BACKGROUND: Nonsteroidal anti-inflammatory drugs are widely used in Brazil in spite of the known risks associated with their use, but investigation of their side effects conducted in this country has been far from sufficient. This study investigates the use of NSAIDs among patients undergoing upper endoscopy in the Hospital das Clínicas of the Federal University of Minas Gerais and the association of this use with the endoscopic diagnosis of gastric erosions, gastric erosions with hematin pigmentation, and gastric ulcer. METHODS: The cross-sectional methodological approach was used; 533 patients aged 17 or older were interviewed, between June and December, 2000. Data were submitted to bivariate and multivariate analyses. RESULTS: More than two thirds of the interviewed population reported the use of nonsteroidal anti-inflammatory drugs in a period of 1 month before the upper endoscopy. The most used nonsteroidal anti-inflammatory drugs were acetylsalicylic acid and diclofenac. An association was clearly shown between the use of these drugs and the occurrence of the studied lesions, with the latter attaining significance. There was also a significant association between nonsteroidal anti-inflammatory drugs use for a period greater than 15 days and the occurrence of the gastric lesions, with a higher odds ratio than for the other comparisons. CONCLUSIONS: The results suggest that nonsteroidal anti-inflammatory drugs have a significant association with the occurrence of the gastric lesions and point to the need of further study of this issue in Brazil.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most consumed drugs worldwide, by different age groups. Objectives: The present study aimed to characterize the NSAIDs consumption in students of Polytechnic Institute of Bragança (IPB) . Methods: A desciptive and cross-sectional study was performed from september 2014 to june 2015, through application of a questionnaire to 563 students of IPB. The sample was composed by 67% female students and 33% male students with ages of 21,9±4.1 years and 62.3% consider their health as good. Results: This study showed an high prevalence of NSAIDS consumption in students of IPB (93.3%). The drug most reported was ibuprofen (95.8%), following by acetylsalicylic acid (39,0%), diclofenac and nimesulide (36,4 e 16,8 %, respectively). Pain and inflammation were main reasons for its consumption (76.4% and 55.8%, respectively) and the oral administration, the most used route of administration (99.4%). A high proportion of students assumes a correct use of NSAIDs, taking the drugs during or after a meal (89.0%) and during a period of time between one to five days (86.3%). It was reported a low rate of adverse events among students (95.0%) and the majority has considered the consumption of NSAID beneficial to health (59.6%). Conclusions:The present study contributes to knowledge of the profile of use of this group of drugs in young adults.

Introdução: a principal razão pela qual as pessoas procuram o tratamento endodôntico é para o alívio da dor causada por infecção bacteriana e inflamação subsequente. Embora a dor diminua após o tratamento, pode haver sintomas residuais devido aos efeitos da inflamação (a dor endodôntica pós-tratamento foi referida por 25% a 40% de todos os pacientes endodônticos). Os AINEs atuam inibindo as enzimas ciclooxigenases (COX) e impedindo a geração de novas moléculas de prostaglandinas (PG). Os corticosteróides (CC) atuam inibindo a resposta inflamatória. Objetivos: encontrar o efeito do uso pré-operatório de AINEs e CC na dor pós-endodôntica em pacientes com pulpite sintomática submetidos ao tratamento endodôntico na redução da dor pós-operatória. Materiais e métodos: foi realizada uma pesquisa eletrónica na PUBMED utilizando uma combinação dos seguintes termos científicos: corticosteroids, postoperative endodontic pain, nonsteroidal antiinflammatory drugs, pulpitis. A pesquisa realizada identificou 146 artigos, dos quais 11 foram considerados relevantes para este estudo. Resultados: 11 estudos (100%) concluíram que os AINEs e corticosteroides reduziram a dor pós-operatória em todos os intervalos de tempo apos TENC. Discussão: A pré-medicação demonstrou reduzir significativamente a dor pós-operatória em comparação com o placebo ou controlo em todos os intervalos de tempo. Conclusão: tanto os AINEs como os corticosteroides são capazes de diminuir a inflamação, inibindo a produção de metabolitos pró-inflamatórios.

ABSTRACT OBJECTIVE: Data on clinical practice in pediatrics on the use of analgesic, antipyretic, and nonsteroidal anti-inflammatory drugs considering the best available evidence and regulatory-agency approved use are uncertain. This study aimed to determine the frequency of prescription of these drugs according to the best scientific evidence and use approved by regulatory agencies. METHODS: This was a cross-sectional study of 150 pediatric prescriptions containing analgesic, antipyretic, and nonsteroidal anti-inflammatory drugs, followed by interview with caregivers at 18 locations (nine private drugstores and nine Basic Health Units of the Brazilian Unified Health System). The assessed outcomes included recommended use or use with no contraindication, indications with benefit evidence, and health surveillance agency-approved use. Data were analyzed in electronic databases and the variables were summarized by simple frequency. RESULTS: A total of 164 analgesic, antipyretic, and nonsteroidal anti-inflammatory drugs were prescribed to 150 children aged 1-4 years (38.6%). Dipyrone was included in 82 (54.6%) and ibuprofen in 40 (26.6%) prescriptions. Non-recommended uses were identified in 15% of prescriptions and contraindicated uses were observed in 13.3%. Nimesulide (1.5%) is still prescribed to children younger than 12 years. The dose was incorrect in 74.3% of prescriptions containing dipyrone. Of the 211 reported clinical indications, 56 (26.5%) had no evidence of benefit according to the best available scientific evidence and 66 (31.3%) had indications not approved by the regulatory agencies. CONCLUSION: There are significant discrepancies between clinical practice and recommended use of analgesic, antipyretic, and nonsteroidal anti-inflammatory drugs in pediatrics.

ABSTRACT Purpose: To assess the efficacy of using a nonste­roidal anti-inflammatory drug preoperatively and of applying the re-dilation technique when necessary to minimize pupil size variation when comparing the degree of mydriasis before femtosecond laser pretreatment with that at the beginning of phacoemulsification. Methods: This retrospective study included patients who underwent cataract surgery using the LenSx (Alcon Laboratories, Inc., Fort Worth, TX). Our routine dilating regimen with flurbiprofen, tropicamide, and phenylephrine was used. The re-dilation technique was applied on eyes that manifested with a pupillary diameter that was smaller than the programmed capsulotomy diameter after laser pretreatment. The technique consists of overcoming pupillary contraction by instilling tropicamide and phenylephrine before phacoemulsification. Pupil size was assessed before femtosecond laser application and at the beginning of phacoemulsification. Results: Seventy-five eyes (70 patients) were included. Nine (12%) eyes underwent the re-dilation technique. There was no significant difference in mean pupillary diameter and mean pupillary area between the two studied surgical time points (p=0.412 and 0.437, respectively). The overall pupillary area constriction was 2.4 mm2. Immediately before opening the wounds for phacoemulsification, none of the eyes presented with a pupillary diameter <5 mm, and 61 (85.3%) eyes had a pupillary diameter >6 mm. Conclusion: Preoperative administration of nonsteroidal anti-inflammatory drug and the re-dilation technique resulted in no significant pupil size variation in eyes that were pretreated with the femtosecond laser, when comparing the measurements made before the laser application and at the beginning of phacoemulsification. This approach can avoid the need to proceed with cataract extraction with a constricted pupil.

SUMMARY OBJECTIVE: Our study aimed to explore the potential risk factors for radiological hip joint involvement in patients with ankylosing spondylitis (AS). METHODS: This cross-sectional convey collected the clinical data, laboratory indicators, and radiographic data of patients with AS. Radiographic hip joint involvement was defined as a Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-hip) score ≥2. Multivariate logistic regression analyses were conducted to explore the potential risk factors for radiological hip involvement in patients with AS. RESULTS: Based on BASRI-hip score, all enrolled 386 patients with AS were classified as patients involving with radiological hip joint involvement (BASRI-hip ≥2; n=203) and those without it (BASRI-hip ≤1; n=183). Mean age of enrolled patients with AS were 36.7±11.9 years, and 320 (82.9%) patients were male. Mean course of disease was 10.7±8.3 years, and 349 (90.4%) patients were with a positive HLAB27. Multivariate analyses indicated that Juvenile onset (onset age ≤16 years) (odds ratio [OR]=4.159, 95% confidence interval [CI], 1.779-9.721, p<0.001), body mass index (BMI) <18.5 kg/m2 (OR=1.986, 95%CI 1.187-3.323, p=0.009), continuous nonsteroidal anti-inflammatory drug (NSAID) use (OR=0.351, 95%CI 0.155-0.794, p=0.012), and bone mass below the expected range for age (Z score ≤-2) (OR=2.791, 95%CI 1.456-5.352, p=0.002) were independently associated with radiological hip joint involvement in patients with AS. CONCLUSIONS: The potential risk factors for radiological hip joint involvement were juvenile onset, lower BMI, and bone mass below the expected range for age. Furthermore, continuous NSAID use was the protective factor for radiological hip joint involvement in these population.

The frequent use of nonsteroidal anti-inflammatory drugs (NSAID) in combination with gentamicin poses the additional risk of nephrotoxic renal failure. Cyclooxygenase-1 (COX-1) is the main enzyme responsible for the synthesis of renal vasodilator prostaglandins, while COX-2 participates predominantly in the inflammatory process. Both are inhibited by non-selective NSAID such as indomethacin. Selective COX-2 inhibitors such as rofecoxib seem to have fewer renal side effects than non-selective inhibitors. The objective of the present study was to determine whether the combined use of rofecoxib and gentamicin can prevent the increased renal injury caused by gentamicin and indomethacin. Male Wistar rats (250-300 g) were treated with gentamicin (100 mg/kg body weight, ip, N = 7), indomethacin (5 mg/kg, orally, N = 7), rofecoxib (1.4 mg/kg, orally, N = 7), gentamicin + rofecoxib (100 and 1.4 mg/kg, respectively) or gentamicin + indomethacin (100 and 5 mg/kg, respectively, N = 8) for 5 days. Creatinine clearance and alpha-glutathione-S-transferase concentrations were used as markers of renal injury. Animals were anesthetized with ether and sacrificed for blood collection. The use of gentamicin plus indomethacin led to worsened renal function (0.199 ± 0.019 ml/min), as opposed to the absence of a nephrotoxic effect of rofecoxib when gentamicin plus rofexicob was used (0.242 ± 0.011 ml/min). These results indicate that COX-2-selective inhibitors can be used as an alternative treatment to conventional NSAID, especially in situations in which risk factors for nephrotoxicity are present.

Universidade Federal do Rio de Janeiro. Faculdade de Farmácia. Laboratório de Avaliação e Síntese de Substâncias Bioativas. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Instituto de Química. Programa de Pós-Graduação em Química. Rio de Janeiro, RJ, Brasil / Universidade Federal de Alfenas. Faculdade de Ciências Farmacêuticas. Alfenas, MG, Brasil.

Postoperative pain remains a significant concern in endodontics, directly impacting patient comfort, satisfaction, and adherence to treatment. Among the strategies for pain management, preoperative administration of corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) has shown promise in reducing inflammatory responses and improving postoperative outcomes. This dissertation aims to analyze and compare the effectiveness of preoperative corticosteroids and NSAIDs in controlling postoperative pain in non-pediatric patients undergoing endodontic treatment, while also discussing their associated adverse effects. A narrative synthesis of current literature, including diverse studies published between 2014 and 2024, was conducted to assess the impact of these pharmacological agents on postoperative endodontic pain. Corticosteroids demonstrated superior and longer-lasting analgesic effects compared to NSAIDs, particularly in cases of symptomatic irreversible pulpitis. They were also associated with reduced need for additional analgesics postoperatively. NSAIDs, on the other hand, provided effective short-term relief, particularly in acute pain scenarios, but their effects were generally less durable and often required repeated dosing. Each class of drug presented distinct risk profiles, with corticosteroids posing potential risks of immunosuppression and hyperglycemia, and NSAIDs being associated with gastrointestinal and renal complications. Preoperative administration of corticosteroids is more effective than NSAIDs in providing prolonged postoperative pain relief in endodontic procedures. However, both drug classes require careful patient selection due to their potential adverse effects. Future research should focus on standardizing treatment protocols, exploring combination therapies, and evaluating the efficacy of personalized pain management approaches.