CONTRASTING PRESENTATION AND FINDINGS BETWEEN PATIENTS WITH RHEUMATIC COMPLAINTS TAKING NONSTEROIDAL ANTI-INFLAMMATORY DRUGS AND A GENERAL POPULATION REFERRED FOR ENDOSCOPY

Rheumatology ◽  
1986 ◽  
Vol 25 (1) ◽  
pp. 50-53 ◽  
Author(s):  
A. J. COLLINS ◽  
JOAN DAVIES ◽  
A. ST. J. DIXON
Keyword(s):  
General Population ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Opioid Use among Same-Day Surgery Patients: Prevalence, Management and Outcomes

2015 ◽  
Vol 20 (6) ◽  
pp. 300-304 ◽  
Author(s):  
Jennifer LC Wilson ◽  
Patricia A Poulin ◽  
Robert Sikorski ◽  
Howard J Nathan ◽  
Monica Taljaard ◽  
...  
Keyword(s):  
General Population ◽  
Acute Pain ◽  
Day Surgery ◽  
Emergency Room Visits ◽  
Opioid Use ◽  
Acute Pain Management ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Long Acting ◽  
Expert Recommendations

OBJECTIVES: To determine whether the prevalence of opioid use among patients requiring elective same-day admission (SDA) surgery is greater than the 2.5% prevalence found in the general population. Secondary objectives were to assess compliance with expert recommendations on acute pain management in opioid-tolerant patients and to examine clinical outcomes.METHODS: A retrospective review of 812 systematically sampled adult SDA surgical cases between April 1, 2008 and March 31, 2009 was conducted.RESULTS: Among 798 eligible patients, 148 (18.5% [95% CI 15.9% to 21.2%]) were prescribed opioids, with 4.4% prescribed long-acting opioids (95% CI 3.0% to 5.8%). Use of opioids was most prevalent among orthopedic and neurosurgery patients. Among the 35 patients on long-acting opioids who had a high likelihood of being tolerant, anesthesiologists correctly identified 33, but only 13 (37%) took their usual opioid preoperatively while 22 (63%) had opioids continued postoperatively. Acetaminophen, nonsteroidal anti-inflammatory drugs and pregabalin were ordered preoperatively in 18 (51%), 15 (43%) and 18 (51%) cases, respectively, while ketamine was used in 15 (43%) patients intraoperatively. Acetaminophen, nonsteroidal anti-inflammatory drugs and pregabalin were ordered postoperatively in 31 (89%), 15 (43%) and 17 (49%) of the cases, respectively. No differences in length of stay, readmissions and emergency room visits were found between opioid-tolerant and opioid-naïve patients.CONCLUSION: Opioid use is more common in SDA surgical patients than in the general population and is most prevalent within orthopedic and neurosurgery patients. Uptake of expert opinion on the management of acute pain in the opioid tolerant patient population is lacking.

scholarly journals ETIOPATHOGENESIS OF PEPTIC ULCER: back to the past?

2014 ◽  
Vol 51 (2) ◽  
pp. 155-161 ◽  
Author(s):  
Mariana Barbosa ARAÚJO ◽  
Paulo BORINI ◽  
Romeu Cardoso GUIMARÃES
Keyword(s):  
Peptic Ulcer ◽  
General Population ◽  
Peptic Ulcers ◽  
Data Bases ◽  
Duodenal Ulcers ◽  
The Past ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
H Pylori ◽  
Made In

ObjectivesTo review some aspects of the etiopathogenesis of peptic ulcerous disease especially on the basis of studies on its correlation withHelicobacter pylori (H. pylori).MethodsA search was made in the data bases MEDLINE, LILACS and PubMed, and in Brazilian and foreign books, referring to the incidence and prevalence of infection by H. pylori and of peptic ulcerous disease in various populations of different countries.ResultsIt was observed that the prevalence of H. pyloriinfection is similar in individuals with peptic ulcerous disease and the general population. There are differences between countries with respect to the prevalence of infection and of gastric or duodenal peptic ulcers. In many countries the prevalence of infection by H. pylorishows stability while the prevalence of peptic ulcerous disease is declining. The prevalence of peptic ulcerous disease without H. pylori infection varies between 20% and 56% in occidental countries.DiscussionThe observations might be suggestive of H. pyloribeing only one more factor to be summed together with other aggressive components in the genesis of peptic ulcerous disease. We would therewith be returning to the classic concept that peptic gastric and duodenal ulcers have multifactorial etiology and would result from imbalance between aggressive and defensive factors. The focus of studies should be enriched with the identification of the defensive factors and of other aggressive factors besides the well known H. pylori and non-steroidal anti-inflammatory drugs, since these two aggressors do not exhaust the full causal spectrum.

scholarly journals Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts

2021 ◽  
pp. annrheumdis-2020-219517 ◽  
Author(s):  
Angel YS Wong ◽  
Brian MacKenna ◽  
Caroline E Morton ◽  
Anna Schultze ◽  
Alex J Walker ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
General Population ◽  
Cohort Analysis ◽  
Harmful Effect ◽  
Risk Of Death ◽  
Nsaid Prescription ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Adjusted Model ◽  
Multivariable Adjusted Model

ObjectivesTo assess the association between routinely prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and deaths from COVID-19 using OpenSAFELY, a secure analytical platform.MethodsWe conducted two cohort studies from 1 March to 14 June 2020. Working on behalf of National Health Service England, we used routine clinical data in England linked to death data. In study 1, we identified people with an NSAID prescription in the last 3 years from the general population. In study 2, we identified people with rheumatoid arthritis/osteoarthritis. We defined exposure as current NSAID prescription within the 4 months before 1 March 2020. We used Cox regression to estimate HRs for COVID-19 related death in people currently prescribed NSAIDs, compared with those not currently prescribed NSAIDs, accounting for age, sex, comorbidities, other medications and geographical region.ResultsIn study 1, we included 536 423 current NSAID users and 1 927 284 non-users in the general population. We observed no evidence of difference in risk of COVID-19 related death associated with current use (HR 0.96, 95% CI 0.80 to 1.14) in the multivariable-adjusted model. In study 2, we included 1 708 781 people with rheumatoid arthritis/osteoarthritis, of whom 175 495 (10%) were current NSAID users. In the multivariable-adjusted model, we observed a lower risk of COVID-19 related death (HR 0.78, 95% CI 0.64 to 0.94) associated with current use of NSAID versus non-use.ConclusionsWe found no evidence of a harmful effect of routinely prescribed NSAIDs on COVID-19 related deaths. Risks of COVID-19 do not need to influence decisions about the routine therapeutic use of NSAIDs.

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