High blood pressure. Causes, symptoms, treatments

Restricted nutrient intake does not alter serum-mediated measures of implant response in cell culture.


NSAID-induced antral ulcers are associated with a specific pattern of gastroduodenal mucosal gene expression. These patterns may provide an insight into the molecular basis of individual susceptibility to mucosal injury.

The effects of 14 non-steroidal anti-inflammatory drugs (NSAIDs)--naproxen, ibuprofen, mefenamic acid, ketoprofen, indomethacin, fenoprofen, diclofenac sodium, aspirin, salicylic acid, piroxicam, sulindac, fenbufen, flurbiprofen and benzydamine, on the plasma protein binding of thiopental and the clinical consequences of such interactions were studied. Four of them, naproxen, ibuprofen, salicylic acid and aspirin, very significantly decreased the protein binding of thiopental in vitro in human plasma (P < 0.005). Structurally, they were salicylates and propionic acid derivatives among the six classes of NSAIDs studied. The aspirin study demonstrated that the protein-displacing phenomenon was temperature-dependent, and concentration-dependent. Clinically, aspirin administered intravenously resulted in a significant increase in the percentage of plasma free thiopental from 16.01 +/- 3.59% to 22.27 +/- 3.96% (P < 0.001, n = 10) in patients undergoing surgery, and resulted in three of seven patients sleeping again during recovery from thiopental-induced anesthesia. Although the effect of chronic use of NSAIDs before anesthesia is uncertain, studies should be carried out to find out if naproxen, ibuprofen, and aspirin influence the depth of anesthesia, time of recovery and duration of action of thiopental.

Patients with osteoarthritis receiving treatment with ibuprofen, piroxicam, or naproxen and experiencing abdominal pain were eligible.

Fenclofenac was shown to possess anti-inflammatory, antinociceptive and antipyretic properties as measured by tests in rats that detect clinically active compounds. In a chronic test for assessing anti-inflammatory activity (established adjuvant arthritis), it was approximately equipotent to alclofenac, fenoprofen calcium and phenylbutazone, more potent than acetylsalicylic acid and ibuprofen, but was less potent than diclofenac sodium, indomethacin, ketoprofen and naproxen. In contrast, the potency of fenclofenac in acute tests for anti-inflammatory, antinociceptive and anti-pyretic activity was generally lower, the drug being approximately equipotent to acetylsalicylic acid in such tests. The anti-inflammatory activity of fenclofenac was not mediated via the pituitary-adrenal axis or a counter-irritant action. Fenclofenac was shown to have remarkably low gastric ulcerogenic potential, both acutely and chronically.

Biosis, SciSearch (1990 to March 2002), Embase (1974 to March 2002), Medline (1966 to March 2002), Toxline, Derwent Drug File (1964 to March 2002), Conference Papers Index and Inside Conferences, Int'l Pharmaceutical Abstracts, Pharma-Online (1978 to March 2002).

Approximately 20 percent of athletes have an acute or chronic injury related to their sport. In acute musculoskeletal disorders, inflammation is an important component of the symptomatology. Recent clinical studies are showing that nonsteroidal anti-inflammatory drugs (NSAIDs) can significantly reduce inflammation and help speed return to full function. In an international study, the efficacy and toleration of piroxicam were compared with that of indomethacin, naproxen, and aspirin in three multicenter, double-blind, parallel studies involving a total of 1,290 patients with acute sprains and tendinitis. The centers compared piroxicam 40 mg once daily for the first two days followed by 20 mg once daily for the remainder of the studies. This regimen was compared with either indomethacin, 50 mg three times per day for two days and 25 mg three times per day for the remainder of the treatment period; naproxen 500 mg twice daily for two days followed by 250 mg in the morning and 500 mg in the evening thereafter; or aspirin 4 g per day for the duration of the study. Treatment normally lasted 14 days; the minimal duration was seven days, with a maximum of 28 days. Overall assessment of efficacy was excellent or good in more than 80 percent of patients. Statistical differences were seen favoring piroxicam over aspirin (p less than 0.05) regarding reduction in tenderness and resumption of daily activities within 16 days (p less than 0.02). The study comparing piroxicam and naproxen showed a statistically significant difference in favor of piroxicam (p less than 0.025). There was no difference between piroxicam and indomethacin in the number of patients who were able to accomplish normal daily activity within 16 days. Furthermore, although efficacy was comparable among the NSAIDs, piroxicam was significantly better-tolerated than either naproxen or indomethacin. Piroxicam was also better-tolerated than aspirin, but a statistical difference was not reached.

Patients with knee osteoarthritis improved more with naproxen treatment than patients with hip osteoarthritis, as monitored by WOMAC and the SF-36 domains bodily pain and role-physical. These findings warrant further investigation and strongly suggest that efficacy of treatment of osteoarthritis of knee and hip should be evaluated separately.