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Introducción. Por lo general, el manejo farmacológico del conducto arterioso permeable (CAP) comprende inhibidores no selectivos de la enzima ciclooxigenasa, en especial indometacina e ibuprofeno. En años recientes también se ha sugerido al acetaminofén como alternativa terapéutica.Objetivo. Realizar una revisión narrativa de la literatura acerca del manejo farmacológico del CAP.Materiales y métodos. Se realizó una búsqueda estructurada de la literatura en las bases de datos ProQuest, EBSCO, ScienceDirect, PubMed, LILACS, Embase, Trip Database, SciELO y Cochrane Library con los términos “Ductus Arteriosus, patent AND therapeutics”; “Ductus Arteriosus, patent AND indometacin”; “Ductus Arteriosus, Patent AND ibuprofen”, y “Ductus Arteriosus, patent AND acetaminophen”. La búsqueda se hizo en inglés con sus equivalentes en español.Resultados. Se encontraron 69 artículos con información relevante para llevar a cabo la presente revisión.Conclusiones. En neonatos prematuros, la base del tratamiento farmacológico del CAP continúa siendo los inhibidores no selectivos de la ciclooxigenasa, indometacina e ibuprofeno, ambos con perfiles similares de seguridad y eficacia. La evidencia disponible sugiere que el acetaminofén podría constituir una alternativa útil para el manejo, pero resulta insuficiente para realizar recomendaciones definitivas respecto a la eficacia y seguridad de este medicamento.

TEXTO COMPLETO NO AUTORIZADO POR LA AUTORA La exodoncia, considerada un tratamiento quirúrgico de rutina en niños puede generar rechazo por parte de ellos, más aún cuando este implique la presencia de dolor ya sea pre, intra o posoperatorio. El objetivo principal de esta investigación fue comparar la efectividad del Ibuprofeno y el Paracetamol, administrados oralmente y de manera profiláctica, con el fin de prevenir el dolor producido por este acto quirúrgico. En este estudio clínico-observacional y prospectivo, la muestra estuvo conformada por 60 niños de 6 a 8 años de edad, seleccionados de acuerdo a los criterios de inclusión, que acudieron a la atención en el Centro Odontológico de la Facultad de Odontología de la Universidad de San Martín de Porres, los cuales fueron distribuidos en tres grupos, cada uno de 20 niños: grupo Paracetamol, grupo Ibuprofeno y el grupo control. En los dos primeros se les administró, vía oral, 30 minutos antes de la cirugía el fármaco correspondiente (Paracetamol 15 mg/kg o Ibuprofeno 10 mg/kg). Fueron evaluadas las siguientes variables: presencia de dolor, tiempo de presencia de dolor, intensidad de dolor, y tiempo transcurrido para analgesia de rescate. Resultados: Se encontraron diferencias significativas en la variable presencia de dolor y en el tiempo de presencia de dolor entre los 3 grupos. No hubo significancia entre las variables estudiadas entre los dos grupos con fármacos. Conclusiones: La profilaxis analgésica es una alternativa eficaz frente al tratamiento convencional farmacológico posquirúrgico. El Ibuprofeno y el Paracetamol son medicamentos con eficacia similar para este fin, a pesar de presentar diferente acción farmacológica.

PURPOSES: To determine the basic expression of ABC transporters in an epithelial ovarian cancer cell line, and to investigate whether low concentrations of acetaminophen and ibuprofen inhibited the growth of this cell line in vitro. METHODS: TOV-21 G cells were exposed to different concentrations of acetaminophen (1.5 to 15 μg/mL) and ibuprofen (2.0 to 20 μg/mL) for 24 to 48 hours. The cellular growth was assessed using a cell viability assay. Cellular morphology was determined by fluorescence microscopy. The gene expression profile of ABC transporters was determined by assessing a panel including 42 genes of the ABC transporter superfamily. RESULTS: We observed a significant decrease in TOV-21 G cell growth after exposure to 15 μg/mL of acetaminophen for 24 (p=0.02) and 48 hours (p=0.01), or to 20 μg/mL of ibuprofen for 48 hours (p=0.04). Assessing the morphology of TOV-21 G cells did not reveal evidence of extensive apoptosis. TOV-21 G cells had a reduced expression of the genes ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 and ABCE1 within the ABC transporter superfamily. CONCLUSIONS: This study provides in vitro evidence of inhibitory effects of growth in therapeutic concentrations of acetaminophen and ibuprofen on TOV-21 G cells. Additionally, TOV-21 G cells presented a reduced expression of the ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 and ABCE1 transporters. OBJETIVOS: Determinar a expressão básica dos transportadores ABC em uma linhagem celular do câncer epitelial de ovário, e investigar se o acetaminofen e o ibuprofeno em baixas concentrações são capazes de inibir o crescimento desta linhagem celular in vitro. MÉTODOS: A linhagem celular TOV-21 G foi exposta a diferentes concentrações de acetaminofen (1,5 a 15 µg/mL) e ibuprofeno (2,0 a 20 µg/mL), de 24 a 48 horas. O crescimento celular foi avaliado utilizando-se um ensaio de viabilidade celular. A morfologia celular foi determinada por meio da microscopia de fluorescência. O perfil de expressão gênica foi estabelecido por um painel de 42 genes da superfamília de transportadores ABC. RESULTADOS: Observou-se um decréscimo significativo no crescimento das células TOV-21 G expostas a 15 µg/mL de acetaminofen durante 24 (p=0,02) e 48 horas (p=0,01), ou a 20 µg/mL de ibuprofeno por 48 horas (p=0,04). Ao avaliar a morfologia das células cultivadas, não foi observada evidência de apoptose extensiva. A linhagem de células estudada subexpressa os genes de ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 e ABCE1 na superfamília de transportadores ABC. CONCLUSÕES: Este estudo fornece evidências in vitro referentes aos efeitos inibidores do crescimento de concentrações terapêuticas do acetaminofen e ibuprofeno na linhagem celular testada. Além disso, as células TOV-21 G apresentaram uma expressão reduzida de genes dos transportadores ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 e ABCE1.

JOURNAL ARTICLE; The high-affinity IgE receptor (Fcε RI) is a heterotetramer of three subunits: Fcε RIα, Fcε RIβ, and Fcε RIγ (αβγ2) encoded by three genes designated as FCER1A, FCER1B (MS4A2), and FCER1G, respectively. Recent evidence points to FCERI gene variability as a relevant factor in the risk of developing allergic diseases. Because Fcε RI plays a key role in the events downstream of the triggering factors in immunological response, we hypothesized that FCERI gene variants might be related with the risk of, or with the clinical response to, selective (IgE mediated) non-steroidal anti-inflammatory (NSAID) hypersensitivity. From a cohort of 314 patients suffering from selective hypersensitivity to metamizole, ibuprofen, diclofenac, paracetamol, acetylsalicylic acid (ASA), propifenazone, naproxen, ketoprofen, dexketoprofen, etofenamate, aceclofenac, etoricoxib, dexibuprofen, indomethacin, oxyphenylbutazone, or piroxicam, and 585 unrelated healthy controls that tolerated these NSAIDs, we analyzed the putative effects of the FCERI SNPs FCER1A rs2494262, rs2427837, and rs2251746; FCER1B rs1441586, rs569108, and rs512555; FCER1G rs11587213, rs2070901, and rs11421. Furthermore, in order to identify additional genetic markers which might be associated with the risk of developing selective NSAID hypersensitivity, or which may modify the putative association of FCERI gene variations with risk, we analyzed polymorphisms known to affect histamine synthesis or metabolism, such as rs17740607, rs2073440, rs1801105, rs2052129, rs10156191, rs1049742, and rs1049793 in the HDC, HNMT, and DAO genes. No major genetic associations with risk or with clinical presentation, and no gene-gene interactions, or gene-phenotype interactions (including age, gender, IgE concentration, antecedents of atopy, culprit drug, or clinical presentation) were identified in patients. However, logistic regression analyses indicated that the presence of antecedents of atopy and the DAO SNP rs2052129 (GG) were strongly related (P < 0.001 and P = 0.005, respectively) with selective hypersensitivity to ibuprofen. With regard to patients with selective hypersensitivity to ASA, men were more prone to develop such a reaction than women (P = 0.011), and the detrimental DAO SNP rs10156191 in homozygosity increased the risk of developing such hypersensitivity (P = 0.039). Yes

O objetivo deste estudo foi investigar se o acetaminofen (paracetamol) e o ibuprofeno em baixas concentrações são capazes de inibir o crescimento de uma linhagem celular de carcinoma epitelial de ovário (CEO) in vitro e determinar a expressão gênica dos transportadores ABC nesta linhagem celular. Foi utilizada a linhagem celular TOV 21Gexposta a diferentes concentrações de paracetamol (1,5-15 g/mL) e ibuprofeno (2,0 a 20 g/mL), durante 24 e 48 horas. O crescimento celular foi avaliado utilizando um ensaio de viabilidade celular. A morfologia celular foi determinada por microscopia de fluorescência. Operfil de expressão gênica foi determinado por um painel de 42 genes da super família de transportadores ABC. Foi observado um decréscimo significativo no crescimento das células TOV 21G expostas a 15 g/mL de paracetamol durante 24 horas (p = 0.02) e 48 horas (p = 0.01) e com 20 g/mL de ibuprofeno por 48 horas (p = 0.04). Ao avaliar a morfologia das células cultivadas, não foi observada evidência de apoptose significativa. A linhagem de células estudada subexpressa os genes de ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 e ABCE1 da super família de transportadores ABC. O presente estudo fornece evidências doefeito inibidor do crescimento de concentrações terapêuticas do paracetamol e do ibuprofeno na linhagem celular testada in vitro. TOV 21G subexpressa os genes dos transportadores ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 e ABCE1. The purposes of this study was investigated whether low concentrations of acetaminophen (paracetamol) and ibuprofen inhibited the growth of this cell line in vitro and determined a basic expression of ABC transporters in an EOC cell line. TOV 21G cells were exposed todifferent concentrations of paracetamol (1.5 to 15 g/mL) and ibuprofen (2.0 to 20 g/mL) for 24 e 48 hours. Cellular growth was assessed using a cell viability assay. Cellular morphology was determined by fluorescence microscopy. The gene expression profile of ABC transporters was determined by assessing a panel of 42 genes of the ABC transporter superfamily. We observed a significant decrease in TOV 21G cell growth after exposure to 15 g/mL of paracetamol for 24 hours (p=0.02) and 48 hours (p=0.01) or to 20 g/mL of ibuprofen for 48hours (p=0.04). Assessing the morphology of TOV 21G cells did not reveal evidence of extensive apoptosis. TOV 21G cell shad reduced expression of the genes ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 and ABCE1 within the ABC transporter superfamily. The current study provides in vitro evidence of growth inhibitory effects of therapeutic concentrations of paracetamol and ibuprofen on TOV 21G cells. Additionally, TOV 21G cells had reduced expression of the ABCA1, ABCC3, ABCC4, ABCD3, ABCD4 and ABCE1 transporters.

Objetivo: Evaluación de la eficacia analgésica para el dolor de la episiotomía entre el paracetamol y el Ibuprofeno, en las primeras 42 horas postparto. Método: Estudio cuasi-experimental (prospectivo y simple ciego) en mujeres que dieron a luz en el HOSPITAL UNIVERSITARIO CENTRAL DE ASTURIAS (OVIEDO), excluyendo alérgicas, patologías asociadas ó aquellas que el idioma impidiese un correcto entendimiento. Dos grupos: 1) Paracetamol 1 gr; 2) Ibuprofeno 600 mg. Tamaño de muestra: 110 por grupo para alcanzar mínimo de 80. Variable principal: grado de dolor según puntuación de escala (0 a 3). Otras variables: edad de paciente, semanas de gestación, peso neonatal, paridad, inicio del parto, anestesia epidural, tipo de parto, desgarro, inflamación y enrojecimiento, hematoma, hemorroides, necesidad de sondaje evacuador, aplicación de hielo y solicitud de analgesia. Tamaño final de la muestra: 88 grupo paracetamol y 97 grupo ibuprofeno. La escala de dolor se midió a las 2 horas postparto (previo al tratamiento) y, posteriormente, cada 8 hasta 42 horas. Se realizó análisis descriptivo y comparación entre grupos. Resultados: No encontramos diferencias significativas en la escala de dolor entre ambos fármacos, ni en los subgrupos analizados, salvo en el subgrupo de partos eutócicos, donde el ibuprofeno fue superior al paracetamol. En el global de la serie, el grupo de paracetamol solicitó hielo y otra medicación con mayor frecuencia que el grupo de ibuprofeno. Conclusiones: El ibuprofeno 600 mg y el paracetamol de 1 gr obtienen una respuesta similar en las primeras 42 horas postparto, si bien el ibuprofeno parece tener algunas ventajas adicionales. Objective: Assessment of the analgesic effectiveness of acetaminofen and ibuprofen in cases of epsiotomy, within the first 42 hours pospartum. Methods: Quasi-experimental research (prospective,singel-blind trial) on women who gave birth at the HUCA (Oviedo), excluding those who suffered from allergies or associated pathologies and the ones whose language skills in Spanish led to misunderstanding. Two groups: 1) Acetaminofen 1 gr; 2) Ibuprofen 600mg. Sample size: 110 per group to amount to a minimum of 80. Main variable: The degree of pain, which was marked on a rating scale (0 to 3). Other variables: The age of the patient, gestational age, neonatal weight, parity, onset of labour, epidural anesthesia, type of delivery, inflammation and reddening, tears, hematoma or hemorrhoids, need for catheter evacuation, application of ice and request for analgesia. Final sample size: 88 group acetaminofen and 97 group ibuprofen. Pain levels were measured through the scale 2 hours after delivery (previous to the treatment), afterwards, every 8 within the first 42 hours postpartum. A descriptive research was carried out and there was a comparison drawn between both groups. Results: The pain scale did not reveal any significant difference between both drugs. The result was the same in the analized subgroups; except for that of eutocic deliveries, where ibuprofen was superior to acetaminofen. The overall series results show that the request for ice and additional medication was more frequent among group acetaminofen. Conclusions: Ibuprofen 600 mg and acetaminofen 1gr get a similar response within the first 42 hours after delivery, even though ibuprofen seems to have some extra advantages.