Association among cardiopulmonary and metabolic rehabilitation, arrhythmias, and myocardial ischemia responses of patients with HFpEF or HFmrEF.

There's limited evidence of the potential benefits of cardiopulmonary and metabolic rehabilitation (CPMR) in patients with heart failure with preserved ejection fraction (HFpEF) or mildly reduced ejection fraction (HFmrEF) and coronary artery disease (CAD). The aim of this study was to investigate the impact of CPMR on the myocardial ischemia response (MIR), exercise-induced arrhythmias (EIA), New York Heart Association (NYHA) functional class, heart rate recovery (HRR), Borg CR10 perceived symptoms, and the SF-36 physical and mental health summary scores. A prospective cohort study was conducted with 106 patients undergoing 12 weeks of CPMR who completed two exercise tests pre- and post-CPMR: 1) maximum incremental test (CPX) and 2) submaximal constant load test (SUB). After CPMR, the effects on MIR, EIA, NYHA functional class, and HRR during both tests were analyzed. There was a significant change in NYHA functional classes after CPMR, with 96% of the patients in class I (vs 62% pre-CPMR, P<0.0001), 4% in class II (vs 32%), and none in class III (vs 6%). There was a significant reduction in the frequency of EIA (P<0.05) and MIR (P<0.001) and a significantly improved performance on both CPX and SUB tests (P<0.0001). Lastly, there was significant progress in the recovery metrics like HRR (P<0.0001), the Borg CR10 (P<0.0001), and the SF-36 summary scores (P<0.0001). The CPMR resulted in a significant decrease in EIA, delayed ischemia threshold in CPX and SUB tests, increased functional capacity, and improved quality of life.

Study of digital palmar and plantar arteries of horses and mules by B-mode and Doppler ultrasonography / Estudo das artérias digitais palmares e plantares de equinos e muares por ultrassonografia modo-B e Doppler

The present study aimed to evaluate and compare the palmar and plantar digital arteries of 10 horses and 10 mules through B-mode and spectral Doppler ultrasound. Likewise, compare the plantar arteries of the pelvic limbs with the palmar arteries of the thoracic limbs, in addition to verifying the differences of the digital arteries in the contralateral limbs (right and left) in horses and mules using B-mode and spectral Doppler ultrasonography. The evaluated parameters were the diameter and the intima-media thickness (IMT), resistivity index (RI), pulsatility index (PI), peak of systolic velocity (pSV), final diastolic velocity (fDV) and mean velocity (MV) of the lateral and medial palmar and plantar arteries digital in healthy horses and mules. The horses presented higher diameters values, IMT, pSV, fDV and MV in comparison to the mules. The variables RI and PI also presented differences between horses and mules. Also, both species showed higher values in the variables of B-mode and Doppler ultrasonography in the thoracic limbs. Differences were also detected in the comparison between the limb sides (right and left) in the two modalities. The B-Mode and spectral Doppler ultrasound techniques are viable tools to identify differences in the palmar and plantar digital arteries in healthy horses and mules, highlight the differences between the thoracic and pelvic limbs and their respective sides (right and left) as well.

O presente estudo teve como objetivo avaliar e comparar as artérias digitais palmares e plantares de 10 equinos e 10 muares, por meio de ultrassom modo B e Doppler espectral. Da mesma forma, buscou-se comparar as artérias plantares dos membros pélvicos com as artérias palmares dos membros torácicos, além de se verificarem as diferenças das artérias digitais nos membros contralaterais (direito e esquerdo) em equinos e mulas, por meio de ultrassonografia modo B e Doppler espectral. Os parâmetros avaliados foram o diâmetro e a espessura médio-intimal (EMI), o índice de resistividade (IR), o índice de pulsatilidade (IP), o pico de velocidade sistólica (pVS), a velocidade diastólica final (VDf) e a velocidade média (VM) das artérias palmares e plantares lateral e medial digitais em equinos e muares sadios. Os equinos apresentaram maiores valores de diâmetros, EMI, pVS, VDf e VM em comparação aos muares. As variáveis IR e IP também apresentaram diferenças entre equinos e muares. Cavalos e mulas apresentaram maiores valores nas variáveis de ultrassonografia modo B e Doppler nos membros torácicos. Também foram detectadas diferenças na comparação entre os lados dos membros (direito e esquerdo) nas duas modalidades. As técnicas de ultrassom modo-B e Doppler espectral são ferramentas viáveis para identificar diferenças nas artérias digitais palmares e plantares em equinos e muares saudáveis, bem como para destacar as diferenças entre os membros torácicos e pélvicos e seus respectivos lados (direito e esquerdo).

Post-COVID-19 tomographic abnormalities.

BACKGROUND: The prevalence of persistent respiratory symptoms tends to be low in patients with a longer recovery time after COVID-19. However, some patients may present persistent pulmonary abnormalities.OBJECTIVE: To evaluate the prevalence of tomographic abnormalities 90 days after symptom onset in patients with COVID-19 and compare two chest high-resolution computed tomography (HRCT) analysis techniques.METHODS: A multicentre study of patients hospitalised with COVID-19 having oxygen saturation <93% on room air at hospital admission were evaluated using pulmonary function and HRCT scans 90 days after symptom onset. The images were evaluated by two thoracic radiologists, and were assessed using software that automatically quantified the extent of pulmonary abnormalities.RESULTS: Of the 91 patients included, 81% had at least one pulmonary lobe with abnormalities 90 days after discharge (84% were identified using the automated algorithm). Ground-glass opacities (76%) and parenchymal bands (65%) were the predominant abnormalities. Both chest HRCT technical assessments presented high sensitivity (95.9%) and positive predictive value (92%), with a statistically significant correlation at baseline (R = 0.80) and after 90 days (R = 0.36).CONCLUSION: The prevalence of pulmonary abnormalities on chest HRCT 90 days after symptom onset due to COVID-19 was high; both technical assessments can be used to analyse the images.

Influence of breed and parasite challenge on the immune response to naturally acquired intestinal nematode infection in sheep.

Natural infection by intestinal nematodes was assessed in Santa Ines and Ile de France sheep breeds, over a five-month grazing period, with emphasis on the development of the immune response in lambs under two anthelmintic treatment regimens. Nineteen Santa Ines and 19 Ile de France male lambs were allocated into two treatment groups: animals under suppressive treatment with anthelmintics; and animals under targeted selective treatment (TST). The nematodes Trichostrongylus colubriformis and Strongyloides papillosus showed the highest infection intensity in the TST animals in both breeds. Parasite-specific immunoglobulin G levels were significantly higher and more rapidly induced in Santa Ines lambs. Additionally, these lambs had higher levels of parasite-specific immunoglobulin A in intestinal mucus. Animals under TST had higher means of mast cells and globule leukocytes in the intestinal mucosa due to longer and greater parasite challenge in comparison with the suppressive group. A breed effect (P < 0.05) was recorded for mast cells, with Santa Ines lambs presenting the highest counts. Although Santa Ines lambs had lower intestinal nematode counts than Ile de France lambs, they had shown a large variation in T. colubriformis burden, with most of them presenting a marked worm burden, despite showing an earlier and more intense immune response to intestinal nematode infection.

Study of Soft/Hard Bimagnetic CoFe²/CoFe²O4 Nanocomposite.

We report an experimental study of the bimagnetic nanocomposites CoFe2/CoFe2O4. The precursor material, CoFe2O4 was prepared using the conventional stoichiometric combustion method. The nano-structured material CoFe2/CoFe2O4 was obtained by total oxygen reduction of CoFe2O4 using a thermal treatment at 350 °C in H2 atmospheres following the partial oxidation in O2 atmospheres at 380 °C during 120; 30; 15, 10, and 5 min. The X-ray diffraction, Mössbauer spectroscopy and transmission electronic microscopy images confirmed the formation of the material CoFe2/CoFe2O4. The magnetic hysteresis for the nanocomposite with different saturation magnetization (from 87 to 108 emu/g) also confirms the formation of the CoFe2/CoFe2O4 with different content of CoFe2O4. Furthermore, the magnetic hysteresis curves for all samples presented a single magnetic behavior, suggesting the magnetic coupling between the phases of the nanocomposite. The effects of high energy milling on the magnetic properties of the precursor material and nanocomposites samples were evaluated.

Systematic review of the ingestion of fructooligosaccharides on the absorption of minerals and trace elements versus control groups.

BACKGROUND & AIMS: Fructooligosaccharides (FOS) are non-caloric and unconventional sugars that are not metabolized by the human body, but can be fermented by the colonic microbiota, leading to some beneficial effects on the absorption of minerals and trace elements. There is, however, a lack of research that describes the continued consumption of FOS in the diet between healthy and ill individuals and their impact. The objective of this systematic review was to evaluate the evidence behind the role of FOS in the absorption of minerals and trace elements in the human body. METHODS: The bibliographic research covered the period from January 2000 to August 2020. Four databases were investigated. We follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). The systematic review protocol was recorded in PROSPERO (139621). Two reviewers examined and extracted data from qualitative and quantitative studies published in the main databases, through a careful analysis. The risk of bias was assessed by four reviewers. RESULTS: Of a total of 1494 texts, 30 complete articles composed this review. Two overarching categories represented the results: animal models and human models (randomized crossover design). Regarding human models, the results showed an improvement in minerals, especially the absorption of calcium, magnesium and iron after the ingestion of FOS, and specifically the absorption of minerals and trace elements in postmenopausal women was improved. CONCLUSIONS: The use of FOS to improve the absorption of minerals and trace elements seems to be beneficial with evidence corroborating both in human and animal studies. However, the literature lacks articles exploring the daily dose and duration for FOS benefits, as well as long-term side effects in healthy or unhealthy subjects. Future research should focus on addressing the extent of the functional effect of this fiber and identifying the impact on overall health.

Effect of maxillary advancement on speech and velopharyngeal function of patients with cleft palate: Systematic Review and Meta-Analysis.

This systematic review (SR) aimed to evaluate speech and velopharyngeal function (VPF) changes of patients with cleft palate (CLP) after maxillary advancement (MA) surgery. A two-phase PROSPERO-registered SR (CRD42019141370) was conducted following the PRISMA statements. Search strategies were developed for main databases (PubMed, Scopus, Web of Science, COCHRANE, LILACS, and EBSCOhost) and Grey literature information sources. The GRADE tool was used to evaluate the quality of evidence. From a total of 908 articles, 10 (205 men and 147 women; mean age ranging from 18.0 to 25.7 years) were selected for meta-analysis. Moderate to high risk of bias (Rob) was observed. The most common methods for outcomes evaluation were the Nasometer (speech) and nasoendoscopy (VPF). Speech changed from normal to hypernasal, and VPF worsening were reported in most studies. Comparing maxillary advancement interventions (osteogenic distraction versus Le Fort I), no statistically significant differences were found regarding benefit on speech and VPF. In summary, the effect of MA on speech and VPF remains controversial in CLP patients. The RoB, inconsistencies, and imprecisions severely affected the overall quality of evidence. Further adequately delineated clinical studies are necessary to investigate the potential effect of MA interventions on speech and VPF in CLP patients.

BIO-NAIL: a bacterial cellulose dressing as a new alternative to preserve the nail bed after avulsion.

Avulsion of the nail plate is the most accomplished surgical procedure among the nail apparatus surgeries. Since it is not possible to use the removed nail to cover the nail bed, some materials have been suggested, however, they are generally not available for use and often at a high cost. To evaluate the use of Bacterial Cellulose (BC) dressing as a biological nail (Bio-Nail) after partial or total avulsion of the nail plate. Twenty-six candidates for nail avulsion, were randomized into two groups: Control, using Vaseline with gauze (11 patients) and Experimental group, BC group, using the Bio-Nail (15 patients). The patients were followed up during the 180-day period. The distribution of the patients in the groups was homogeneous for both sociodemographic and clinical data. The occurrence of infection (1 case in the control group) was not statistically relevant. The BC group had lower pain intensity (p = 0.011) with earlier temporal resolution when compared to the control group (p = 0.003). The BC group presented earlier reepithelization (p = 0.022) and better quantitative (p = 0.021) and qualitative conditions (p = 0.011) for the exudate. Regarding satisfaction, all the patients were satisfied. Good preservation of the nail plate area was observed in the BC group at the end of the 180-day period (p = 0.024). Average time of BC dressing permanence was 16.4 ± 7.1 days. BC showed to be appropriate as a dressing after partial or total avulsion of the nail plate. BC is a Bio-Nail promising for nail bed healing.

Effects of NO/cGMP inhibitors in a rat model of anaphylactoid shock.

Anaphylactic shock can be defined as an acute syndrome, and it is the most severe clinical manifestation of allergic diseases. Anaphylactoid reactions are similar to anaphylactic events but differ in the pathophysiological mechanism. Nitric oxide (NO) inhibitors during anaphylaxis suggest that NO might decrease the signs and symptoms of anaphylaxis but exacerbate associated vasodilation. Therefore, blocking the effects of NO on vascular smooth muscle by inhibiting the guanylate cyclase (GC) would be a reasonable strategy. This study aimed to investigate the effects of NO/cGMP pathway inhibitors methylene blue (MB), Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME), and indigo carmine (IC) in shock induced by compound 48/80 (C48/80) in rats. The effect was assessed by invasive blood pressure measurement. Shock was initiated by C48/80 intravenous bolus injection 5 min before (prophylactic) or after (treatment) the administration of the inhibitors MB (3 mg/kg), L-NAME (1 mg/kg), and IC (3 mg/kg). Of the groups that received drugs as prophylaxis for shock, only the IC group did not present the final systolic blood pressure (SBP) better than the C48/80 group. Regarding shock treatment with the drugs tested, all groups had the final SBP similar to the C48/80group. Altogether, our results suggested that inhibition of GC and NO synthase in NO production pathway was not sufficient to revert hypotension or significantly improve survival.

Effects of NO/cGMP inhibitors in a rat model of anaphylactoid shock

Anaphylactic shock can be defined as an acute syndrome, and it is the most severe clinical manifestation of allergic diseases. Anaphylactoid reactions are similar to anaphylactic events but differ in the pathophysiological mechanism. Nitric oxide (NO) inhibitors during anaphylaxis suggest that NO might decrease the signs and symptoms of anaphylaxis but exacerbate associated vasodilation. Therefore, blocking the effects of NO on vascular smooth muscle by inhibiting the guanylate cyclase (GC) would be a reasonable strategy. This study aimed to investigate the effects of NO/cGMP pathway inhibitors methylene blue (MB), Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME), and indigo carmine (IC) in shock induced by compound 48/80 (C48/80) in rats. The effect was assessed by invasive blood pressure measurement. Shock was initiated by C48/80 intravenous bolus injection 5 min before (prophylactic) or after (treatment) the administration of the inhibitors MB (3 mg/kg), L-NAME (1 mg/kg), and IC (3 mg/kg). Of the groups that received drugs as prophylaxis for shock, only the IC group did not present the final systolic blood pressure (SBP) better than the C48/80 group. Regarding shock treatment with the drugs tested, all groups had the final SBP similar to the C48/80group. Altogether, our results suggested that inhibition of GC and NO synthase in NO production pathway was not sufficient to revert hypotension or significantly improve survival.

FUT3 expression in human breast cancer cells under hypoxia and serum deprivation.

This study aimed to investigate the effects of hypoxia and serum deprivation on regulation of fucosyltransferase-3 (FUT3) expression in breast cancer cells. MATERIALS AND METHODS: FUT3 expression was evaluated in T47D and MCF7 cells. Transcriptional and protein analysis was performed under hypoxia and serum deprivation conditions after 6 and 24 hours; and after 24 and 48 hours, respectively. RESULTS: In T47D cells, experimental conditions induced a significant decrease in FUT3 expression at both, transcriptional and protein levels, while in MCF7 cells the same conditions induced a significant increase of FUT3 expression. CONCLUSIONS: Regulation of FUT3 expression under hypoxic and serum deprivation conditions may be involved in the acquisition of advantages related to apoptosis resistance and metastasis promotion, according to the intrinsic differences presented by T47D and MCF7 cells.

Serogroup identification, phenotypic detection of hemolysis and extended spectrum beta-lactamases of Escherichia coli isolated from psittacine of illegal wildlife trade in Fortaleza, Brazil / Identificação de sorogrupo e detecção fenotípica de betalactamase de espectro estendido e produção de hemolisina em Escherichia coli isoladas de psitacídeos do tráfico de animais silvestres em Fortaleza-CE

This study aimed to identify serogroups of Escherichia coli important for human health in isolates from psittacine of illegal wildlife trade in Ceará State. In addition, hemolysis and production of Extended Spectrum Beta-Lactamases (ESBL) was assessed in the isolates. A total of 78 E. coli strains isolated from different Psittaciformes species from a wildlife rehabilitation center in Fortaleza, Brazil. The isolates used in this study were previously identified and stored. Serogroup identification was performed using polyvalent sera for EPEC (O55, O111, O119, O114, O125, O86, O126, O127, O128), EIEC (O136, O124) and EHEC (O157). ESBL detection was performed with double disk synergy method. For hemolysis detection, isolates were inoculated in blood agar base enriched with ovine blood. Only 31 (39.7%) isolates were seropositive and the most frequent were O127, O114, O128 and O111. There was no agglutination for serogroups O55, O124, O136 or O157. Considering both seropositive and seronegative isolates, 9 (11.5%) and 35 (44.9%) presented hemolysis and ESBL production, respectively. In conclusion, the investigated psittacine from illegal wildlife trade hosted ESBL-producing E. coli strains and some belong to important serogroups often linked to severe human infections.(AU)

Este trabalho teve como objetivo identificar sorogrupos de E. coli importantes para a saúde humana, oriundos de psitacídeos provenientes do tráfico no estado do Ceará, assim como detectar atividade hemolítica e produção de betalactamase de espectro estendido (ESBL). Foram testadas 78 cepas de Escherichia coli provenientes de psitaciformes do Centro de Triagem de Animais Silvestres, Fortaleza, CE. Para a identificação dos sorogrupos, utilizaram-se soros polivalentes EPEC (O55, O111, O119, O114, O125, O86, O126, O127, O128), EIEC (O136, O124) e EHEC (O157). Para detecção de ESBL, as cepas foram submetidas ao método de aproximação de disco e, para a detecção de hemolisina, foram plaqueadas em ágar sangue base enriquecido com sangue de carneiro. No geral, 31 (39,7%) das amostras foram soropositivas. Os sorogrupos mais frequentemente detectados foram O127, O114, O128 e O111. Não houve positividade para os sorogrupos O55, O124, O136 e O157. Considerando-se as amostras sororreagentes e não sororreagentes, observou-se que nove (11,5%) e 35 (44,9%) cepas de E. coli apresentaram produção de hemolisinas e de ESBL, respectivamente. Em conclusão, constatou-se que psitacídeos provenientes do tráfico de animais silvestres albergam cepas de E. coli produtoras de ESBL e providas de importantes sorogrupos implicados em graves infecções humanas.(AU)

Isolation and antimicrobial resistance profiles of enterobacteria from nestling grey-breasted parakeets (Pyrrhura griseipectus)

The psittacine Pyrrhura griseipectus is a threatened species currently only found in Ceará State, Brazil. A microbiological survey was conducted to determine the composition of the enteric microbiota of this species, as well as the phenotypic profiles of antimicrobial susceptibility presented by the isolates. Cloacal swabs were collected from individual birds and submitted to microbiological processing. Antimicrobial susceptibility profiles were evaluated using the disk diffusion method. Bacteria of the genus Escherichia, Proteus, Citrobacter, Pantoea, Klebsiella, Enterobacter, Morganella, Hafnia, Enterobacter, and Serratia were isolated. The most frequently isolated species were Escherichia coli, Proteus mirabilis and Proteus vulgaris, corresponding to 36.1%, 26.4%, and 8.3%, respectively. Isolates were more frequently resistant to azithromycin and tetracycline, while Escherichia coli was the main species presenting multidrug resistance. In conclusion, free-living grey-breasted parakeets may harbor enterobacteria with high antimicrobial resistance rates.(AU)

Isolation and antimicrobial resistance profiles of enterobacteria from nestling grey-breasted parakeets (Pyrrhura griseipectus)

The psittacine Pyrrhura griseipectus is a threatened species currently only found in Ceará State, Brazil. A microbiological survey was conducted to determine the composition of the enteric microbiota of this species, as well as the phenotypic profiles of antimicrobial susceptibility presented by the isolates. Cloacal swabs were collected from individual birds and submitted to microbiological processing. Antimicrobial susceptibility profiles were evaluated using the disk diffusion method. Bacteria of the genus Escherichia, Proteus, Citrobacter, Pantoea, Klebsiella, Enterobacter, Morganella, Hafnia, Enterobacter, and Serratia were isolated. The most frequently isolated species were Escherichia coli, Proteus mirabilis and Proteus vulgaris, corresponding to 36.1%, 26.4%, and 8.3%, respectively. Isolates were more frequently resistant to azithromycin and tetracycline, while Escherichia coli was the main species presenting multidrug resistance. In conclusion, free-living grey-breasted parakeets may harbor enterobacteria with high antimicrobial resistance rates.

Serogroup identification, phenotypic detection of hemolysis and extended spectrum beta-lactamases of Escherichia coli isolated from psittacine of illegal wildlife trade in Fortaleza, Brazil / Identificação de sorogrupo e detecção fenotípica de betalactamase de espectro estendido e produção de hemolisina em Escherichia coli isoladas de psitacídeos do tráfico de animais silvestres em Fortaleza-CE

This study aimed to identify serogroups of Escherichia coli important for human health in isolates from psittacine of illegal wildlife trade in Ceará State. In addition, hemolysis and production of Extended Spectrum Beta-Lactamases (ESBL) was assessed in the isolates. A total of 78 E. coli strains isolated from different Psittaciformes species from a wildlife rehabilitation center in Fortaleza, Brazil. The isolates used in this study were previously identified and stored. Serogroup identification was performed using polyvalent sera for EPEC (O55, O111, O119, O114, O125, O86, O126, O127, O128), EIEC (O136, O124) and EHEC (O157). ESBL detection was performed with double disk synergy method. For hemolysis detection, isolates were inoculated in blood agar base enriched with ovine blood. Only 31 (39.7%) isolates were seropositive and the most frequent were O127, O114, O128 and O111. There was no agglutination for serogroups O55, O124, O136 or O157. Considering both seropositive and seronegative isolates, 9 (11.5%) and 35 (44.9%) presented hemolysis and ESBL production, respectively. In conclusion, the investigated psittacine from illegal wildlife trade hosted ESBL-producing E. coli strains and some belong to important serogroups often linked to severe human infections.(AU)

Este trabalho teve como objetivo identificar sorogrupos de E. coli importantes para a saúde humana, oriundos de psitacídeos provenientes do tráfico no estado do Ceará, assim como detectar atividade hemolítica e produção de betalactamase de espectro estendido (ESBL). Foram testadas 78 cepas de Escherichia coli provenientes de psitaciformes do Centro de Triagem de Animais Silvestres, Fortaleza, CE. Para a identificação dos sorogrupos, utilizaram-se soros polivalentes EPEC (O55, O111, O119, O114, O125, O86, O126, O127, O128), EIEC (O136, O124) e EHEC (O157). Para detecção de ESBL, as cepas foram submetidas ao método de aproximação de disco e, para a detecção de hemolisina, foram plaqueadas em ágar sangue base enriquecido com sangue de carneiro. No geral, 31 (39,7%) das amostras foram soropositivas. Os sorogrupos mais frequentemente detectados foram O127, O114, O128 e O111. Não houve positividade para os sorogrupos O55, O124, O136 e O157. Considerando-se as amostras sororreagentes e não sororreagentes, observou-se que nove (11,5%) e 35 (44,9%) cepas de E. coli apresentaram produção de hemolisinas e de ESBL, respectivamente. Em conclusão, constatou-se que psitacídeos provenientes do tráfico de animais silvestres albergam cepas de E. coli produtoras de ESBL e providas de importantes sorogrupos implicados em graves infecções humanas.(AU)

Effect of pre-emptive analgesia on clinical parameters and tissue levels of TNF-α and IL-1ß in third molar surgery: a triple-blind, randomized, placebo-controlled study.

This study aimed to evaluate whether pre-emptive analgesia modifies the tissue expression of tumour necrosis factor alpha (TNF-α) and interleukin 1 beta (IL-1ß), and whether there is an association with postoperative surgical outcomes. A triple-blind, randomized, placebo-controlled study of patients undergoing mandibular third molar removal was performed. Volunteers were allocated randomly to receive etoricoxib 120 mg, ibuprofen 400 mg, or placebo 1h before surgery. Twenty-four surgical sites per group were required (95% confidence level and 80% statistical power). Pain scores differed significantly between groups (P<0.001). Etoricoxib and ibuprofen reduced pain scores compared to placebo (P<0.05). Pain scores peaked at 4h postoperative in the experimental groups, but at 2h postoperative in the placebo group (P<0.05). A significant reduction in TNF-α concentration from time 0' to time 30' was seen for ibuprofen (P=0.001) and etoricoxib (P=0.016). The ibuprofen group showed a significant reduction in IL-1ß levels from time 0' to time 30' (P=0.038). In conclusion, TNF-α and IL-1ß levels and the inflammatory events in third molar surgery were inversely associated with the degree of cyclooxygenase 2 selectivity of the non-steroidal anti-inflammatory drugs used pre-emptively. Patients given pre-emptive analgesia showed significant reductions in the clinical parameters pain, trismus, and oedema when compared to the placebo group.