Tem como principais limitações o facto de ser operador dependente

Tem como principais limitações o facto de ser operador dependente e ter uma baixa reprodutibilidade. A natureza das lesões sólidas do pâncreas é vasta. As entidades malignas compreendem o adenocarcinoma ductal (ADC), os tumores neuroendócrinos (TNE), o linfoma pancreático, as metástases de tumores extrapancreáticos, LY2109761 o carcinoma de células acinares,

a neoplasia pseudopapilar sólida e, ainda, as neoplasias quísticas com componente sólido. As lesões benignas incluem os pseudotumores inflamatórios, que podem ocorrer no contexto de pancreatite crónica, pancreatite focal ou pancreatite autoimune (PAI), e as lesões quísticas complexas. A aplicação clínica GSKJ4 da EE na abordagem das lesões sólidas do pâncreas tem sido avaliada segundo a sua capacidade na deteção e diagnóstico, bem como no estadiamento e determinação da ressecabilidade das mesmas. Estudos comparativos datados de há 2 décadas reportam uma maior sensibilidade da EE na deteção de lesões sólidas do pâncreas (94-99%) comparativamente com a ultrassonografia abdominal

(67%), tomografia computorizada (TC) (69-77%) e ressonância magnética (RM) (83%), uma superioridade mais notória no caso das lesões com menos de 3 cm (sensibilidade 93-100% para a EE, 50-89% para a TC e 67% para a RM)3, 4, 5 and 6. A EE permite detetar e puncionar lesões com menos de 1 cm7. O seu valor preditivo negativo (VPN) aproxima-se dos 100%, sendo os falsos negativos geralmente resultantes de aspetos infiltrativos difusos das lesões tumorais, coexistência de pancreatite crónica ou episódio recente (< 4 semanas) de pancreatite aguda8. Em contraste com a elevada sensibilidade, a EE apresenta

uma especificidade diagnóstica relativamente baixa, porque as características da imagem ultrassonográfica convencional em modo B não permitem diferenciar tumores pancreáticos malignos de massas inflamatórias pseudotumorais. No entanto, a realização de PAAF-EE possibilita o diagnóstico diferencial na maioria dos casos9. A EE pode ser utilizada no estadiamento loco-regional das lesões malignas do pâncreas (sistema TNM, American until Joint Committee on Cancer), ao permitir avaliar a sua relação com os órgãos e as estruturas vasculares adjacentes, aspeto crítico na determinação do estádio T e da ressecabilidade tumoral, e a existência de linfadenopatias malignas peripancreáticas. A validade dos estudos existentes acerca do valor da EE neste contexto é, contudo, limitada, sendo os resultados heterogéneos. Em geral, admite-se que a EE é superior à TC no estadiamento T e na avaliação da invasão vascular do confluente esplenoportal, e equivalente na determinação do estadiamento N e na predição da ressecabilidade tumoral 6 and 10.

After being formed in the systemic circulation, bilirubin is tran

After being formed in the systemic circulation, bilirubin is transported into the hepatocytes, metabolized to give diglucuronide metabolite and excreted into the bile by Mrp2. Mrp2 (ABCC2) is also known to mediate the biliary excretion of glutathione and sulfate metabolites. Mrp2 impairment can affect the hepatic clearance of endogenous compounds, such as steroids, leukotrienes and many clinically important drugs (Gerk and Vore, 2002). The

clinical importance of Mrp2-inhibition has been demonstrated by Mrp2 gene mutations (Kartenbeck et al., 1996) as well as by the down-regulation of its expression (Terui et al., 2011 and Yamada et al., 2005) and its association with the occurrence of hyperbilirubinemia. Hence, it is of importance to dispose of an Buparlisib concentration assay to avoid drug inhibition of Mrp2. The present data show that the exposure of rat hepatocytes to CsA, CPZ and TGZ resulted into the inhibition of Mrp2-mediated

transport of DCF in a dose- and time-dependent manner. A reduction of fluorescent signal in the canaliculi followed by accumulation of the fluorescent dye into the cytoplasm was the result of Mrp2 inhibition. These effects were shown to occur already after 3 days of treatment, whereas cytotoxicity was observed only after 10 days of exposure. Side effects of the immunosuppressive drug CsA are ranging from renal, neuronal to hepatic adverse side effects in animals and man (Kahan, 1989 and Wiesner et al., 1990). The most common abnormalities related to hepatotoxicity are increases of serum bile salt levels, cholestasis BAY 80-6946 order (Kahan, 1989 and Myara et al., 1996) and hyperbilirubinemia (Ertorer et al., 1997). Mrp2, together with BSEP and MDR1, are ATP-dependent transporters known to be inhibited by CsA (Bohme et al., 1993, Kahan, 1989 and Kobayashi et al., 2004). TGZ has been shown to decrease PAK5 Mrp2 expression in liver (Foster et al., 2012), whereas CPZ has been shown to inhibit directly Mrp2-mediated transport of estradiol-17-β-glucuronide (Pedersen et al., 2008). Other studies suggested that an imbalance of intracellular ATP might occur

following CsA, CPZ and TGZ treatment, leading to a reduction of ATP-dependent canalicular transport of bile salts in the liver (Ballantyne et al., 1989, Funk et al., 2001, Samuels and Carey, 1978 and Ziegler and Frimmer, 1986). However, changes in the content of ATP during early stages were not observed here, suggesting that additional mechanisms must be involved. AMD is an antiarrhythmic drug being reported, among several other cationic amphiphilic drugs such as CPZ, to induce PLD (Halliwell, 1997). Both drugs are regarded as inhibitors of phospholipase activity and therefore impairing phospholipid catabolism (Shaikh et al., 1987). While PLD does not constitute overt toxicity per se, it has been reported to be associated with drug or metabolite accumulation in affected tissues ( Hruban, 1984), and as such, possibly contributing to untoward side effects.

84) The instrument of non-verbal intelligence ( Kornmann and Hor

84). The instrument of non-verbal intelligence ( Kornmann and Horn, 2001) was developed as part of a educational screening/counseling battery, with items based on the Figure Reasoning Test (FRT) (25 items) and also validated within a large sample (N=4319, Cronbach׳s α=0.81). Together with gender, these measures allowed to control for and analyze possible influences of learner features on the effects of the intervention.

Moreover, School Type (ST) was included as covariate, due to the general educational level coming along with it. According to the variable LDK378 plan and the quasi-experimental design described above, ANOVA and ANCOVA were applied as relevant methods (using SPSS in version 22). Motivation and achievement in physics served as dependent variables, while group membership, school type and gender served as independent variables as well as non-verbal intelligence, reading comprehension and pre-test physics achievement served as covariates. The reported measure of effect size is omega squared (ω2), i.e. the population estimate of (total) explained variance, with the usual size categorization (see Cohen,1988: small effects:

0.01<ω2<0.06; buy PCI-32765 medium effects: 0.06≤ω2<0.14; large effects: 0.14≤ω2). A 2×2-analysis of variance (ANOVA) was carried out using ‘prior achievement level in physics’, ‘non-verbal intelligence’ and ‘reading comprehension’ as dependent variables and group membership and school type as independent variables (descriptive data: see Table 4). Whereas the groups did not differ in any pre-test variables, else the factor ‘school type’ had a significant but small influence on non-verbal intelligence (F(1,

118)=5.6; p<0.05; ω2=0.04) and – much stronger – on reading comprehension (F(1, 118)=20.6; p<0.01; ω2=0.14) before the intervention. This fact was not surprising: because education level in school type 2 is generally significantly more demanding (see PISA-Konsortium Deutschland, 2008), students in this school type are strongly expected to have higher reading comprehension and non-verbal intelligence. For this reason, the covariates in question had to be taken into account. Furthermore, there was a small, but significant interaction of group membership and school type for motivation (total: F(1, 118)=6.8; p<0.05; ω2=0.05; “classroom climate” (CC): F(1, 118)=4.8; p<0.05; ω2=0.04; and “self-concept” (SC): F(1, 118)=6.3; p<0.05; ω2=0.06). In school type (ST) 1, measures of classroom climate (CC), self-concept (SC) and motivation in total were higher in the TG than in the CG. In contrast, the same measures were lower in the TG than in the CG in ST 2 (see Table 4). After treatment subject specific physics achievement was tested with the same instrument in both groups.

1 ± 0 05 μmol g−1) (Fig  1) The highest concentration of GL was

1 ± 0.05 μmol g−1) (Fig. 1). The highest concentration of GL was found in the stalks of organic broccoli (1.5 ± 0.4 μmol g−1); this value is similar to values

reported by Aires, CTLA-4 antibody Rosa, and Carvalho (2006). However, the GL stalk concentration is considerably higher than those reported by Song and Thornalley (2007), which resembled the concentrations we observed in inflorescences. Some authors have attributed these differences to the type of cultivation, soil conditions, climate, humidity, photoperiod and several other environmental factors (Fahey et al., 2001). The high glucosinolate concentration found in this present study could be due to the extraction medium, which contained TFA. Data reported by other authors (Song & Thornalley, 2007) utilized an extraction method conducted with pure methanol. This hypothesis is supported by the data shown in Fig. 1, which compares the extraction of GL with and without TFA. Another possibility for the discrepancy is the time period used for calculating thioglucosidase activity (24 h). This time Ganetespib in vitro duration was optimized for complete GL hydrolysis, and this may have led to the

generation of increased amounts of glucose, the product of the hydrolysis reaction. These data are interesting, and we verified some differences in glucosinolate concentrations among different plant parts. We also considered the vegetable parts that are usually discarded by consumers. Some of the discarded plant tissues contain the highest concentration of these substances, which have been reported to have possible positive effects on human health (Tang and Zhang, 2005 and Hu et al., 2006). Furthermore, our data suggest that plants cultivated in accordance with organic procedures can be promising sources for elucidating the metabolic synthesis pathways of glucosinolates and for extracting bioactive and natural compounds for industrial use. The data reported in Fig. 1 show that no significant differences in GL content were observed among various morphological

parts of the broccoli grown under conventional cultivation. Furthermore, as first reported by Song and Thornalley (2007), the cooking process did not significantly decrease the total GL content in these conventionally cultivated vegetables. However, this result is controversial and has been discussed by Vallejo, Tomas-Barberan, and (-)-p-Bromotetramisole Oxalate Garcia-Viguera (2002). This present work noted a significant decrease in the GL content of organic broccoli following simulated cooking. According to Song and Thornalley (2007), cooking affects glucosinolate composition and content in Brassica vegetables; these changes in composition depending on the processing manner, cooking time, vegetable type and damage to vegetable tissues. In our study, cooking time was short (5 min) and minimized the loss of these compounds from conventional vegetables. However, inactivation of myrosinase and tissue damage by the boiling water treatment may have affected the organic broccoli.

thaliana (TAIR9, Swarbreck et al , 2008) and O sativa (Rice Geno

thaliana (TAIR9, Swarbreck et al., 2008) and O. sativa (Rice Genome Annotation Project v6.1, Ouyang

et al., 2007) via BLASTX (for a complete workflow see Fig. S4). Gene-expression profiles were analyzed by multivariate analysis to SB431542 identify similarities and differences of the entire transcriptomic response between species and treatment conditions. Transcription profiles of the eight libraries were normalized for library size and composition of expressed transcripts (Robinson and Oshlack, 2010). Groupings of expression profiles based on the biological coefficient of variation between library pairs were identified with multidimensional-scaling (MDS) using the R package “edgeR” v2.5.1 (Robinson et al., 2010). Identified groupings were tested by ANOSIM analysis (analysis of similarity, tests distances within vs. between groups) implemented in the R package “vegan” v2.0–3 (Oksanen et al., 2012). Multivariate analysis and subsequent expression analysis along with plotting functions were performed in R (R Development Core Team, 2008). Differential expression analysis was performed with the R package “edgeR”, which employs an overdispersed Poisson model (negative binomial) to account for technical and biological variability,

with the generalized linear model (GLM) functionality for multifactor experiments (Robinson et al., 2010 and McCarthy et al., 2012). Differentially expressed genes were determined for three data sets: 1) eight libraries including samples of both species, 2) four libraries GKT137831 of Z. marina and 3) four libraries of N. noltii. In all three data sets, the expression profiles were normalized for library size and composition of expressed transcripts ( Robinson and Oshlack,

2010). For the data set including both species (data set 1), the single factor species was fitted to the GLM to test for differential expression between both species consistent across treatments. In this case, all four libraries per species from the two different populations and treatments were used as biological replicates on the species level. For Z. marina alone Cyclooxygenase (COX) (data set 2) the data were analyzed with GLM including the factors treatment and population (the factor population was suggested by the grouping of expression profiles; Fig. 1). Differential expression, with respect to heat treatment, was tested, while adjusting for the remaining factor. For N. noltii alone (data set 3) the factor “group identity” with three factor levels identified by MDS ( Fig. 1) was fitted to the GLM. Genes displaying differential expression between heat and control treatment in the northern population (two of the three groups, Fig. 1) were identified. In all three data sets, the biological replication as defined by the design of the respective GLM was used to calculate the tagwise dispersion, the overdispersion value in the negative binomial model ( Robinson et al., 2010 and McCarthy et al., 2012).

e , cardiovascular, gastrointestinal) [21] Table 1 provides a no

e., cardiovascular, gastrointestinal) [21]. Table 1 provides a non-exhaustive overview of susceptible CNS and ANS neuronal populations affected in PD, together with their known or putative clinical correlates. PD pathology requires years to reach its full extent throughout the nervous system and the temporal relationships of the lesions are still not well established. Braak and co-workers proposed a neuroanatomical staging system based on α-SYN immunoreactivity distribution www.selleckchem.com/products/abt-199.html in the brains of PD patients and clinically asymptomatic incidental Lewy pathology cases. The authors predicted that PD pathology follows a stereotyped and selective

caudo-rostral progression within vulnerable structures of the CNS (Table 1). In this scenario, the

disease begins in the DMV and in the olfactory bulb (Braak 1), ascends in the brainstem to reach the raphe nuclei and the locus coeruleus (Braak 2) before affecting the SN (Braak 3). Finally, in later stages (Braak 4–6), the disease enters the temporal mesocortex and eventually the neocortex. Stage 1 and 2 are considered as pre-motor stages, with motor symptoms emerging only in stage 3 when SN neurodegeneration PFT�� purchase begins [17] and [22]. The predictive validity of Braak’s concept of neuropathological staging has been somehow disputed as it does not seem to correlate with PD clinical severity and duration [23]. In fact, there is a considerable variability in the temporal sequence and topographical distribution of Lewy pathology among patients. Some

studies have reported cases of aged individuals dying with Braak stages 4–6 without any clinical record of neurological impairment [24], [25] and [26]. Moreover, the relationship between Lewy pathology and neuronal dysfunction or death is still uncertain, representing an additional challenge BCKDHB for the Braak’s hypothesis. Although Braak’s staging might require further clinical and pathological validation, it is still widely accepted as it broadly concurs with clinical observations and might be accurate in about 80% of the cases [27]. A more sensitive PD staging system might include neurodegeneration patterns in addition to Lewy pathology. Braak and co-workers suggested that an unknown environmental insult initiates the pathological process, which may spread trans-synaptically from one susceptible brain region to another via thin, long and unmyelinated axons [28]. CNS may be accessed through both a nasal and a gastric route via preganglionic fibers of the DMV which innervate the enteric nervous system [47], [48] and [49]. This hypothesis fits with the neuropathological evidence of LB in the olfactory and enteric systems of both PD and incidental cases [32], [50] and [51] as well as the clinical observations of olfactory deficit and gastrointestinal dysfunction in PD patients, which precede the disease motor onset [52] and [53].

, 2004 and Suzuki et al , 2002)

, 2004 and Suzuki et al., 2002). ABT-888 mw Therefore, descending serotonergic facilitation could equally be mediated through 5-HT acting at spinal 5-HT2A receptors. The present study provides electrophysiological evidence for a pronociceptive role for spinal 5-HT2 receptors on the evoked responses of deep dorsal horn wide dynamic range neurones and supports a pronociceptive role for the 5-HT2A

receptor on spinal nociceptive transmission, without excluding a 5-HT2C involvement. The data also implicate a role for 5-HT2 receptors in mediating descending facilitation of spinal nociceptive processing. Interestingly, evidence from pain patients suggests that 5-HT2A

receptor gene polymorphisms could influence individual differences in pain sensitivity (Bondy et al., 1999 and Pata et al., 2004) and a recent study has demonstrated a link between single nucleotide polymorphisms in the 5-HT2A receptor gene and individual analgesic requirements for post-operative pain management (Aoki et al., 2010). Therefore, unravelling the role of the 5-HT2A receptor in pain modulation presents a promising avenue PI3K activity for future drug development and pain therapy. Male Sprague–Dawley rats (230–250 g) were employed for this study (Central Biological Services, University College London, UK). All experimental procedures follow the UK Animals (Scientific Procedures) Act 1986 and the guidelines under the International Association for the Study of Pain (Zimmermann, Florfenicol 1983). Animals were anaesthetised with isofluorane (1.5–1.7%; 66% N2O and 33% O2) and a laminectomy was performed to expose the L4-5 segments of the spinal cord. Extracellular

recordings were made from ipsilateral deep dorsal horn neurones (lamina V–VI) using parylene coated tungsten electrodes (A-M Systems, USA). A train of 16 transcutaneous electrical stimuli (2 ms wide pulses, 0.5 Hz) was applied at 3 times the threshold current for C-fibres; following which a post-stimulus histogram was constructed. Responses evoked by Aβ-(0–20 ms), Aδ- (20–90 ms) and C-fibres (90–350 ms) were separated and quantified on the basis of latency. Neuronal responses occurring after the C-fibre latency band of the neurone were classed as post-discharge, a result of repeated stimulation leading to wind-up neuronal hyperexcitability. The ‘input’ (non-potentiated response), and the ‘wind-up’ (potentiated response, evident by increased neuronal excitability to repeated stimulation) were calculated. Input = (action potentials evoked by first pulse at 3 times C-fibre threshold) × total number of pulses (16). Wind-up = (total action potentials after 16 train stimulus at 3 time C-fibre threshold) − Input.

Results were statistically analyzed t-test,

with signific

Results were statistically analyzed t-test,

with significance of 0.05. The bloom extract showed the presence of 2 MCs (Fig. 1), while the mass spectrometry analyses on reflective mode showed the mass components at 995.577 Da and 908.961 Da, suggesting the presence of Microcystin-LR and Microcystin-LA respectively (Fig. 2). The mass spectrometry analyses in lift mode confirmed the presence of MCs by showing in the fragment pattern the ion 135.0, an ADDA fragment exclusive to microcystin toxins (Data not shown). The concentration of total MCs estimated in the extract was 138.30 μg mL−1. Separately, the concentrations were 41.0 μg mL−1 and Torin 1 chemical structure 97.9 μg mL−1 for MC-LR and MC-LA respectively. Neither mortality nor visible adverse effects were observed in the two exposure routes during the experiments. Doses of 13.80 μg kg−1 bw for 72 h in the ip assay and 103.72 μg L−1 for 72 h in the exposure assay were considered the maximum tolerated doses, because previously tested higher doses caused toxic signals such as refusing food, scale loss, alteration in the behavior and mortality. The LC50 was greater than 103.72 μg L−1 of microcystin in the body exposure route and the LD50 was greater than 13.80 μg kg−1 bw

via ip. The micronucleus test showed that only the highest concentration of 103.72 μg L−1, this website via body exposure, was statistically significant (P = 0.040, Table 1). Treatment by intraperitoneal injection did not induce MN ( Table 1). The highest treatment via body exposure and both treatments via intraperitoneal injection significantly increased the index of DNA damage ( Table 2). Apoptosis-necrosis test showed that at lower concentrations more apoptosis was found. On the other hand, at higher concentrations more necrosis was found ( Table 3). Gaudin et al. (2008) reported DNA damage in different tissues through single cell gel electrophoresis (comet assay)

in mice after single acute oral administration and intraperitoneal injection of MCs. An extract of cyanobacteria containing MCs from a water source in China was mutagenic to Salmonella typhimurium (Ames test), induced DNA damage in rat hepatocytes (comet assay) and induced micronucleated polychromatic erythrocytes in mouse bone marrow Farnesyltransferase ( Ding et al., 1999). Zegura et al. (2004) demonstrated in human hepatoma HepG2 cells that MC-LR increases the levels of reactive oxygen species (ROS), providing evidence that the observed genotoxicity was mediated by ROS. MC-LR and -RR increased the antioxidant enzymatic activities of superoxide dismutase and catalase in tilapia fish Oreochromis sp ( Jos et al., 2005 and Prieto et al., 2006). In our previous study in Astyanax bimaculatus (Pisces: characidae), this same batch of microcystin induced comets and MN ( Silva et al., 2010). Thus, there is evidence that MCs are genotoxic to different aquatic species and mammals, including human cells. In contrast, Abramsson-Zetterberg et al.

These findings corroborate the evidences that the high frequency

These findings corroborate the evidences that the high frequency of suicidal ideation among women who experience a rape-induced pregnancy reduces significantly after the abortion.1 Undoubtedly, all care provided by a skilled and attentive staff, greatly help the recovery of the woman. Advances in public policies for women are encouraging and promising in Brazil, but the number and distribution of health services performing legal abortion is still insufficient to ensure equal opportunity for all women.17 The invisibility of sexual violence find more during attendance

is also related to the difficulties of professionals dealing with Dabrafenib solubility dmso the subject, due to a moralistic attitude of society in the face of the difficulties in handling with issues of sexuality. Often, health professionals, when in the care of women who have suffered an act of sexual violence, try to shift the “problem” to other services,

the judiciary, the public safety sector or social service institution. Many of these professionals are not trained to deal with the testimonies of sexual violence of women, which reinforces the need for the guidance of legal and regulatory instruments, such as constitutional rules, code of ever professional ethics, federal laws, ministerial decrees, agreements and international human rights.11 Jakovski et al. (2011)18 emphasized that incest victims are rapidly changing physically and psychologically and may suffer serious consequences in their further development.

Therefore, if an abortion is to be performed it is being best to be done in the early stage of the first trimester. Incest may be the most extreme form of sexual abuse involving adult-child. Forward and Buck (1989)19 claimed that it is powerful and its devastation is greater than that of non-incestuous sexual violence against children, because it falls within the constellations of emotions and family conflicts, with an expression of complex family dynamics. The child no longer feels safe even in her own bed, being forced to learn to live with incest. The aggressor is always present and incest is a constant horror for the victim. Literature has reported different important aspects that involve an abortion procedure after rape, but there is no clear evidence of which factors are directly associated to the late search for abortion.

A descriptive analysis of the results obtained was performed For

A descriptive analysis of the results obtained was performed. For continuous variables the Student’s t-test was used and the One-way analysis of variance (ANOVA) for the assessment of the regional differences. The adopted significance level was set at 0.05. SPSS software v17.0 (Chicago, IL, USA) was used for data analysis. Interviews were carried out between learn more June and July 2007 in Portugal (mainland). To achieve the pretended 300 interviews, 957 Family Physicians were needed to contact by

phone as 657 (69%) refused to participate. Three hundred interviews were performed, stratified by region as follows: 140 in the district of Lisbon; 100 in Porto and 30 in Coimbra and Faro/Portimão. From the inquired physicians, 45% were women, 75% had more than 20 years of clinical practice and 79% worked also in emergency units. Five hundred and three patients were, in average, followed per month per doctor ROCK inhibitor with no significant differences by region. The proportion of perceived patients receiving NSAIDs was 38%, from whom 24% were aged ≥ 65 years old; from this last group, 55% were receiving gastroprotective agents (Table 1). Twenty five per cent of perceived patients were receiving ASA, from which 61% were aged ≥ 65 years old (Table 2). Physicians referred that around 57% of their patients had gastrointestinal symptoms. In the rating scale used (values ranging from 1 – never to 6 – always), the mean value obtained

was 3.6. The main NSAIDs-related gastrointestinal adverse events were dyspepsia or gastric pain (Table 3). Also 69% referred that gastrointestinal symptoms had a negative impact in the

quality of life of their patients. In the rating scale used (values ranging from 1 – no impact to 6 – great impact) the mean value obtained was 4.1. Proton Pump Inhibitors (PPIs) were the most commonly used drugs for gastroprotection in patients receiving NSAIDs: 74% of the respondents referred that they would always or often use PPIs in their patients if they were initiating a NSAIDs therapy, while 28% referred the use of H2-blockers (Table 4). Risk factors for gastrointestinal complications identified by the respondents are described in Table 5. Florfenicol All these risk factors were identified by more than 85% of the respondents, first spontaneously and afterwards by being specifically asked about those not previously reported. However, only in the case of complicated peptic ulcer, more than 80% of the respondents would always prescribe gastroprotective agents, while the administration of high doses or the administration of two or more NSAIDs only motivated such gastroprotection in 60% of the physicians. For the remaining risk factors identified the gastroprotective prescription intention would be only around 50% or even lower. For all gastrointestinal risk factors identified, gastroprotection’s prescription would be used in only 47.3% of cases (95% confidence interval: 45.6–49.0%).