The use of H2 antagonists in treating and preventing NSAID-induced mucosal damage

Pain affects the quality of life for millions of individuals and is a major reason for healthcare utilization. As populations age, medical personnel will need to manage more and more patients suffering from pain associated with degenerative and inflammatory musculoskeletal disorders. Nonsteroidal anti-inflammatory drugs (NSAIDs) are an effective treatment for both acute and chronic musculoskeletal pain; however, their use is associated with potentially significant gastrointestinal (GI) toxicity. Guidelines suggest various strategies to prevent problems in those at risk for NSAID-associated GI complications. In this article, we review the data supporting one such strategy - the use of histamine type-2 receptor antagonists (H2RAs) - for the prevention of GI adverse events in NSAID users. Older studies suggest that high-dose H2RAs are effective in preventing upper GI ulcers and dyspepsia. This suggestion was recently confirmed during clinical trials with a new ibuprofen/famotidine combination that reduced the risk of ulcers by 50% compared with ibuprofen alone.     

Taurine deficiency in maned wolves (Chrysocyon brachyurus) maintained on two diets manufactured for prevention of cystine urolithiasis

This study assesses the long‐term effects of an experimental diet vs. a commercially available manufactured diet, intended to reduce clinical disease related to cystinuria, on the taurine status of captive maned wolves. For 13 weeks, two pairs of maned wolves were maintained on the commercially available maintenance diet, whereas two individually housed wolves were maintained on the experimental diet. All six wolves, at the beginning and at the end of the diet trial, had severely decreased plasma concentrations of taurine (as compared to the normal canine reference range of 60–120 nmol/ml) (National Research Council [2003] National Academies Press) with average taurine concentrations of 16 nmol/ml at the beginning of the study and 3 nmol/ml at the end of the study. There was no statistically significant difference in the taurine concentrations between animals on the maintenance vs. experimental diets. Both diets were supplemented subsequently with taurine at a concentration of 0.3%. All study animals were eventually switched to the taurine‐supplemented version of the commercially manufactured maintenance diet and subsequent samplings were carried out to monitor plasma taurine concentrations. A final sampling, carried out approximately 5 months after the initiation of taurine supplementation, showed an average taurine concentration within the target canine reference range (90.25 nmol/ml). There are numerous physiologic (e.g., possible unique metabolism and requirements for taurine in this species as compared to other canids) and dietary factors (e.g., effects of the types and concentrations of fiber and protein on nutrient availability, taurine metabolism, and enterohepatic circulation of taurine‐conjugated bile salts; impaired taurine synthesis secondary to low cysteine availability) that could be potential contributors to the development of taurine deficiency in the maned wolves in this study. Taurine supplementation should be considered in maned wolves maintained on diets intended for reduction of cystinuria‐related complications. Zoo Biol 0:1–14, 2005. © 2005 Wiley‐Liss, Inc.