Quantitation of thermography in arthritis using multi-isothermal analysis. II. Effect of nonsteroidal anti-inflammatory therapy on the thermographic index.

Ring, E. F. J.; Collins, A. J.; Bacon, P. A.; Cosh, John A.

doi:10.1136/ard.33.4.353

Cited by 63 publications

(24 citation statements)

References 3 publications

(1 reference statement)

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“…This claim is largely based on early work showing that paracetamol does not suppress serious inflammation associated with rheumatoid arthritis 16 17. This lack of effect can now be explained by the high extracellular concentrations of arachidonic acid and peroxide in the inflamed tissue, both of which diminish the effect of paracetamol on prostaglandin synthesis 4 9 10.…”

Section: Inflammationmentioning

confidence: 99%

Paracetamol and cyclooxygenase inhibition: is there a cause for concern?

2011

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Paracetamol is recommended as fi rst-line therapy for pain associated with osteoarthrosis and is one of the most widely used over-the-counter analgesic drugs worldwide. Despite its extensive use, its mode of action is still unclear. Although it is commonly stated that paracetamol acts centrally, recent data imply an inhibitory effect on the activity of peripheral prostaglandin-synthesising cyclooxygenase enzymes. In this context paracetamol has been suggested to inhibit both isoforms in tissues with low levels of peroxide by reducing the higher oxidation state of cyclooxygenase enzymes. Two recent studies have also demonstrated a preferential cyclooxygenase 2 (COX-2) inhibition by paracetamol under different clinically relevant conditions. This review attempts to relate data on paracetamol's inhibitory action on peripheral cyclooxygenase enzymes to the published literature on its anti-infl ammatory action and its hitherto underestimated side-effects elicited by cyclooxygenase inhibition. As a result, a pronounced COX-2 inhibition by paracetamol is expected to occur in the endothelium, possibly explaining its cardiovascular risk in epidemiological studies. A careful analysis of paracetamol's cardiovascular side-effects in randomised studies is therefore strongly advised. On the basis of epidemiological data showing an increased gastrointestinal risk of paracetamol at high doses or when co-administered with classic cyclooxygenase inhibitors, paracetamol's long-term gastrointestinal impact should be investigated in randomised trials. Finally, paracetamol's fast elimination and consequently short-lived COX-2 inhibition, which requires repetitive dosing, should be defi nitely considered to avoid overdosage leading to hepatotoxicity.Paracetamol is one of the most widely used overthe-counter antipyretic and analgesic drugs worldwide. It is recommended as fi rst-line therapy for pain associated with osteoarthrosis. 1 Although discovered over 100 years ago and extensively used for over 50 years, its mode of action is still a matter of debate. For more than three decades it was commonly stated that paracetamol acts centrally and is at best a weak inhibitor of prostaglandin synthesis by cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2). 2 This concept is based on early work by Flower and Vane 3 who showed that prostaglandin production in the brain is 10 times more sensitive to inhibition by paracetamol than that in the spleen. Later it turned out that paracetamol elicits no measurable inhibition of prostaglandin formation in broken cell preparations, but a profound suppression in intact cells (comprehensively reviewed in Graham and Scott). 4 Attempts to explain the pharmacological action of paracetamol as inhibition of a central cyclooxygenase isoform, derived from the same gene as COX-1 and referred to as cyclooxygenase 3, 5 have meanwhile been rejected. 6 Instead, several data published during the past few years suggest a tissue-dependent inhibitory effect of paracetamol on the activity of both central and pe...

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Section: Inflammationmentioning

confidence: 99%

Paracetamol and cyclooxygenase inhibition: is there a cause for concern?

2011

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“…O efeito do tratamento na gota tem sido demonstrado por imagem IR. A redução térmica foi registrada 2 horas após administrações de indometacina, e em 24 horas a articulação estava quase assintomática (52,53) .…”

Section: Gotaunclassified

Utilização da imagem infravermelha em reumatologia

Brioschi

Yeng

Pastor

et al. 2007

Rev. Bras. Reumatol.

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artigo de reVisão reView article INTRODUÇÃOO infravermelho é uma radiação do espectro eletromagnético com comprimentos de onda entre 0,75 μm a 100 μm, em meio ao limite da percepção visual do vermelho e as microondas. Dependendo de sua intensidade, elas podem ser percebidas como calor pelas terminações nervosas livres, corpúsculos de Krause e de Ruffini da pele.A imagem infravermelha (IR) é uma técnica que capta radiação na faixa do infravermelho longo (7,5-13 μm) emitido pelo corpo humano, proporcionando uma imagem da distribuição térmica da superfície cutânea. A temperatura da pele, sob condições ambientais cuidadosamente controladas, é influenciada principalmente pela atividade microcirculatória desta e pela produção de calor conduzida para a superfície gerada em tecidos mais profundos.Conhecida desde a década de 1970, na reumatologia, pelo nome de termografia (1)(2)(3)(4)(5) , tem recebido nova atenção nos últimos cinco anos, sendo recentemente renomeada de imagem infravermelha (IR) devido aos novos detectores RESUMOA imagem infravermelha (IR) é um método diagnóstico inócuo e sem radiação iônica, capaz de quantificar objetivamente por imagem as reações inflamatórias locais do sistema músculo-esquelético. Para o diagnóstico diferencial, a imagem IR deve ser analisada em conjunto com o exame clínico e outros exames complementares. A imagem IR quantitativa é útil particularmente quando aplicada na monitoração do curso da atividade inflamatória e da terapia antiinflamatória local e sistêmica. Palavras-chave: reumatologia, imagem infravermelha, raios infravermelhos. ABSTRACTInfrared thermography is unique objective imaging procedure for the quantitative assessment of local inflammatory reactions in parts of the locomotor system. For differential diagnosis the thermographic results should be evaluated in conjuction with clinical examination and other technical procedures. As a means of monitoring the course of the local inflammatory activity, however, quantitative infrared thermography is a useful tool in itself, particularly during the application of local and systemic anti-inflammatory therapy.Keywords: rheumatology, infrared imaging, infrared rays.infravermelhos ultra-sensíveis. É um método inócuo, não-invasivo, não-ionizante, sem contraste, capaz de mensurar a temperatura cutânea a distância com altíssima precisão em forma de imagens de alta resolução. Essa técnica, além de digitalizar as imagens, quantifica a informação em tempo real, distinguindo diferenças de temperatura menores do que 0,07ºC em menos de 0,03 segundo (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) . Recentemente, distintos métodos de imageamento infravermelho foram descritos além do estático: dinâmico com ou sem subtração de imagem, multiespectral e hiperespectral, mapeamento de textura térmica, multimodal, fusão de sensores, fusão com imagens de ressonância magnética (MRIF) e imageamento infravermelho tridimensional com e sem MRIF (21) .A melhor compreensão dessa tecnologia está permitindo avaliar por outra perspectiva a efet...

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“…Although acetaminophen is effective for mild to moderate pain, such as for the osteoarthritis and acute pain from dental procedures, 19,20 it does not possess the anti-inflammatory activity observed with NSAIDs. 21,22 In the case of osteoarthritis, some studies performed with NSAIDs suggest greater efficacy in comparison to acetaminophen. 23 The anti-inflammatory effects of COX-2 inhibition may explain this difference in efficacy between NSAIDs and acetaminophen.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the efficacy and safety of etoricoxib in the treatment of hemophilic arthropathy

Tsoukas

Eyster

Shingo

et al. 2006

Blood

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This 2-part, double-blind, placebo-controlled study was conducted to determine the safety and efficacy of etoricoxib, a COX-2 selective inhibitor, for the treatment of hemophilic arthropathy. In part 1 (6 weeks), 102 patients (> 12 years old) with hemophilic arthropathy were randomized to receive 90 mg etoricoxib once daily or placebo (1:1 ratio). In part 2 (6 months), 51 patients taking placebo in part 1 were randomized to receive 90 mg etoricoxib or 25 mg rofecoxib once daily; patients taking etoricoxib in part 1 continued the same treatment. Efficacy end points included

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Quantitation of thermography in arthritis using multi-isothermal analysis. II. Effect of nonsteroidal anti-inflammatory therapy on the thermographic index.

Cited by 63 publications

References 3 publications

Paracetamol and cyclooxygenase inhibition: is there a cause for concern?

Paracetamol and cyclooxygenase inhibition: is there a cause for concern?

Utilização da imagem infravermelha em reumatologia

Evaluation of the efficacy and safety of etoricoxib in the treatment of hemophilic arthropathy

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