγ activity levels.

Intra-Articular Injection of Hydrolyzed Collagen to Treat Symptoms of Knee Osteoarthritis. A Functional In Vitro Investigation and a Pilot Retrospective Clinical Study.

Among all joints affected, knee osteoarthritis has a prevalence of about 10% in men and 13% in women over 60 years old. Knee osteoarthritis has high economic and social costs and may have a devastating impact on patient quality of life. Treatment of symptomatic knee Osteoarthritis may involve oral or topical administration of non-steroidal anti-inflammatory drugs or intra-articular injection of corticosteroids. Recently, a novel injectable collagen formulation (ChondroGrid) consisting of bovine hydrolyzed <3 kDa type I collagen has been developed and is currently available on the market as an injectable medical device. The primary objective of this study was to investigate the in vitro and in vivo effects of ChondroGrid in treating knee osteoarthritis symptoms to assess its safety and performance. Viability and proliferation of ChondroGrid-exposed human chondrocytes derived from five donors were assessed through the Alamar Blue/CyQuant assays. Their expression of MMP1/MMP3 and TIMP1/TIMP3 was then assessed through RT-PCR and that of TGFβ1, IGF-I, and VEGF using ELISA assays. Shape and ECM deposition were assessed using the Bern score after a 28-day ChondroGrid exposure, and collagen deposition was assessed using immunostaining. Records of 20 patients affected by Kellgren Lawrence grade 1 to 4 knee osteoarthritis who received three 4 mg/2 mL ChondroGrid injections 2 weeks apart were then retrospectively assessed to compare VAS, Lequesne, and WOMAC scores collected before and 15, 45, and 225 days after the first injection. ChondroGrid had no effects on the markers under consideration, but induced type-II and inhibited type-I collagen deposition; the Bern score was higher when cells were cultured with ChondroGrid. Patients experienced a 44% Lequesne score and a 55% VAS at moving score reduction. All other scores decreased >70%. ChondroGrid may prompt chondrocytes to produce hyaline cartilage, prevent fibrous tissue formation, and be a safe and effective adjuvant to treat symptomatic knee osteoarthritis.

Percutaneous Closure of the Patent Ductus Arteriosus in Very Low Weight Infants: Considerations Following US Food and Drug Administration Approval of a Novel Device

Percutaneous Closure of the Patent Ductus Arteriosus in Very Low Weight Infants: Considerations Following US Food and Drug Administration Approval of a Novel Device

Intramuscular versus oral diclofenac for acute pain in adults with acute musculoskeletal injuries presenting to the ED setting: a prospective, double-blind, double-dummy, randomised controlled trial

ObjectiveThe current study aimed to ascertain differences in early postmedication pain reduction in participants presenting with acute musculoskeletal injuries (MSI) to the ED receiving intramuscular (IM) versus per oral (PO)...

Ruminal Acidosis Caused by Excessive Ingestion of Mango Fruit (Mangifera indica) in Cow

Background: Digestive disturbances in ruminants are associated with forage shortages during periods of dry weather. Foods available at this time are generally of poor quality and low digestibility, which makes it necessary to pursue alternative food sources where available. Grain-heavy diets; concentrated rations rich in rapidly fermenting carbohydrates; and whey, tubers and fruits high in starch and glucose, contribute to ruminal acidosis. Here we report a case of ruminal acidosis due to excessive ingestion of the mango fruit (Mangifera indica), "manguita" cultivate, by an adult bovine.Case: In the municipality of Boa Vista, Roraima, during December, a Dutch female bovine adult, weighing approximately 600 kg, was observed showing signs of apathy for two days with diarrhea. The animal had a rumenostomy with flexible cannula in the left paralumbar fossa and was in the final third of gestation. During clinical examination, the animal was in season, and an increase in the volume of the left dorsal region and changes in physiological variables were observed (lightly pale mucosa, capillary filling time of 4 s, heart rate [HR] of 82 beats per min; respiratory rate (f) of 30 moments per min; absence of ruminal movements and rectal temperature [RT] of 39.5°C). Upon removal of the cannula lid, a considerable amount of liquid and a large quantity of mango (Mangifera indica), "manguita" cultivate, were observed. Blood sample and ruminal fluid were collected and ruminal contents weighing approximately 40 kg were evacuated. Physical-chemical analysis of the ruminal liquid (pH = 4.0, brown color, aqueous consistency and characteristic fruit odor) resulted in a diagnosis of ruminal acidosis. Treatment included administration of fluid therapy (Lactate Ringer; 2 mL/kg/h), hepatoprotector (1 mL/20 kg), antimicrobial (Ampicillin Sodium; 10 mg/kg/IV and Sulfadoxine; 30 mg/kg/IV) and non-steroidal anti-inflammatory (Meloxicam; 0.5 mg/kg/IV) drugs, associated with evacuation of ruminal contents, and administration of grass and transfaunation, for three days. Following treatment, the physiological variables and physical-chemical characteristics of the ruminal liquid returned to normal limits (pH = 6.0, greenish brown coloration, aqueous consistency and aromatic normal ruminal liquid odor). By 30 days of initial care, the animal was active and had given birth, with no abnormal changes in physiological variables and physical-chemical characteristics of the ruminal fluid.Discussion: A decrease in food supplies during the dry season forces animals to seek alternative sources of food to meet their needs, as observed in this case study. Intake of a large amount of mango was the cause of ruminal acidosis due to an overabundance of simple sugars. The measures established for the clinical evaluation, diagnostic methods used, collection of blood sample and rumen fluid, and the adopted therapy, administration of fluid therapy, antimicrobial and non-steroidal anti-inflammatory, associated with evacuation of the ruminal content, transfaunation, administered directly to the rumen, were essential to directing the diagnosis and obtaining a fast recovery time for the female bovine. Therefore, it can be concluded the excessive intake of fruit was the primary cause of rumen acidosis, and efficient case management led to observed clinical improvements in the physical-chemical characteristics of the ruminal liquid, with no recurrence of previous clinical signs.

Post-operative non-steroidal anti-inflammatory drugs do not affect clinical outcomes of rotator cuff repair

BackgroundThe administration of non-steroidal anti-inflammatory drugs (NSAIDs) to patients is thought to impair rotator cuff healing and clinical outcomes. Methods36 patients who underwent rotator cuff repair were divided into 3 groups based on their post-operative analgesia regimes. ResultsAt 4.4 years postoperative, there was significant improvement in SST and UCLA scores (p < 0.001). There were no significant differences in post-operative clinical outcome scores between the groups (p > 0.05). Administration of NSAIDs and duration of their use did not influence outcomes of rotator cuff repair (p = 0.151). ConclusionNSAIDs has no significant influence on clinical outcomes of rotator cuff repair.

PHARMACOEPIDEMIOLOGICAL STUDY OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS AND ITS EFFECTS ON CARDIOVASCULAR SYSTEM AMONG SELECTED AREAS OF CHITRADURGA.

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are used worldwide to treat pain and inflammation.&#x0D; Non-steroidal anti-inflammatory drugs (NSAIDs) are a broad class of agents with analgesic and anti-inflammatory properties that inhibit the two recognized iso enzymes of prostaglandin G/H synthase (also known as cyclo -oxygenase (COX))—namely, COX 1 and COX 2.&#x0D; It is generally accepted that oral non-steroidal anti-inflammatory drugs (NSAIDs) can increase the risk of acute myocardial infarction. Randomized controlled trials of NSAIDs have been of limited use for assessing this rare adverse event, as they had small cohorts and poor generalizability. The trials excluded those at highest cardiovascular risk or with established cardiovascular disease.&#x0D; Objectives: 1. To assess the various classes of NSAID’S giving rise to cardiovascular risks. 2. To assess the prevalence of NSAID’s induced various cardiovascular risks.&#x0D; Materials and Methods: The study was carried out in selected areas of Chitradurga District.&#x0D; Results: 1. In our study, subjects who were having CVS risks were found to be the major users of Selective cox-2 inhibitor 20(27.7) followed by preferential cox-2 inhibitor 8(11.1)) and phenyl acetic acid 6(8.3).&#x0D; &#x0D; Among 401 subjects, 72 subjects were diagnosed as cardiovascular problem. The prevalence of NSAIDs induced cardiovascular problem was found to be 18%&#x0D; &#x0D; Conclusion: Our study concluded that prevalence of cardiovascular risk due to administration of NSAIDs more in rural areas than in urban areas.&#x0D; Key words: NSAIDs, CVS risks, Prevalence.