Guía de seguimiento farmacoterapéutico sobre úlcera péptica

Coordinador de esta edición Emilio García JiménezEsta guía tiene como objetivo facilitar la fase de estudio necesaria para realizar Seguimiento Farmacoterapéutico de un paciente. La fase de estudio trata de profundizar en los problemas de salud y en los medicamentos que toma el paciente, o sea, un análisis lo más completo posible del Estado de Situación del paciente a una fecha determinada. De dicho Estado de Situación se obtendrán las sospechas de Problemas Relacionados con Medicamentos (PRM) que el paciente puede estar sufriendo, y a partir de éstos se realizarán sucesivas intervenciones para intentar resolver los PRM

Application of colon capsule endoscopy (CCE) to evaluate the whole gastrointestinal tract: a comparative study of single-camera and dual-camera analysis

Journal Article;BACKGROUND AND STUDY AIMS Colon capsule endoscopy (CCE) was developed for the evaluation of colorectal pathology. In this study, our aim was to assess if a dual-camera analysis using CCE allows better evaluation of the whole gastrointestinal (GI) tract compared to a single-camera analysis. PATIENTS AND METHODS We included 21 patients (12 males, mean age 56.20 years) submitted for a CCE examination. After standard colon preparation, the colon capsule endoscope (PillCam Colon™) was swallowed after reinitiation from its "sleep" mode. Four physicians performed the analysis: two reviewed both video streams at the same time (dual-camera analysis); one analyzed images from one side of the device ("camera 1"); and the other reviewed the opposite side ("camera 2"). We compared numbers of findings from different parts of the entire GI tract and level of agreement among reviewers. RESULTS A complete evaluation of the GI tract was possible in all patients. Dual-camera analysis provided 16% and 5% more findings compared to camera 1 and camera 2 analysis, respectively. Overall agreement was 62.7% (kappa = 0.44, 95% CI: 0.373-0.510). Esophageal (kappa = 0.611) and colorectal (kappa = 0.595) findings had a good level of agreement, while small bowel (kappa = 0.405) showed moderate agreement. CONCLUSION The use of dual-camera analysis with CCE for the evaluation of the GI tract is feasible and detects more abnormalities when compared with single-camera analysis.Ye

Role of vascular mechanisms involved in the acute gastric mucosal injury induced by droxicam and piroxicam in rats

We describe the formation of severe gastric erosions produced in fasted rats by intragastric administration of droxicam and its active species piroxicam, non-steroidal anti-inflammatory drugs of the oxicam group. The time course of gastric damage and the possible role of mucus secretion, changes of gastric vascular permeability, and neutrophil activation in the development of droxicam- and piroxicam-induced astric lesions, were also investigated. Both drugs dose-dependently (1-25-20 mg kg - ) caused acute gastric haemorrhagic erosions in the rat. These lesions were significantly greater with piroxicam treatment 6 h after dosing. Only the lower doses of droxicam and piroxicam (1.25 mg kg-') induced a significant increase of mucus gel production at different times (3 and 6 h). However, there was no increase in the concentration of its components. Oral pretreatment of the animals with either agent did not induce any changes on the values of mucosal vascular permeability. In contrast, myeloperoxidase activity as an index of neutrophil infiltration was significantly increased. A marked relationship was found between the lesion index and myeloperoxidase activity. These results suggest that neutrophil infiltration could play an important role in the pathogenesis of gastric mucosal injury induced by these oxicam agent

Protective Effect of L‐Arginine Against Ibuprofen‐induced Gastric Injury in Rats

This study has been designed to confirm the protective effect of different single oral doses of L‐arginine in the presence of equimolar doses of ibuprofen, and to compare the results with those obtained after treatment with ibuprofen alone. Different parameters were assessed in rats: gastric damage (mm2 and score), ratio of lesionated stomachs/total stomachs evaluated, and presence of haemorrhage. Six hours after dosing, oral administration of ibuprofen (0·3, 0·6 and 1·2 mmol kg −1) produced a progressive dose‐dependent increase in damage to the gastric mucosa. All treatments with equimolar doses of L‐arginine considerably reduced lesions (mm2 and score) and the same tendency was observed with the other parameters examined. We also evaluated the gastroprotective effect of L‐arginine against anti‐ulcer reference drugs, ranitidine and roxatidine (two antisecretory agents) and misoprostol (a cytoprotective drug). The degree of inhibition of damage provided by L‐arginine was similar to those obtained with the other drugs. Thus, we conclude that the simultaneous administration of equimolar doses of ibuprofen and L‐arginine offers significant protection compared with gastrolesive doses of ibuprofen alone, with an important decrease in the lesionated areas and improvement of the vascular state. The extent of this protective action is comparable with that observed with anti‐ulcer reference drugs