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CRITERIOR PICO DESARROLLO DE PREGUNTA DE INVESTIGACION DESARROLLO CDE ARTROSIS...

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METODOLOGIA DE LA INVESTIGACION INTEGRANTES 1. katerina Balcazar De Los Santos, médico residente 1 año, medicina familiar, hospital I Albrecht, ESSALUD,TRUJILLO. 2. Antonio Vargas Masías, médico residente 1 año, medicina familiar, hospital I Albrecht, ESSALUD,TRUJILLO. 3.

1. PLANTEAMIENTO DE LA PREGUNTA PICO:

p: población o pacientes i: intervención o indicador c: comparador o control o: resultado

ejemplo 1: ¿en hombres adultos con osteartrosis de rodilla sin derrame sinovial, es más efectiva la aplicación de metilprednisolona intraarticular que el tramadol paracetamol por vía oral para el alivio del dolor durante las exacerbaciones? p: hombres adultos con osteoartrosis de rodilla sin derrame sinovial i: metilprednisolona intra-articular c: tramadol paracetamol -oral o: alivio del dolor durante las exacerbaciones Pregunta:

¿Es más efectiva la aplicación de metilprednisolona intra-articular que el tramadol paracetamol oral por vía oral para el alivio del dolor durante las exacerbaciones en hombres adultos con osteoartrosis de rodilla sin derrame sinovial?

2.ESTRATEGIA DE BUSQUEDA PUBMED Nuestra estrategia de busqueda ((((Knee Osteoarthritides) OR (Knee Osteoarthritis)) OR (Osteoarthritis of Knee)) OR (Osteoarthritis of the Knee)) AND (Paracetamol)) AND (Tramadol)

3. RECUPERAR LISTA DE BUSQUEDA ZOTERO Buscamos 8 referencias importantes

4.CONSTRUIR UNA CARA DE CUALQUIER TEXTO Y CITAR BIBLIOGRAFÍA

Effects of tramadol on synovial fluid concentrations of substance P and interleukin-6 in patients with knee osteoarthritis: comparison with paracetamol BACKGROUND: Combined tramadol/acetaminophen is used to treat pain related to osteoarthritis. However, adverse events (AEs) leading to discontinuation can occur.

Dose

titration may decrease the risk for AEs. OBJECTIVE: The aim of this study was to assess the effect of tramadol/acetaminophen titration on the development of AEs leading to treatment discontinuation in patients with knee osteoarthritis.(1) Inpain group, and tramadol, celecoxib, and diclofenac in the lower pain group. CONCLUSION: In the overall analysis, etoricoxib, celecoxib, and aceclofenac had the highest rankings for improving WOMAC pain. The ability to improve knee OA symptoms may differ depending on baseline pain and radiologic features.(2) Both the analgesic drugs tramadol and paracetamol are widely used for the symptomatic therapy of osteoarthritis (OA). The aim of this double-blind, randomised study in patients with knee OA was to compare their effects on synovial fluid concentrations of interleukin (IL)-6 and substance P (SP). Moreover, we evaluated plasma and synovial fluid concentrations of tramadol and its active metabolite (O-desmethyl-tramadol, M1) after oral treatment with this drug.(3) Opioid analgesics may be a useful alternative in patients with osteoarthritis who have not responded to first-line treatment with acetaminophen and

in whom nonsteroidal anti-

inflammatory drugs are contraindicated, ineffective, or poorly tolerated. OBJECTIVE: This study compared the efficacy and tolerability of tramadol LP 200 mg, a new once-daily,sustainedrelease formulation, with those of placebo in patients with osteoarthritis of the hip or knee. In this study, tramadol LP 200 mg was significantly more effective than placebo in alleviating pain in patients with osteoarthritis of the hip or knee. It appeared to be relatively well tolerated for an opioid compound.(4)

REFERENCIAS BIBLIOGRAFICAS

1. Choi c-b, song js, kang ym, suh ch, lee j, choe j-y, et al. A 2-week, multicenter, randomized, double-blind, double-dummy, add-on study of the effects of titration on tolerability of tramadol/acetaminophen combination tablet in korean adults with knee osteoarthritis pain. Clin ther. Julio de 2007;29(7):1381-9. 2. Jung s-y, jang ej, nam sw, kwon hh, im sg, kim d, et al. Comparative effectiveness of oral pharmacologic interventions for knee osteoarthritis: a network meta-analysis. Mod rheumatol. Noviembre de 2018;28(6):1021-8. 3. Bianchi m, broggini m, balzarini p, baratelli e, ferrario p, panerai ae, et al. Effects of tramadol on synovial fluid concentrations of substance p and interleukin-6 in patients with knee osteoarthritis: comparison with paracetamol. Int immunopharmacol. Diciembre de 2003;3(1314):1901-8. 4. Malonne H, Coffiner M, Sonet B, Sereno A, Vanderbist F. Efficacy and tolerability of sustainedrelease tramadol in the treatment of symptomatic osteoarthritis of the hip or knee: a

multicenter, randomized, 2004;26(11):1774-82.

double-blind, placebo-controlled study. Clin Ther. noviembre de...