No abstract

Selective COX-2 inhibitors have been shown to produce fewer gastrointestinal adverse reactions than classical NSAIDs. Nevertheless, these new agents may worsen and delay the healing of experimentally induced gastric ulcers in animals. In this study, we compared the effects of a selective COX-2 inhibitor (celecoxib), a preferential COX-1 inhibitor (piroxicam), and a nonnarcotic analgesic (metamizol) on normal gastric mucosa of rats and, on the other hand, in a setting of preexisting acute gastric lesions induced by 0.6 N hydrochloric acid. Under normal conditions, only piroxicam produced appreciable gastric lesions. However, after acid challenge the three assayed drugs induced significant macroscopic and microscopic damage. Myeloperoxidase activity as an index of neutrophil infiltration was elevated with celecoxib and piroxicam on normal gastric mucosa. On inflamed mucosa, celecoxib augmented enzymatic activity at the lower dose, which was parallelled by an increase in the interleukin 1beta level. Acid instillaton produced a significant rise in PGE2 content at 7 hr. Drug treatment after acid challenge decreased prostaglandin values in all cases, although to a lesser extent than after single drug dose administration. COX-2 mRNA expression was visible 1 hr after acid application, whereas COX-2 protein could only be detected at 7 hr. Piroxicam increased both expression levels. All NSAIDs enhanced transforming growth factor alpha and epidermal growth factor receptor immunoreactivity around the acid-induced lesions. It is concluded that selective COX-2 inhibitors, like conventional NSAIDs, impair the healing of gastric damage, and therefore special attention should be paid in patients with gastric pathologies.

The aerial parts of Bidens aurea (Aiton) Sherff have been used in folk medicine as an antiulcer agent. The efficacy of an ether extract to prevent gastric mucosal damage produced by several necrotic agents was studied in rats. The best efficiency was against lesions induced by 30% NaCl with a significant decrease of damage at all doses tested (250, 125 and 62.5 mg kg-1). In contrast, only the highest dose (250 mg kg-1) was effective on gastric erosions induced by 0.6 ɴ HCl. This effect could not be related with the mucus gel production only since the groups treated with of absolute ethanol or 30% NaCl before and then received 250 mg kg-1 of the ether extract increased significantly the amount of gastric mucus and its glycoprotein content. However, the ether extract of Bidens aurea enhanced the production of mucosal non-protein SH groups at all doses assayed after treatment with absolute ethanol and 0.6 ɴ HCl. With NaCl-induced gastric injury, also the highest dose (250 mg kg-1) produced an increase of this parameter. The results suggest that a slight augmentation of the mucus gel concentration and the increase of non-protein sulfhydryl compounds, could con­ tribute to the functional protection mechanism mediated by a flavonoid fraction of B.aurea in these experimental models.

Introducción: El futuro inmediato de la farmacia requiere la incorporación de servicios profesionales orientados a optimizar la gestión personalizada del paciente.Objetivos del trabajo: Determinar las características de los pacientes/usuarios registrados en la base de datos de una farmacia comunitaria con el fin de detectar sus necesidades sanitarias para establecer las pautas de intervención más adecuadas y eficaces.Material y métodos: Se diseñó un cuestionario adaptado al ámbito de la farmacia comunitaria que facilitara el almacenamiento y tratamiento de los datos de los pacientes/usuarios seleccionados a través de entrevistas personales.Resultados: En la muestra predominan los pacientes pluripatológicos (80,5%) y polimedicados (72,2%) de edad avanzada (70,6±9,8 años) con bajo nivel de estudios (86,1%). Dislipemia (63,9%), HTA (61,1%), artrosis (56,6%), enfermedades vasculares periféricas (38,9%) y diabetes II (30,6%) fueron las patologías más prevalentes. Aunque el 69,4% realizaba ejercicio físico regularmente, el 81,8% tenía exceso de peso y no realiza dietas adecuadas. El fármaco más consumido fue omeprazol (97,0%) seguido de paracetamol (50,0%), estatinas (47,2%), benzodiacepinas, hidroclorotiazida y metformina.Conclusión: La caracterización de pacientes a través de cuestionarios estructurados y consensuados pueden ayudar al farmacéutico a localizar los grupos más vulnerables a los que ofrecer servicios profesionales adaptados a sus necesidades y a elaborar programas de prevención y protocolos de actuación más eficientes. Patient characterization as a useful tool for offering personalized professional services in the community pharmacy ABSTRACT Introduction:The immediate future of the pharmacy requires the incorporation of professional services aimed to optimizing personalized patient management.Aims of the study: To determine the characteristics of patients registered in the database of a community pharmacy in order to detect their health needs, from these, establish guidelines most appropriate and effective intervention.Material and methods: A questionnaire adapted to the field of community pharmacy was designed to facilitate the storage and processing of data of patients / users, who were registered in the pharmacy database, through personal interviews.Results: Pluripatological (80.5%) and polypharmacy patients (72.2%), older (70.6 ± 9.8 years) with low educational level (86.1%) predominate in the study. Dyslipidemia (63.9%), hypertension (61.1%), arthritis (56.6%), peripheral vascular disease (38.9%) and diabetes II (30.6%) were the most prevalent diseases. Although 69.4% performed physical exercise regularly, almost 82% were overweight and do not perform adequate diets. The most consumed drug was omeprazole (97.0%), followed by acetaminophen (50.0%), statins (47.2%), benzodiazepines, hydrochlorothiazide and metformin.Conclusion: The patients'characterization through structured and agreed questionnaires can help the pharmacist to locate the most vulnerable groups of the population studied in order to p...