Intake Of Non-steroidal Anti-inflammatory Drugs Research Articles

COMPARISON OF TRAMADOL AND OXACEPROL IN PATIENTS WITH OSTEOARTHRITIS

Introduction: Osteoarthritis (OA) is a chronic, degenerative disease of unknown origin which is characterised by gradual loss of articular cartilage. It is the most prevalent disease with a worldwide distribution. Earlier, osteoarthritis was seen as an inevitably progressive, degenerative disease process. Now it has been suggested that it is a dynamic process that may progress episodically. It is a heterogeneous group of diseases characterised by an adaptive response of synovial joints to a variety of genetic, environmental, aging and biomechanical stresses. NSAIDs intake increases the risk of gastritis and does not a have direct impact on the underlying pathogenesis of articular diseases. Tramadol augments serotonergic and noradrenergic neurotransmission, although it’s main active metabolite, O-desmethyltramadol. Oxaceprol is an atypical inhibitor of inflammation, used as a drug for joint disease without less side-effects with better safety profile than non-steroidal anti-inflammatory drugs (NSAIDs).
 Material and Methods: Participants were randomized in two study groups of 50 patients each sing computer generated random number list. Each group was given either oxaceprol 200 mg capsule or tramadol 50 mg capsule, thrice daily after food, for 12 weeks. The primary efficacy variable for this study was symptom relief stiffness, and physical function, measured on 100 mm Visual analogue scale (VAS) scale. Rescue medication used during the study period was also recorded. Complete blood count, blood glucose, liver function tests, and serum creatinine was recorded at the start of the study and. Vital signs were recorded at each visit and adverse events were reported. 
 Results: A total of 100 patients were included in the study of which 50 each were placed in tramadol group and oxaceprol group. No statistically significant difference was noted in both the group about baseline parameters about sex, age and blood pressure. Blood sugar was higher in Oxaceprol group as compared to tramadol group (P =0.0042) which was statistically significant. No statistically significant difference was observed between groups for WOMAC scores. Significant reduction in pain, stiffness and physical function was observed between oxaceprol and tramadol group at baseline and after 6 months follow-up. None of the adverse events were severe in nature in both the group commonest were dizziness and nausea.
 Conclusion: Oxaceprol efficacy and tolerability was comparable with tramadol and the drug can be considered as an alternative to low-potency opioids in the management of knee osteoarthritis. Further studies are required to confirm the clinical utility of oxaceprol in osteoarthritis.
 Keywords: OA, tramadol, oxaceprol, NSAID, WOMAC

Hemorragia digestiva alta no varicosa

Upper gastrointestinal bleeding is a common emergency, with a high mortality, around 5%, occurring mainly in patients who have significant comorbidity and with adjuvant therapies favoring bleeding. Causes are diverse, standing out peptic ulcer. Bleeding is controlled by endoscopic therapy after clinical stabilization of the patient. The best therapeutic option is endoscopy hemostasis with adrenaline injection, mechanical clips or application of heat. Nowadays, new endoscopic strategies are emerging: Hemospra®, OVESCO®, cyanoacrylate. In rebleeding episodes, a second endoscopic therapy is recommended. Embolization or surgery are required when bleeding persists. Once bleeding is controlled, the benefits of reintroduction of antiplatelet and anticoagulant medication outweigh the risks. Long-term, in order to prevent peptic ulcer, both Helicobacter pylori eradication and cessation of non-steroidal anti-inflammatory drugs intake are essential.

Enfermedad ulcerosa péptica

Peptic ulcer is a mucosal break of diameter 5mm or larger, reaching submucosal layer. H. pylori and non-steroidal anti-inflammatory drugs (NSAID) intake, are the main causes. Their incidence has fallen during last years, in parallel with the incidence of H. pylori and the improvement in the knowledge of NSAID's effects. Symptoms are unspecific. Predominant symptom is epigastric pain, however asymptomatic cases are possible and may appear like a complication of another disorder. Nowadays, diagnosis is mainly endoscopic, allowing both ulcer visualization and to take biopsy samples in order to discard H. pylori and malignancy. Digestive hemorrhage is the most frequent complication, its treatment requires: adequate staging, fluid management, proton pump inhibitors (PPIs) use and endoscopic therapy in ulcer recurrence in high-risk patients. Gastric-wall perforation and obstruction are other possible complications. The two pillars of peptic ulcer treatment are H. pylori eradication therapy and PPI treatment when necessary, according with ulcer location and etiology.

Assessment of the relationship between estimated cardiovascular risk and structural damage in patients with axial spondyloarthritis.

Aims:To evaluate the association of estimated cardiovascular (CV) risk and subclinical atherosclerosis with radiographic structural damage in patients with axial spondyloarthritis (axSpA).Methods:Cross-sectional study including 114 patients axSpA from the SpA registry of Córdoba (CASTRO) and 132 age- and sex-matched healthy controls (HCs). Disease activity and the presence of traditional CV risk factors were recorded. The presence of atherosclerotic plaques and carotid intima media thickness (cIMT) were evaluated through carotid ultrasound and the SCORE index was calculated. Radiographic damage was measured though modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The association between mSASSS and SCORE was tested using generalized linear models (GLM), and an age-adjusted cluster analysis was performed to identify different phenotypes dependent on the subclinical CV risk.Results:Increased traditional CV risk factors, SCORE, and the presence of carotid plaques were found in axSpA patients compared with HCs. The presence of atherosclerotic plaques and SCORE were associated with radiographic structural damage. The GLM showed that the total mSASSS was associated independently with the SCORE [β coefficient 0.24; 95% confidence interval (CI) 0.10–0.38] adjusted for disease duration, age, tobacco, C-reactive protein, and non-steroidal anti-inflammatory drugs (NSAID) intake. Hard cluster analysis identified two phenotypes of patients. Patients from cluster 1, characterized by the presence of plaques and increased cIMT, had a higher prevalence of CV risk factors and SCORE, and more structural damage than cluster two patients.Conclusion:Radiographic structural damage is associated closely with increased estimated CV risk: higher SCORE levels in axSpA patients were found to be associated independently with mSASSS after adjusting for age, disease duration, CRP, tobacco and NSAID intake.

Factors associated with the presence of abnormal levels of fecal calprotectin in patients with negative panenteric studies

fecal calprotectin is a selection tool prior to endoscopic studies in patients with gastrointestinal symptoms. However, some symptomatic patients with altered fecal calprotectin will not have any endoscopic lesions. The aim of the study was to determine the factors associated with the presence of altered fecal calprotectin in patients with negative endoscopic studies of the colon and small bowel. this was an observational, prospective study of patients with digestive symptoms. The association of different clinical factors with elevated fecal calprotectin in the absence of endoscopic lesions of the colon and small bowel were analyzed. 143 patients were included in the study, 98 were female (68.5 %) and the mean age was 40.06 ± 16.42 (15-82) years. Smoking and non-steroidal anti-inflammatory drug intake were associated with altered fecal calprotectin in patients with a negative endoscopy of the colon and small bowel (p = 0.029 and p = 0.006). The mean values of fecal calprotectin were significantly higher in smokers, users of non-steroidal anti-inflammatory drugs and patients with small intestine bacterial overgrowth. Smoking (OR: 3.505; p = 0.028), non-steroidal anti-inflammatory drugs intake (OR: 3.473; p = 0.021) and small intestine bacterial overgrowth (OR: 3.172; p = 0.013) were independent risk factors for altered fecal calprotectin in the absence of endoscopic lesions. No association was found for any of the other variables. smoking and the use of non-steroidal anti-inflammatory drugs are strongly associated with elevated levels of fecal calprotectin in symptomatic patients with a negative colonoscopy and capsule endoscopy of the small bowel. Small intestine bacterial overgrowth is also associated.

Tolerability to paracetamol and preferential COX-2 inhibitors in patients with cross-reactive nonsteroidal anti-inflammatory drugs hypersensitivity.

BackgroundAcetylsalicylic acid/aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used drugs that may cause hypersensitivity reactions in a substantial proportion of patients. Physicians ought to be aware of these situations.ObjectiveWe aimed to present the clinical characteristics and rates of tolerability to cyclooxygenase (COX)-2 inhibitor analgesics in patients who had admitted due to multiple cross-reactive type of NSAID hypersensitivity.MethodsThe files of the patients who had admitted with multiple NSAIDs-induced symptoms were investigated retrospectively. Age, sex, underlying diseases, clinical manifestation, skin test results, and drug provocation test results were analyzed.ResultsIn 105 patients with multiple cross-reactive type of NSAID hypersensitivity, we found the rate of cross-reactivity to any of the relatively safe alternatives including paracetamol, meloxicam, and nimesulide to be 16.1%. The rate of cross-reactivity to these relatively safe drugs was significantly higher in patients with a history of anaphylaxis induced by NSAID intake (p = 0.006).ConclusionThe diagnosis of COX-1-mediated multiple NSAID hypersensitivity can be often established with a detailed history. Although rare, severe hypersensitivity reactions may be observed in these patients. Undesired situations for both patients and physicians may be avoided by testing relatively safe paracetamol and COX-2 inhibitors in experienced centers.

Rhinitis medicamentosa

One type of non-allergic non-infectious rhinitis is represented by a heterogeneous group of rhinitis medicamentosa, which can be divided into several pathogenetic types. The most common rebound nasal congestion associated with the use of topical decongestants. Excessive use of intranasal decongestants leads to a decrease in the number of alpha-adrenoreceptors on the surface of cell membranes and uncoupling their connection with the G-protein and the development of tachyphylaxis. To prevent the development of rebound nasal congestion caused by topical decongestants, it is important to limit the frequency of their use. In most cases, the duration of the use of vasoconstrictor drugs should be limited to 5-7 days, according to Patient information leaflets for the drugs. However, in patients who have had a history of episodes of rebound nasal congestion, which develops including the previously indicated periods, the duration of decongestant therapy should be limited to 3 days. Rhinitis associated with local inflammation is caused by the intake of acetylsalicylic acid (ASA) or other non-steroidal anti-inflammatory drugs. Currently, the so-called "aspirin triad" is well known - a combination of bronchial asthma, rhinosinusitis (often polyposis) and intolerance to ASA. Neurogenic rhinitis develops due to the use of drugs that violate vascular tone, for example, antihypertensive drugs or type 5 phosphodiesterase inhibitors. Drug-induced rhinitis has a significant impact on the patient's quality of life: nasal congestion, rhinorrhea, secondary night apnea, insomnia as a result of nasal breathing disturbances, headaches, irritability, weakness after sleepless nights disturb patients to a large extent. Timely diagnosis and withdrawal of a provocative drug, the use of topical corticosteroids in case of severe rhinitis are the basis of the treatment of rhinitis medicamentosa. In severe cases, there is a need, including surgical treatment, such as, for example, submucosal laser destruction of the lower nasal concha.

STW1 and Its Versatile Pharmacological and Clinical Effects in Rheumatic Disorders: A Comprehensive Report.

Aim To review the published and unpublished experimental and clinical studies about the efficacy and tolerability of STW1 and to compare the results to the efficacy and tolerability of investigated NSAIDs in parallel. Content. STW1 (Phytodolor®) contains a fixed combination of extracts from aspen leaves and bark (Populus tremula), common ash bark (Fraxinus excelsior), and goldenrod herb (Solidago virgaurea). It belongs to the group of anti-inflammatory and antirheumatic drugs, and it is authorized for the treatment of painful disorders of degenerative and inflammatory rheumatic diseases. The individual components have complementary effects. Its multifocal mode of action includes antiphlogistic, analgesic, antiexudative, antioxidative, antipyretic, and antiproliferative properties. The effects of both STW1 and its components have been verified in comprehensive pharmacological investigations. Open and randomized, placebo- and verum-controlled, and single-blind (sb) or double-blind (db) clinical trials, performed in different subtypes of rheumatic diseases confirm the pharmacological evidence. Its efficacy is comparable to a range of standard nonsteroidal anti-inflammatory drugs (NSAIDs) studied in parallel, but it has a superior safety profile. Conclusion STW1 is a reasonable alternative to NSAIDs with comparable efficacy and a superior safety profile. It is also suitable to reduce the intake of NSAIDs.

Anemia and Dietary Behaviors among Young Adults in Riyadh, Saudi Arabia

The study sought to assess the prevalence and the risk factors associated with anemia among male and female young adults in (Riyadh city, Saudi Arabia). A cross-sectional study was conducted at King Saud University and Alfaisal University in September 2016 among young adults aged 18 to 28 years old. Data were collected using an interview questionnaire. Additionally, the respondents were evaluated clinically and via laboratory testing for anemia. Our study population showed a higher percentage of men as compared to women participants. About half of our study sample had a lightly active lifestyle, and more than one-third of the study participants were overweight (34.7%). The average age of the respondents was 22.08 ± 1.98 years. The only factor significantly associated with anemia was gender, in that female gender showed a positive association with anemia. The most explicit risk factor for anemia among Saudi individuals of college and young professional ages was the female gender. Dietary lifestyle, heavy menstruation, pregnancy, and intake of non-steroidal anti-inflammatory drugs were additional important risk factors among these individuals, but they were statistically not significant.

Status of non-steroidal anti-inflammatory drugs use in areas with a high incidence of upper gastrointestinal cancer in China: a multi-center cross-sectional survey

Objective: To describe the status of non-steroidal anti-inflammatory drugs (NSAIDs) use in areas with a high incidence of upper gastrointestinal cancer in China. Methods: This study was based on the National Key Research and Development Program of "National Precision Medicine Cohort of Esophageal Cancer" and "Study on Identification and Prevention of High-risk Populations of Gastrointestinal Malignancies (Esophageal cancer, Gastric cancer and Colorectal cancer)" . From January 2017 to August 2018, 212 villages or communities with a high incidence of esophageal cancer or gastric cancer were selected from 12 regions in 6 provinces. A total of 35 910 residents aged between 40 and 69 years old who met the inclusion criteria and signed the informed consent were investigated and enrolled in this study. The use of NSAIDs, demographic characteristics, health-related habits, height, weight, and blood pressure were collected by the questionnaire and physical examination. The status of main NSAIDs (aspirin, acetaminophen and ibuprofen) use with the difference varying in genders, age groups and regions were analyzed by using χ(2) test and Cochran-Armitage trend analysis method. Results: Of 35 910 subjects, the mean age was (54.6±7.1) years old and males accounted for 43.42% (15 591). The overall prevalence of NSAIDs intake was 4.56% (1 638), but it significantly varied in different provinces (P<0.001). The overall prevalence of NSAIDs intake was 4.87% (1 750) in females, which was significantly higher than that in males 4.24% (1 524) (P<0.001). The prevalence of NSAIDs intake increased with age (P for trend <0.001). As the frequency of NSAIDs intake increased, the incidence of gastrointestinal symptoms, gastrointestinal ulcers and black stools increased (P for trend <0.05 for all). Conclusion: The use of NSAIDs is prevalent in some areas with a high incidence of upper gastrointestinal cancer in China. The increased use of NSAIDs may lead to more adverse effects related to the gastrointestinal tract.

Risk factors for immersion pulmonary edema in recreational scuba divers: a case-control study

Immersion can cause immersion pulmonary edema (IPE) in previously healthy subjects. We performed a case-control study to better identify IPE risk factors. We prospectively included recreational scuba divers who had presented signs of IPE and control divers who were randomly chosen among diving members of the French Underwater Federation. We sent an anonymous questionnaire to each diver, with questions on individual characteristics, as well as the conditions of the most recent dive (controls) or the dive during which IPE occurred. Univariate logistic regressions were performed for each relevant factor. Then, multivariate logistic regression was performed. Of the 882 questionnaires sent, 480 (54%) were returned from 88 cases (90%) and 392 control divers (50%). Multivariate analysis identified the following independent risk factors associated with IPE: being aged over 50 years ((OR) 3.30, (95%CI) 1.76-6.19); female sex (OR 2.20, 95%CI 1.19-4.08); non-steroidal anti-inflammatory drug (NSAID) intake before diving (OR 24.32, 95%CI 2.86-206.91); depth of dive over 20 m (OR 2.00, 95%CI 1.07-3.74); physical exertion prior to or during the dive (OR 5.51, 95%CI 2.69-11.28); training dive type (OR 5.34, 95%CI 2.62-10.86); and daily medication intake (OR 2.79, 95%CI 1.50-5.21); this latter factor appeared to be associated with hypertension in the univariate analysis. To reduce the risk of experiencing IPE, divers over 50 years of age or with hypertension, especially women, should avoid extensive physical effort, psychological stress, deep dives and NSAID intake before diving.

Retrospective study of the use of medication and supplements during the 2018 FIFA World Cup Russia

ObjectiveExamine the intake of medication and supplements used by top-level players during the 2018 FIFA World Cup Russia.Participants736 top-level playersSettingThe team doctors uploaded a list of the medications used by...

Peptic ulcer: Current prospects of diagnostic and nanobiotechnological trends on pathogenicity

A peptic ulcer is a chronic and recurrent disease, massively effect on the morbidity and mortality and almost 20% of the world human population experiences from this illness. The main factors lead to peptic ulcer is the infection of Helicobacter pylori bacteria and regular intake of non-steroidal anti-inflammatory drugs (NSAIDs). Huge development has been accomplished in deciding the pathogenesis of this disease and finding the right biomarkers are mandatory with understanding the current scenario. The existence and form of ulcers cannot be anticipated precisely from the signs and the differential diagnosis is comprehensive. Ultimately, diagnostics on H. pylori have been in front of the beneficial health of human and a special focus in the future. On the other hand, nanoencapsulation is an advanced methodology, can be applied in peptic ulcer treatment from the natural sources. Indeed, nanocellulose particles have been proposed and studied as novel formulations to enhance the stability and solubility of phytochemicals, improve their absorption, protect them from untimely degradation in the body and lengthen their circulation time. Merging the current prospects of diagnostics and nanotechnological approaches are necessary for the remedy from peptic ulcer.

Risks Related to the Use of Non-Steroidal Anti-Inflammatory Drugs in Community-Acquired Pneumonia in Adult and Pediatric Patients.

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to alleviate symptoms during community-acquired pneumonia (CAP), while neither clinical data nor guidelines encourage this use. Experimental data suggest that NSAIDs impair neutrophil intrinsic functions, their recruitment to the inflammatory site, and the resolution of inflammatory processes after acute pulmonary bacterial challenge. During CAP, numerous observational data collected in hospitalized children, hospitalized adults, and adults admitted to intensive care units (ICUs) support a strong association between pre-hospital NSAID exposure and a delayed hospital referral, a delayed administration of antibiotic therapy, and the occurrence of pleuropulmonary complications, even in the only study that has accounted for a protopathic bias. Other endpoints have been described including a longer duration of antibiotic therapy and a greater hospital length of stay. In all adult series, patients exposed to NSAIDs were younger and had fewer comorbidities. The mechanisms by which NSAID use would entail a complicated course in pneumonia still remain uncertain. The temporal hypothesis and the immunological hypothesis are the two main emerging hypotheses. Current data strongly support an association between NSAID intake during the outpatient treatment of CAP and a complicated course. This should encourage experts and scientific societies to strongly advise against the use of NSAIDs in the management of lower respiratory tract infections.

Effects Of Nsaid Use On Biomarkers Of Kidney Stress Following A Marathon

The use of nonsteroidal anti-inflammatory drugs (NSAID) is common practice by participants in marathons and other endurance events. Previous research suggests that renal stress is apparent immediately following marathon completion. However, the potential exacerbating effect of NSAID use during a marathon is not well-understood. PURPOSE: Investigate the effect of NSAID use on biomarkers of renal stress following a marathon. METHODS: Twenty-two volunteer participants (14 males, 8 females; 38 ± 10.2y, 70.7 ± 10.1kg, 171.0 ± 7.7cm) at the Kansas City Marathon were recruited and assigned to either a control (n = 15) or NSAID (n = 7) group based on planned or habitual use. Pre-race NSAID ingestion was self-reported as 9.15 ± 4.62 mg/kg of ibuprofen (n=4) or 3.75 ± 1.73mg/kg naproxen sodium (n=3). Urine samples were collected pre-marathon, post-marathon, and 24-h post-marathon. Samples were stored at -80°C and later analyzed for urinary neutrophil gelatinase lipocalin (uNGAL) and urinary cystatin C (uCyC). A robust two-way mixed ANOVA with trimmed means was utilized to account for potential outliers. When significant interaction or main effects were observed, pairwise comparisons were calculated using robust bootstrapped effect sizes with 95% confidence intervals. RESULTS: Immediately post-marathon, there was a significant increase in uNGAL (Cohen’s dR = 0.47 95%C.I. [0.23,0.85]) but there was no longer a significant elevation by 24-h post-marathon (Cohen's dR = 0.16 95%C.I. [-0.61,3.36]). There were no significant effects detected for Cystatin C. Further, NSAID ingestion did not affect uCyC or uNGAL values. CONCLUSION: Renal stress biomarkers suggest potential kidney tubular injury immediately post-marathon, but potential renal stress was negated by 24-h of recovery. Moderate NSAID ingestion before the marathon did not affect kidney stress biomarkers.

NUTRITION FOR CORRECTING METABOLISM DISORDERS OF THE JOINT-LIGAMENT SYSTEM IN PHYSICALLY ACTIVE PEOPLE

Aim. The article deals with developing and assessing the efficiency of a complex nutritional support program for the joint-ligament system in athletes and physically active people. Materials and methods. The clinical evidence of biologically active substance (BAS) efficiency and functional orientation was obtained from the representative group of people with knee-joint osteoarthrosis. The main group of participants received a BAS complex with synergistic properties in terms of metabolism correction during osteoarthrosis: BAS 1 – 2 pills, BAS 2 – 1 capsule (2 times per day, 12 weeks), and BAS 3 – 1 capsule (2 times per day, 8 weeks). Nonsteroidal anti-inflammatory drugs were also prescribed to participants from the main and control groups. We used the general and special methods for assessing the quality and functional properties of specialized products. Knee joints were studied by using the Lequesne index (scores) characterizing pain syndrome, maximal distance, and daily movement activity. The intensity of pain syndrome was assessed with the visual analog scale (VAS, in mm). Results. We provided a scientific justification for the qualitative and quantitative content of BAS recipes for complex nutritional support of the joint-ligament system: BAS 1 – chondroprotective orientation; BAS 2 – an optimal source of minerals and vitamins; BAS 3 – polyunsaturated fatty acids. The results obtained revealed that specialized products improve the movement activity of participants with osteoarthrosis and significantly decrease pain syndrome (36 %). Apart from a chondroprotective effect such nutrition provides an anti-inflammatory effect and allows decreasing the intake of Nonsteroidal anti-inflammatory drugs in the absence of side effects. We revealed an insignificant number of disease recurrence – 6.7% (in the control group – 36.5 %) and established the mechanisms of such an influence. Conclusion. The application of biologically active complexes could serve as a reliable means of preventing and treating the diseases of the joint-ligament system, providing physical performance, and preserving health in athletes and physically active people.

The Effect of Eradication of the Helicobacter Pylori Microorganisms on the Risk of the Development of Gastropathy Associated with the Intake of Nonsteroidal Antiinflammatory Drugs

The Effect of Eradication of the Helicobacter Pylori Microorganisms on the Risk of the Development of Gastropathy Associated with the Intake of Nonsteroidal Antiinflammatory Drugs

Noninvasive Interactive Neurostimulation Therapy for the Treatment of Low-Grade Lateral Ankle Sprain in the Professional Contact Sport Athlete Improves the Short-Term Recovery and Return to Sport: A Randomized Controlled Trial

Ankle injuries are very common between professional athletes and recreational sports. Lateral stable ligaments injury can be treated conservatively. Noninvasive interactive neurostimulation (NIN) is a form of electric therapy that works by locating areas of lower skin impedance. The objective of this prospective, double-blinded, randomized controlled trial was to compare the results in terms of improvement of a foot functional score, lower level of reported pain, and return to sports in 2 groups of contact sport athlete affected by a grade I or II lateral ankle sprain. Patients were randomized using random blocks to the NIN program (group I) or a sham device (group II). The outcome measurements were the use of a self-reported Inability Walking Scale, patient-reported subjective assessment of the level of pain using a standard visual analogue scale, and daily intake of nonsteroidal antiinflammatory drugs (etoricoxib 60 mg). Patients were also reached by telephone at 2 and 4 months of follow-up to register their return to sport activity. Beyond baseline evaluation, follow-ups were done after 5 (1 week) and 10 sessions (2 weeks) of treatment, and then at 30 days after the end of therapy. Of the 70 athletes admitted to the study, 61 eligible patients were randomized using random blocks to group I (n = 32) and group II (n = 29). Group I patients showed better improvement in terms of functional impairment (Inability Walking Scale), reported pain (visual analogue scale), and daily intake of etoricoxib 60 mg. Athletes of group I registered a faster resuming of sport activities. This prospective, randomized trial showed NIN can improve short-term outcomes in athletes with acute grade I or II ankle sprain and that it can hasten resuming of sport activities.

Levels of fecal «hemoglobin/ haptoglobin» complex in patients with osteoarthritis depending on the intake of nonsteroidal anti-inflammatory drugs

Objective — to study levels of fecal «hemoglobin/ haptoglobin» (Hb/ Hp) complex in patients with osteoarthritis (OA) and to assess the probability of its correlation with the fecal calprotectin (FCP) levels.Materials and methods. Stool specimens were collected from 36 patients with OA, aged 34 ‑ 85 years, from the hospitals and outpatient medical facilities of Kyiv and Kyiv Region. These patients were divided into two groups: the NSAID group included patients who regularly received NSAIDs, and group of patients, not treated with NSAIDs. The control group consisted of twelve healthy individuals. Immediately after collection, the stool samples were frozen up to –20°C. The Hb/ Hp levels in feces were determined by ELISA using the RIDASCREEN® Haemo‑/ Haptoglobin Complex kit (R‑Biopharm AG, Germany) and Rayto RT‑2100C reader (China). The concentration of the Hb/ Hp complex ≥ 2 mg/ g and higher were considered as a positive result.Results. The median fecal Hb/ Hp level in patients receiving NSAIDs was 0.669 mg/ g (IQR 0.65 — 7.3) and was statistically higher (p = 0.013) than in healthy subjects 0.65 mg/ r (IQR 0.65 — 0.65). In patients who did not take NSAIDs, the median level of fecal Hb/ Hp complex was also equal to the lower limit of determination — 0.65 µg/ g (IQR 0.65 — 0.65), however, due to single patients with elevated levels, the difference in the levels of Hb/ Hp complex in this group of patients did not reach statistical significance (p &gt; 0.1) when compared to the patients of NSAIDs and control groups. Despite this fact, a trend has been revealed to the increase of the levels of investigated parameter in the groups (from healthy subjects to the ОА patients, receiving NSAIDs). The direct correlation of moderate strength has been established between the levels of the Hb/ Hp complex and period of NSAIDs’ administration (r = 0.411; p = 0.0115), between the levels of the Hb/ Hp complex and Lequesne index values (r = 0.512; p = 0.00631), and between the levels of the Hb/ Hp complex and FCP levels (r = 0.486; p = 0.000457).Conclusions. It has been established that NSAIDs administration was associated with the increased levels of fecal Hb/ Hp complex. This biomarker, together with fecal calprotectin, can be useful as a non‑invasive indicator of possible NSAID‑induced intestinal damage in patients with OA receiving NSAIDs.

Use of therapeutic plasma exchange to treat nonsteroidal anti-inflammatory drug overdose in dogs.

BackgroundTherapeutic plasma exchange (TPE) may be an effective technique for treatment of accidental nonsteroidal anti‐inflammatory drug (NSAID) overdose, but information regarding the use of this technique in veterinary medicine is currently limited.ObjectivesTo evaluate the overall outcome for dogs with NSAID overdose treated with TPE and to determine if any presenting factors can predict or influence overall outcome. Secondary objectives included investigating TPE complications as well as the utility of other adjunctive treatments.AnimalsEleven client‐owned dogs presented for NSAID overdose that received TPE. All patients also received additional supportive treatment including IV lipid infusion.MethodsRetrospective review of medical records.ResultsEleven cases were included in the study. Of these, the NSAID ingested was ibuprofen in 6 (54.5%), naproxen in 4 (36.4%), and deracoxib in 1 (9.1%). All dogs survived to discharge with 3 (27.3%) developing acute kidney injury during hospitalization. A larger initial dose of NSAID ingested was associated with a higher maximum serum creatinine concentration during hospitalization (P = .04) and larger change in serum creatinine concentration from baseline (P = .02). Six dogs (54.5%) developed complications associated with TPE. The use of other treatments did not affect the overall outcome.Conclusions and Clinical ImportanceWe identified TPE as an effective treatment for NSAID overdose with good outcomes despite high doses of NSAID ingestion in dogs treated with a single TPE treatment. Complications were common but did not affect the final outcome. Therapeutic plasma exchange should be considered in patients presenting for high‐dose NSAID ingestion.