Lack of correlation between the central anti-nociceptive and peripheral anti-inflammatory effects of selective COX-2 inhibitor parecoxib.

Non-steroidal anti-inflammatory drugs (NSAIDs) are thought to exert their pharmacological actions by a common mechanism: inhibition of cyclooxygenase (COX)-mediated prostanoid synthesis. Yet, differences and dissociation between their analgesic and anti-inflammatory effects have not been related to this enzymatic mechanism but mainly to pharmacokinetic factors. Thus, we have compared the effects of an equieffective anti-inflammatory dose (6 mg/kg i.p.) of two NSAIDs with comparable spinal pharmacokinetics, ketoprofen (moderately preferential for COX-1) and parecoxib (selective COX-2), on the activation of spinal nociceptive neurons (measured as c-Fos expression) induced by carrageenan-induced acute inflammation in the rat paw. Both NSAIDs showed a similar anti-inflammatory effect when administered after carrageenan injection (post-treatment). Post-treatment with ketoprofen produced inhibition of c-Fos but parecoxib did not have any significant effect. In addition, parecoxib anti-inflammatory effect was greater than that of ketoprofen, when administered before carrageenan injection (pre-treatment). Paradoxically, pre-treatment with ketoprofen produced a greater inhibition of c-Fos expression than with parecoxib, in all lamina of ipsilateral dorsal horn of the lumbar spinal cord. This suggests that NSAIDs therapeutic profile is related to their selectivity for COX isoforms and COX-2 is involved in the initiation but not in the maintenance of nociceptive spinal activation, which depends on COX-1.

Serial pulsatility index measurements in renal grafts before, during, and after episodes of urinary obstruction.

The usefulness of pulsatility index determinations for the diagnosis of obstructive collecting system dilatation was investigated in 10 renal transplant patients whose grafts developed urinary obstruction from different causes. For this purpose we compared pulsatility index values obtained (1) before the ultrasonographic detection of obstruction or baseline study, (2) 1 day before surgical repair, and (3) within 2 weeks after surgery. In 7 of 10 obstructed grafts, the pulsatility index values were increased only mildly to moderately preoperatively. In the remaining three grafts, a mild decrease in pulsatility index was observed in spite of severe collecting system dilatation. Changes in pulsatility index were not statistically significant. Impedance measurements appeared not to be useful for diagnosing obstructive collecting system dilatation.

[Chromosomal abnormalities in malignant hematologic diseases]. / Anomalías cromosómicas en enfermedades hematológicas malignas.

The inclusion of cytogenetic studies in the protocol study of patients with hematological malignant diseases is a very important contribution because these results contribute to establish better precision of diagnosis, prognostic and suggest adequate therapeutic management precociously. The Karyotypes of 200 patients between ages of 2 and 84 years, 56/200 acute lymphoblastic leukemia (ALL), 55/200 acute myeloid leukemia (AML), 63/200 chronic myeloid leukemia (CML), 20/200 myelodysplastic syndrome (MDS), and 6/200 chronic lymphocytic leukemia, (CLL), are analyzed. Certain differences were noted. In ALL, hyperdiploidy was the chromosomal abnormality more frequently observed and no cases of Ph+ chromosome were reported; with respect to AML, the autosomal monosomy and trisomy were the most frequent findings. MDS reports only one case with 5q deletion, 10% of patients presented trisomy 14, rarely reported. CML do no report any case with double Ph+ and only one case with i(17q); nevertheless, one case with 21q deletion was found, which is an unreported anomaly. CLL did not present any case with trisomy 12. These findings are discussed in the context of geographical heterogeneity of chromosomal abnormalities in leukemia, and emphasize the importance of continued epidemiological studies.