salicylates and Acute-Disease

Rubefacients containing salicylates cause irritation of the skin and are believed to relieve various musculoskeletal pains. They are available on prescription, and are common components in over-the-counter remedies. This is an update of a review of rubefacients for acute and chronic pain, originally published in 2009, which found limited evidence for efficacy.. To assess the efficacy and safety of topically applied salicylates in acute and chronic musculoskeletal pain in adults.. We searched CENTRAL, MEDLINE, and EMBASE, from inception to 22 August 2014, together with the Oxford Pain Relief Database, two clinical trial registries, and the reference lists of included studies and relevant reviews.. Randomised, double-blind, placebo- or active-controlled clinical trials of topical rubefacients containing salicylates to treat musculoskeletal pain in adults, with at least 10 participants per treatment arm, and reporting outcomes at close to 7 (minimum 3, maximum 10) days for acute conditions and 14 (minimum 7) days or longer for chronic conditions.. Two review authors independently assessed trials for inclusion and risk of bias, and extracted data. We calculated risk ratio (RR) and number needed to treat to benefit or harm (NNT or NNH) with 95% confidence intervals (CI) using a fixed-effect model. We analysed acute and chronic conditions separately.. New searches for this update identified one new study that satisfied our inclusion criteria, although it contributed information only for withdrawals. Six placebo- and one active-controlled studies (560 and 137 participants, respectively) in acute pain, and seven placebo- and three active-controlled studies (489 and 182 participants, respectively) in chronic pain were included in the review. All studies were potentially at risk of bias, and there were substantial differences between studies in terms of the participants (for example the level of baseline pain), the treatments (different salicylates combined with various other potentially active ingredients), and the methods (for example the outcomes reported). Not all of the studies contributed usable information for all of the outcomes sought.For the primary outcome of clinical success at seven days in acute conditions (mostly sprains, strains, and acute low back pain), the RR was 1.9 (95% CI 1.5 to 2.5) and the NNT was 3.2 (2.4 to 4.9) for salicylates compared with placebo, but this result was not robust (very low quality evidence). Using a random-effects model for analysis the RR was 2.7 (1.05 to 7.0). For the same outcome in chronic conditions (mostly osteoarthritis, bursitis, and chronic back pain), the RR was 1.6 (1.2 to 2.0) and the NNT was 6.2 (4.0 to 13) (very low quality evidence). This result was not substantially changed using a random-effects model for analysis. In both categories there were a number of factors might have influenced the results but sensitivity analysis was limited because of the small number of studies and participants.For both acute and chronic painful conditions any evidence of efficacy came from the older, smaller studies, while the larger, more recent studies showed no effect.Adverse events were more common with salicylate than with placebo but most of the events occurred in only two studies. There was no difference when these studies were removed from the analysis (very low quality evidence). Local adverse events (at the application site) were again more common with salicylate but were nearly all in one study (in which salicylate was combined with another irritant). There was no difference when this study was removed (very low quality evidence).There were insufficient data to draw conclusions against active controls.. The evidence does not support the use of topical rubefacients containing salicylates for acute injuries or chronic conditions. They seem to be relatively well tolerated in the short-term, based on limited data. The amount and quality of the available data mean that uncertainty remains about the effects of salicylate-containing rubefacients.

Topics: Acute Disease; Administration, Topical; Adult; Chronic Disease; Humans; Irritants; Musculoskeletal Pain; Randomized Controlled Trials as Topic; Salicylates

Rubefacients (containing salicylates or nicotinamides) cause irritation of the skin, and are believed to relieve various musculoskeletal pains. They are available on prescription, and are common components in over-the-counter remedies. A non-Cochrane review in 2004 found limited evidence for efficacy.. To review current evidence for efficacy and safety of topically applied rubefacients in acute and chronic painful musculoskeletal conditions in adults.. Cochrane CENTRAL, MEDLINE, EMBASE, the Oxford Pain Relief Database, and reference lists of articles were searched; last search December 2008.. Randomised, double blind, placebo or active controlled clinical trials of topical rubefacient for musculoskeletal pain in adults, with at least 10 participants per treatment arm, and reporting outcomes at close to 7 (minimum 3, maximum 10) days for acute conditions and 14 (minimum 7) days or longer for chronic conditions.. Two review authors independently assessed trials for inclusion and quality, and extracted data. Relative benefit or risk and number needed to treat to benefit or harm (NNT or NNH) were calculated with 95% confidence intervals (CI). Acute and chronic conditions were analysed separately.. Six placebo and one active controlled studies (560 and 137 participants) in acute pain, and seven placebo and two active controlled studies (489 and 90 participants) in chronic pain were included. All used topical salicylates. The evidence in acute conditions was not robust; using only better quality, valid studies, there was no difference between topical rubefacient and topical control, though overall, including lower quality studies, the NNT for clinical success compared with placebo was 3.2 (95% CI: 2.4 to 4.9). In chronic conditions the NNT was 6.2 (95% CI: 4.0 to 13) compared with topical placebo. Adverse events and withdrawals occurred more often with rubefacients than placebo, but analyses were sensitive to inclusion of individual studies, so not robust. There were insufficient data to draw conclusions against active controls.. The evidence does not support the use of topical rubefacients containing salicylates for acute injuries, and suggests that in chronic conditions their efficacy compares poorly with topical non-steroidal antiinflammatory drugs (NSAIDs). Topical salicylates seem to be relatively well tolerated in the short-term, based on limited data. There is no evidence at all for topical rubefacients with other components.

Topics: Acute Disease; Administration, Topical; Adult; Chronic Disease; Humans; Irritants; Musculoskeletal Diseases; Pain; Salicylates

Although aspirin (acetylsalicylic acid) has become widely available without prescription, cases of self-poisoning due to overdose of salicylates are quite uncommon, with a low reported mortality. However, severe poisoning with these preparations is life threatening. Besides the aspirin, there are other sources of salicylate poisoning, such as an excessive application of topical agents, ingestion of salicylate containing ointments, use of keratolytic agents or agents containing methyl salicylate (e.g. oil of wintergreen). Most of these preparations are liquid, highly concentrated and lipid soluble, and, therefore, they are able to provoke a severe, rapid salicylate poisoning. On the basis of clinical and metabolic features or salicylate concentration in plasma it is very important to diagnose severe poisoning with salicylates in time and prescribe an adequate treatment. In the present review article various aspects of salicylate poisoning and its treatment are discussed: epidemiology, pharmacokinetics and pharmacodynamics of salicylates, clinical manifestations of their toxicity, management, enhanced elimination and prognosis.

Topics: Acute Disease; Adult; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Child; Child, Preschool; Diagnosis, Differential; Drug Interactions; Drug Overdose; Fixatives; Humans; Ointments; Poisoning; Prognosis; Pulmonary Edema; Salicylates; Time Factors

The acutely poisoned patient remains a common problem facing doctors working in acute medicine in the United Kingdom and worldwide. This review examines the initial management of the acutely poisoned patient. Aspects of general management are reviewed including immediate interventions, investigations, gastrointestinal decontamination techniques, use of antidotes, methods to increase poison elimination, and psychological assessment. More common and serious poisonings caused by paracetamol, salicylates, opioids, tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, non-steroidal anti-inflammatory drugs, and cocaine are discussed in detail. Specific aspects of common paediatric poisonings are reviewed.

Topics: Acetaminophen; Acute Disease; Anti-Inflammatory Agents, Non-Steroidal; Antidepressive Agents, Tricyclic; Antidotes; Benzodiazepines; Child; Diagnostic Tests, Routine; Emergency Treatment; Gastric Lavage; Humans; Narcotics; Poisoning; Risk Factors; Salicylates; Selective Serotonin Reuptake Inhibitors

To determine the efficacy and safety of topical rubefacients containing salicylates in acute and chronic pain.. Electronic databases and manufacturers of salicylates.. Randomised double blind trials comparing topical rubefacients with placebo or another active treatment, in adults with acute or chronic pain, and reporting dichotomous information, around a 50% reduction in pain, and analyses at one week for acute conditions and two weeks for chronic conditions.. Relative benefit and number needed to treat, analysis of adverse events, and withdrawals.. Three double blind placebo controlled trials had information on 182 patients with acute conditions. Topical salicylate was significantly better than placebo (relative benefit 3.6, 95% confidence interval 2.4 to 5.6; number needed to treat 2.1, 1.7 to 2.8). Six double blind placebo controlled trials had information on 429 patients with chronic conditions. Topical salicylate was significantly better than placebo (relative benefit 1.5, 1.3 to 1.9; number needed to treat 5.3, 3.6 to 10.2), but larger, more valid studies were without significant effect. Local adverse events and withdrawals were generally rare in trials that reported them.. Based on limited information, topically applied rubefacients containing salicylates may be efficacious in the treatment of acute pain. Trials of musculoskeletal and arthritic pain suggested moderate to poor efficacy. Adverse events were rare in studies of acute pain and poorly reported in those of chronic pain. Efficacy estimates for rubefacients are unreliable owing to a lack of good clinical trials.

Topics: Acute Disease; Administration, Topical; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Chronic Disease; Double-Blind Method; Humans; Irritants; Pain; Randomized Controlled Trials as Topic; Salicylates; Treatment Outcome

Arthritis, following infection caused by group A beta-hemolytic streptococcus, is classically attributed to acute rheumatic fever. However, a new clinical syndrome, called poststreptococcal reactive arthritis, as a distinct entity from acute rheumatic fever, was described recently. The purpose of this paper is to provide a summary of published information on poststreptococcal reactive arthritis. The paper outlines its clinical description and proposed diagnostic criteria. Similarities and differences between poststreptococcal reactive arthritis and acute rheumatic fever are discussed. Information regarding long-term risk of carditis following poststreptococcal reactive arthritis is provided, and therapeutic recommendations are outlined.

Topics: Acute Disease; Adolescent; Adult; Age Factors; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Juvenile; Arthritis, Reactive; Child; Diagnosis, Differential; Humans; Rheumatic Fever; Risk Factors; Salicylates; Streptococcal Infections; Time Factors

Topics: Acute Disease; Adult; Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Child; Diclofenac; Drug Therapy, Combination; Ergotamine; Humans; Ibuprofen; Indoles; Migraine Disorders; Naproxen; ortho-Aminobenzoates; Oxazolidinones; Piperidines; Pyrrolidines; Salicylates; Serotonin Receptor Agonists; Sumatriptan; Triazoles; Tryptamines

Topics: Acute Disease; Adult; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Child; Drug Therapy, Combination; Humans; Migraine Disorders; Randomized Controlled Trials as Topic; Salicylates; Serotonin Receptor Agonists; Treatment Outcome

Topics: Acute Disease; Adult; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Child; Drug Therapy, Combination; Humans; Migraine Disorders; Salicylates; Serotonin Receptor Agonists

Although new salicylates are now available for the treatment of ulcerative colitis, sulphasazaline still has an important therapeutic role. The role of salicylates in Crohn's disease is limited to the mild activity phase; further data are required to clarify its role in maintenance on remission. New steroids are a real alternative to traditional steroids in active ulcerative colitis and Crohn's disease.

Topics: Acute Disease; Aspirin; Beclomethasone; Budesonide; Colitis, Ulcerative; Crohn Disease; Drug Therapy, Combination; Glucocorticoids; Humans; Inflammatory Bowel Diseases; Prednisolone; Randomized Controlled Trials as Topic; Salicylates; Sulfasalazine

CD and UC represent a spectrum of chronic IBD that present in protean ways and are accompanied by a variety of systemic sequelae. Sulfasalazine and the newer 5-aminosalicylates are important in the management of mild-to-moderate disease, whereas corticosteroids remain the primary therapy for most patients with moderate-to-severe disease (Tables 2-5). The toxicities associated with long-term steroid therapy, combined with their ineffectiveness as maintenance medications, have led to increased use of immunomodulators, such as azathioprine and 6-MP, for the treatment of steroid-dependent and steroid-resistant IBD. Infliximab is a novel therapeutic adjunct for chronically active and fistulizing CD that will herald a new era of biologic therapy for IBD. Meanwhile, CSA remains an alternative to urgent colectomy in severe UC unresponsive to corticosteroids and also for CD patients with severe disease or refractory fistulas. Finally, continued insights into the etiopathogenic pathways in IBD will provide evolving and innovative approaches until the eventual causes and cures are elucidated. In the meantime, clinicians should remain optimistic regarding current ability to reduce the morbidity and maintain the quality of life for patients suffering with these frustrating diseases.

Topics: Acute Disease; Adrenal Cortex Hormones; Anti-Bacterial Agents; Anti-Inflammatory Agents; Colitis, Ulcerative; Crohn Disease; Cyclosporine; Humans; Immunosuppressive Agents; Inflammatory Bowel Diseases; Methotrexate; Recurrence; Salicylates; Severity of Illness Index; Steroids

In the past, numerous reports on drugs probably causing acute pancreatitis have been published. However, most of these case reports were anecdotal with a lack of obvious evidence and did not present a comprehensive summary. Although drug-associated pancreatitis is rare, it is gaining increasing importance with the introduction of several potent new agents, i.e., anti-acquired immunodeficiency syndrome drugs. The following comprehensive review scrutinizes the evidence present in the world literature on drugs associated with acute or chronic pancreatitis and, based on this, categorizes in a definite, probable, or possible causality. In addition, explanations for the pathophysiological mechanisms are discussed.

Topics: Acute Disease; Anti-Bacterial Agents; Antineoplastic Agents; Antiviral Agents; Calcium; Chronic Disease; Diuretics; Humans; Immunosuppressive Agents; Pancreatitis; Salicylates; Steroids

Topics: Acute Disease; Adult; Humans; Male; Pericarditis; Salicylates; Thyrotropin; Time Factors

Topics: Acute Disease; Female; Humans; Ichthyosis, Lamellar; Infant; Ointments; Poisoning; Salicylates

Physicians are familiar with the "slapped cheek" rash seen in childhood cases of erythema infectiosum. Less well known is that infection with its pathogen, parvovirus B19, often becomes manifest in adults as acute viral arthropathy. In evaluation of suspected cases, a complete blood cell count and blood chemistry profile are useful additions to thorough history taking and physical examination. Differential diagnosis includes Lyme disease, other viral infections, acute rheumatoid arthritis, systemic lupus erythematosus, and psoriatic arthritis. Treatment is symptomatic with nonsteroidal anti-inflammatory drugs.

Topics: Acute Disease; Adult; Antibodies, Viral; Arthritis, Infectious; Bed Rest; Diagnosis, Differential; Erythema Infectiosum; Humans; Immunoglobulin G; Immunoglobulin M; Male; Medical History Taking; Parvovirus B19, Human; Physical Examination; Salicylates

Topics: Acute Disease; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Respiratory Tract Infections; Salicylates; Seizures; Valproic Acid; Virus Diseases

Various available forms of therapy can decrease morbidity and mortality associated with acute diarrhea. Oral fluids represent the cornerstone of therapy of all cases. A variety of agents acting nonspecifically can decrease diarrhea and improve other worrisome symptoms associated with enteric infection. Kaopectate makes the stool more formed but has little additional effects. Bismuth subsalicylate, an antisecretory agent, reduces the number of stools passed by about 50 percent and improves other associated symptomatology. The drugs that affect motility such as loperamide and diphenoxylate are the most active of the nonspecifically acting drugs. They must be avoided in patients with significant fever and dysentery. Trimethoprim/sulfamethoxazole is now considered the drug of choice for shigellosis due to the presence of ampicillin-resistant Shigella strains in most regions of the world. Trimethoprim/sulfamethoxazole is also an effective form of therapy for enterotoxigenic Escherichia coli infection and for traveler's diarrhea without definable cause. Erythromycin, although not proved to be effective against Campylobacter, probably shortens the disease. Furazolidone, although not dramatically effective, has a spectrum of activity that includes Shigella, enterotoxigenic E. coli, Campylobacter, and Giardia lamblia. It may not be effective in severely ill (hospitalized) patients with diarrhea. The various forms of available therapy can be administered empirically, depending on symptomatology. Mildly ill patients (one to three unformed stools in 24 hours with minimal additional symptoms) probably are best treated with fluids only. Mild to moderately ill persons (three to six unformed stools in 24 hours) can be treated with a drug that acts nonspecifically, such as bismuth subsalicylate or loperamide. Those with severe diseases (six or more unformed stools with moderate to severe associated symptoms), particularly when associated with fever and the passage of bloody mucoid stools, may be given an antimicrobial agent. The antimicrobial drug given will be determined by ancillary laboratory tests (dark-field examination or examination of a wet-mount preparation for motile Campylobacter or stool culture for Shigella, Campylobacter, or Salmonella) or may be administered on an empiric basis. Traveler's diarrhea can be eliminated in selected persons by the administration of a pharmacologic agent. Liquid bismuth subsalicylate is effective in large doses, which may be impr

Topics: Acute Disease; Adult; Anti-Infective Agents; Bismuth; Campylobacter Infections; Child; Child, Preschool; Clinical Trials as Topic; Diarrhea; Diarrhea, Infantile; Drug Combinations; Dysentery, Amebic; Dysentery, Bacillary; Escherichia coli Infections; Giardiasis; Humans; Infant; Kaolin; Loperamide; Narcotics; Organometallic Compounds; Parasympatholytics; Pectins; Salicylates; Salmonella Infections; Travel

In reviewing the literature we discussed the problem, whether there is a correspondence between the morphological picture of acute gastritis and the clinical expression including a complex of symptoms "acute gastritis", which should better be called acute dyspepsia. There is no good accord.--The histological main features of acute gastritis are infiltration of mucosa by neutrophils and the leucodiapedesis. this acute gastritis is very seldom the cause of clinical symptoms of acute dyspepsia. Alcohol, spices or drugs may produce a "toxic damage" of the mucosa, but they do not cause an acute gastritis, just as little as some viral diseases or staphylococcal toxins.

Topics: Acute Disease; Adult; Condiments; Dyspepsia; Ethanol; Gastric Juice; Gastric Mucosa; Gastritis; Hepatitis, Viral, Human; Humans; Influenza, Human; Male; Neutrophils; Salicylates

Topics: Acute Disease; Adolescent; Age Factors; Arthritis, Rheumatoid; Child; Chronic Disease; Diagnosis, Differential; Glucocorticoids; Humans; Indomethacin; Salicylates; Sex Factors; Somatotypes; Spondylitis, Ankylosing

Topics: Acidosis, Respiratory; Acute Disease; Age Factors; Animals; Central Nervous System; Hyperventilation; Oxidative Phosphorylation; Poisoning; Rabbits; Rats; Salicylates

The aim of the study was to investigate total antioxidant capacity (TAC) and homocysteine levels in children with acute rheumatic fever (ARF).. Nineteen patients with ARF and twenty healthy children, age- and sex-matched were included in the study. Follow-up studies were made at the 7(th), 14(th), 21(st) and 28(th) day of diagnosis.. Children with ARF had significantly higher serum homocysteine levels and lower TAC than the same parameters of the controls at all measurements. Following the anti-inflammatory therapy, we found a progressive increase in TAC and a decrease in homocysteine levels of the patients.. We concluded that increased serum homocysteine levels and decreased serum TAC of the patients with ARF can be considered as a sign of increased inflammation and oxidative stress in these patients which needs to be considered during therapy. Further studies are needed to understand the underlying mechanisms of these findings.

Topics: Acute Disease; Adolescent; Anti-Inflammatory Agents; Antioxidants; Blood Sedimentation; C-Reactive Protein; Child; Child, Preschool; Female; Follow-Up Studies; Homocysteine; Humans; Male; Oxidative Stress; Prednisolone; Rheumatic Fever; Salicylates; Time Factors

To compare the costs to the Spanish healthcare system of 35 days' treatment with triflusal (600 mg/day) and aspirin (300 mg/day) in patients with confirmed acute myocardial infarction within 24 hours of onset of symptoms.. A cost minimisation analysis based on the results of the Triflusal in Acute Myocardial Infarction study (TIM) was conducted. The hypothesis was that despite a higher acquisition cost of triflusal, savings would result because of differences in efficacy and safety outcome (non-fatal cerebrovascular event and haemorrhagic events). Diagnostic Related Groups were used as a proxy for determining hospital costs in Spain and the values were obtained from different sources and refer to year 2000 costs. Only direct medical costs were considered for the economic analysis.. Although the acquisition cost of triflusal was more expensive than that of aspirin, the cost of prevented events - non-fatal ischaemic cerebrovascular events and cerebral haemorrhages - entirely compensated for the cost of triflusal. The overall cost of treating patients with triflusal, compared with aspirin, represented a net saving of 28.4% per patient treated.. Our study showed that triflusal is cost saving compared with aspirin in the treatment of the acute phase of myocardial infarction.

Topics: Acute Disease; Aspirin; Double-Blind Method; Drug Costs; Humans; Myocardial Infarction; Platelet Aggregation Inhibitors; Recurrence; Salicylates; Spain

A controlled, randomized, double-blind study in Bangladeshi children (ages 4-36 mo) with acute diarrhoea was undertaken to determine whether bismuth subsalicylate (BSS) would prevent the development of persistent diarrhoea (PD) in young children. The children were randomized to two groups: 226 were given liquid oral BSS, (as Pepto-Bismol), 100 mg/kg/d for 5 d; 225 were given placebo of identical appearance. On admission to the study, the two groups were comparable both clinically and microbiologically. Rotavirus was found in 56% of all the children, and enterotoxigenic E. coli in 31% of a subsample studied. Children treated with BSS had less severe and less prolonged illness than those treated with placebo (p = 0.057). There was, however, no difference in the development of PD between the two groups (8% and 11%). Unexpectedly, patients treated with BSS gained significantly more weight (2.3%) than those treated with placebo (0.5%; p < 0.001) during the course of the study. No toxicity of BSS was detected.. Treatment with BSS had a modest therapeutic effect on acute diarrhoea, as has been previously demonstrated, but with no suggestion of a therapeutic effect on the prevention of persistent diarrhoea in this group of patients.

Topics: Acute Disease; Bismuth; Child, Preschool; Diarrhea; Double-Blind Method; Escherichia coli Infections; Humans; Infant; Organometallic Compounds; Rehydration Solutions; Retroviridae Infections; Salicylates

ORS has led to improved outcome of acute gastroenteritis in both industrialised and developing countries. In both settings there is an increasing demand for active therapy to reduce the duration of diarrhoea and its complications. Persistent diarrhoea is a major consequence of intestinal infections and is responsible for a high number of deaths in poor countries. Bismuth subsalicylate has been used for treatment of acute diarrhoea, with preliminary promising results. In this issue of Acta Paediatrica, a trial with BSS is essential. However the results were marginal and did not justify a mass scale use of BSS, also because of poor cost efficacy rate.

Topics: Acute Disease; Bismuth; Child, Preschool; Diarrhea; Gastroenteritis; Humans; Infant; Organometallic Compounds; Rehydration Solutions; Salicylates

The aim of this investigation was to elucidate whether the analgesic effect was due to the local aspirin or to the systemic drug. This was done by comparing skin and plasma levels of acetylsalicylic acid (ASA) and salicylic acid (SA) after topically administered ASA/diethyl ether (ADE) mixture in acute herpetic neuralgia (AHN) and postherpetic neuralgia (PHN). The analgesia and the plasma and skin levels of ASA were also determined after oral administration of aspirin.. Nineteen patients, 11 (57.9%) with AHN and 8 (42.1 %) with PHN were given, on different days, a single 500-mg oral dose of ASA or a topical dose (750 mg) of (ADE) daubed onto the painful skin. The analgesic effect was assessed by means of a visual analogue scale (VAS). Overall pain relief was graded as: excellent, good, fair, or poor. AHN as well as PHN patients had severe pain at baseline (6.83 and 5.93). Levels of ASA and SA in plasma and in the stratum corneum after adhesive tape stripping of the treated area were determined by HPLC.. After ADE application, the analgesic effect was very rapid and VAS scores were lower than at baseline. Pain significantly decreased by 82.6% after topical and 15.4% after oral ASA. After ADE, 95% of the patients had excellent or good pain relief, but after oral administration 79% of the patients had a poor response. Pain relief was similar in the two subgroups after ADE. Skin concentrations of ASA, but not of SA, after ADE were about 80- to 100-fold those after oral administration. Levels of ASA and SA in plasma after oral administration were similar to those previously found, but after ADE were undetectable or very low. Patients with excellent pain relief showed a trend towards higher ASA skin concentrations.. The analgesic effect can be obtained only after topical administration, because by this route the skin levels of ASA are much higher than after oral administration. The mechanism is exclusively local; there are no active drugs in plasma after topical administration.

Topics: Acute Disease; Administration, Oral; Administration, Topical; Aged; Analgesics; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Cross-Over Studies; Double-Blind Method; Ether; Female; Herpes Zoster; Herpesviridae Infections; Humans; Male; Middle Aged; Neuralgia; Pain; Pain Measurement; Salicylates; Salicylic Acid; Skin; Solvents; Treatment Outcome

Bismuth subsalicylate is a common constituent of over-the-counter medications for diarrhea. However, it is uncertain whether bismuth offers any more benefit than standard oral rehydration therapy with early feeding.. We conducted a placebo-controlled, randomized trial to evaluate the effect of bismuth subsalicylate (100 or 150 mg per kilogram of body weight per day for up to 5 days) on the duration and volume of acute watery diarrhea in 275 male infants and young boys (mean age, 13.5 months). Serum salicylate and bismuth levels were monitored throughout the study and were also measured two weeks after discharge. All the patients received fluid replacement by the oral route and early feeding of easily digestible foods with high caloric density.. Diarrhea stopped within 120 hours of admission in 74 percent of the patients given placebo, 89 percent of those given 100 mg of bismuth per kilogram (P = 0.009 vs. the placebo group), and 88 percent of those given 150 mg of bismuth per kilogram (P = 0.019 vs. the placebo group). As compared with the patients given placebo, those given bismuth had significant reductions in their total stool output (P = 0.015), total intake of oral rehydration solution (P = 0.013), and duration of hospitalization (P = 0.005); there was no significant difference between the two groups given bismuth in these clinical outcomes. All measurements of bismuth and salicylate concentrations in blood were well below concentrations considered toxic. No adverse reactions were seen.. Treatment with bismuth subsalicylate decreases the duration of diarrhea and is a safe and effective adjunct to oral rehydration therapy for infants and young children with acute watery diarrhea.

Topics: Acute Disease; Bismuth; Body Weight; Chemotherapy, Adjuvant; Child, Preschool; Diarrhea, Infantile; Double-Blind Method; Fluid Therapy; Humans; Infant; Male; Multivariate Analysis; Organometallic Compounds; Salicylates

Bismuth subsalicylate (BSS) and placebo were evaluated in a double-blind, placebo-controlled study as adjunct to rehydration therapy in 123 children, aged 4 to 28 months, hospitalized with acute diarrhea. The dosing regimen was 20 mg/kg five times daily for 5 days. Significant benefits were noted in the BSS group compared with placebo as manifested by decreases in stool frequency and stool weights and an improvement in stool consistency, significant improvement in clinical well-being, and shortening of the disease duration. Patients treated with BSS had a significant reduction in duration of hospital stay (6.9 days) compared with placebo-treated patients (8.5 days). Also, intravenous fluid requirements decreased significantly more rapidly and to a greater degree in the BSS-treated group. Bismuth subsalicylate was associated with clearance of pathogenic Escherichia coli from the stools in 100% of cases but was not different from placebo in rotavirus elimination. Bismuth subsalicylate was well tolerated with no reported adverse effects. Blood bismuth and serum salicylate levels were well below levels considered toxic. In this study, BSS provided effective adjunctive therapy for acute diarrhea, allowing children to get well sooner with less demand on the nursing and hospital staff.

Topics: Acute Disease; Bismuth; Child, Preschool; Diarrhea, Infantile; Double-Blind Method; Escherichia coli Infections; Feces; Fluid Therapy; Humans; Infant; Length of Stay; Organometallic Compounds; Rotavirus Infections; Salicylates

An open-label, parallel comparison of loperamide hydrochloride (Imodium A-D) and bismuth subsalicylate (Pepto-Bismol) was conducted using nonprescription dosages in adult students with acute diarrhea (three or more unformed stools in the preceding 24 hours plus at least one additional symptom of enteric infection). For the two-day study period, the daily dosage was limited to 8 mg (40 ml) for loperamide-treated subjects and to 4.9 g for bismuth subsalicylate-treated subjects. At these dosages, loperamide significantly reduced the average number of unformed bowel movements relative to bismuth subsalicylate. Following the initial dose of treatment, control of diarrhea was maintained significantly longer with loperamide than with bismuth subsalicylate. Time to last unformed stool was significantly shorter with loperamide than with bismuth subsalicylate. In providing overall subjective relief, subjects rated loperamide significantly better than bismuth subsalicylate at the end of the 24 hours. Both treatments were well tolerated, and none of the minor adverse effects reported resulted in discontinuation of therapy. It was concluded that loperamide is effective at a daily dosage limit of 8 mg (40 ml) for the treatment of acute nonspecific diarrhea and provides faster, more effective relief than bismuth subsalicylate.

Topics: Acute Disease; Adult; Bismuth; Clinical Trials as Topic; Diarrhea; Dose-Response Relationship, Drug; Female; Humans; Loperamide; Male; Nonprescription Drugs; Organometallic Compounds; Piperidines; Salicylates

A double-blind, 18-center, balanced trial of diflunisal vs. cyclobenzaprine HCl vs. these two drugs combined vs. placebo produced complete results from 175 patients. They had sought treatment at the cooperating centers for acute painful spasms of the back within a day or two of trauma or strain. Global results over the 7 to 10 days of observations revealed a clinically and statistically significant superiority of the combined therapy by Day 4 (P = 0.006) and almost all patients recovered within a week to 10 days. A combination therapy with an effective safe analgesic and a true muscle relaxant for less than a week appears to be an excellent relief measure for acute back problems.

Topics: Acute Disease; Amitriptyline; Back Pain; Diflunisal; Double-Blind Method; Drug Therapy, Combination; Humans; Multicenter Studies as Topic; Muscle Cramp; Muscle Relaxants, Central; Salicylates

Benzalazine (salicylazobenzoic acid, SAB), a 5-azo derivative of 5-aminosalicylic acid, has been designed as a new therapeutic agent for the treatment of inflammatory bowel disease which might lack the frequent side effects caused by the sulfapyridine moiety of the sulfasalazine molecule (SASP). Here, we report on a prospective, randomized, double-blind comparison of SAB and SASP in patients with an acute relapse of ulcerative colitis. 43 patients with an acute relapse of ulcerative colitis proven by the pertinent endoscopic-macroscopic and histologic criteria were randomized to receive a 6-week course of either 1 g SASP (n = 21) or the equivalent dose of 0.72 g SAB (n = 22) three times a day. Both groups were comparable with respect to demographic data, previous duration and extension of the disease as well as clinical, endoscopic and histologic severity of the relapse. 1 patient on SASP had to be removed from the study due to side effects, while 3 patients on SAB were removed due to rapid worsening of the disease requiring either surgery (1 patient with toxic megacolon) or additional steroid treatment (2 patients). 2 SAB patients were lost to follow-up after substantial improvement had been observed within the first 3 weeks of treatment. In the remaining patients (20 SASP, 17 SAB), stool frequency, stool consistency and macroscopic appearance as well as histology of the diseased mucosa were improved within 6 weeks, with no significant difference between the two groups with respect to any of the parameters recorded. Side effects were recorded in 5 patients on SASP (3 with nausea, 1 with pruritus and 1 with a generalized exanthema) and in 3 patients on SAB (all nausea and vomiting; difference not statistically significant). We conclude that SAB and SASP in equivalent doses are of similar efficacy in the treatment of active ulcerative colitis.

Topics: Acute Disease; Administration, Oral; Adolescent; Adult; Aged; Aminosalicylic Acids; Clinical Trials as Topic; Colitis, Ulcerative; Double-Blind Method; Humans; Middle Aged; Random Allocation; Salicylates; Sulfasalazine

Acute soft tissue injuries create pain and limitation of function. Treatment requires analgesia and time for full recovery. Acetaminophen with codeine (650 mg plus 60 mg, respectively, every 4 to 6 hours) is used frequently as the analgesic of choice. Diflunisal (1,000 mg initially then 500 mg twice a day) vs acetaminophen with codeine was prospectively studied in the treatment of acute mild to moderate pain from soft tissue injuries. Thirty-five patients with acute strains, sprains, or low back pain were randomized to treatment (17 acetaminophen with codeine vs 18 diflunisal). Both groups were similar in the amount of pain and type of injury at initiation of therapy. Patient pain rating went from 3.3 +/- 0.6 to 1.6 +/- 1.5 for acetaminophen with codeine and from 3.3 +/- 0.6 to 1.3 +/- 1.1 for diflunisal. However, 65 percent of acetaminophen with codeine patients experienced side effects, with 35 percent of these patients stopping the medication because of intolerable side effects. In the diflunisal group, 28 percent of the patients experienced side effects and 5 percent had to stop the medication early. Diflunisal was found to be an effective analgesic in mild to moderate pain of acute soft tissue injuries, and caused fewer and more tolerable side effects than did acetaminophen with codeine.

Topics: Acetaminophen; Acute Disease; Adult; Back Pain; Clinical Trials as Topic; Codeine; Diflunisal; Drug Combinations; Drug Tolerance; Female; Humans; Male; Pain; Prospective Studies; Random Allocation; Salicylates; Sprains and Strains

Fifty-six patients entered into an open-label, randomized study to compare the efficacy and tolerability of diflunisal and naproxen in the treatment of mild to moderate pain associated with acute low back strain. Thirty-three patients completed the two-week study. No patients withdrew because of side effects, and both drugs were well tolerated. Results showed that diflunisal was more effective than naproxen (81% versus 41%) in relieving pain. Of the 16 patients taking diflunisal, 13 rated its efficacy as very good or excellent; six (35%) of 17 patients taking naproxen rated their drug similarly. Overall, diflunisal rated slightly better in efficacy and tolerability and in improving limitation of function and motion. In addition, diflunisal has a longer duration of action and thus requires less frequent dosing than naproxen.

Topics: Acute Disease; Adult; Back Pain; Clinical Trials as Topic; Diflunisal; Drug Tolerance; Female; Humans; Male; Naproxen; Random Allocation; Salicylates; Sprains and Strains

Loperamide hydrochloride was compared with bismuth subsalicylate for the treatment of acute nondysenteric travelers' diarrhea in 219 students visiting seven countries in Latin America. Subjects whose condition was not improved with therapy could elect to take trimethoprim-sulfamethoxazole. Persons receiving loperamide passed fewer unformed stools when compared with the bismuth subsalicylate group during the first four hours of therapy, from four to 24 hours, and from 24 to 48 hours after therapy was initiated. Among subjects with disease due to enterotoxigenic Escherichia coli, Shigella sp, other pathogens, and unknown agents, fewer unformed stools were passed by the loperamide-treated subjects than the bismuth subsalicylate-treated subjects for all time periods studied. No significant prolongation of disease was seen in subjects with shigellosis treated with loperamide. Eight of the loperamide-treated subjects experienced constipation compared with one in the bismuth subsalicylate-treated group; otherwise, there was no difference in minor side effects experienced between both treatment groups. We conclude that loperamide is a safe and effective alternative to bismuth subsalicylate for the treatment of nondysenteric travelers' diarrhea.

Topics: Acute Disease; Adult; Antidiarrheals; Bismuth; Diarrhea; Humans; Latin America; Loperamide; Organometallic Compounds; Piperidines; Salicylates; Travel; United States

One hundred and twelve patients with acute mechanical low back pain were randomly divided into three treatment groups. All patients received ergonomic advice and then either a non-steroidal anti-inflammatory drug or conservative or manipulative types of physiotherapy. Serial assessments of pain and spinal mobility showed similar response rates in all three treatment groups and no significant difference between therapies. The overall improvement ratings, time off work, and economic cost favoured the group treated with the nonsteroidal anti-inflammatory drug, but this group had a better range of spinal flexion at the onset so firm conclusions regarding the preferred management of these patients in general practice cannot be drawn. Treatment failures occurred in all groups highlighting the need for a variety of therapeutic approaches in managing the patient with low back pain.

Topics: Acute Disease; Adolescent; Adult; Back Pain; Clinical Trials as Topic; Diflunisal; Female; Humans; Male; Manipulation, Orthopedic; Middle Aged; Physical Therapy Modalities; Random Allocation; Salicylates

Various available forms of therapy can decrease morbidity and mortality associated with acute diarrhea. Oral fluids represent the cornerstone of therapy of all cases. A variety of agents acting nonspecifically can decrease diarrhea and improve other worrisome symptoms associated with enteric infection. Kaopectate makes the stool more formed but has little additional effects. Bismuth subsalicylate, an antisecretory agent, reduces the number of stools passed by about 50 percent and improves other associated symptomatology. The drugs that affect motility such as loperamide and diphenoxylate are the most active of the nonspecifically acting drugs. They must be avoided in patients with significant fever and dysentery. Trimethoprim/sulfamethoxazole is now considered the drug of choice for shigellosis due to the presence of ampicillin-resistant Shigella strains in most regions of the world. Trimethoprim/sulfamethoxazole is also an effective form of therapy for enterotoxigenic Escherichia coli infection and for traveler's diarrhea without definable cause. Erythromycin, although not proved to be effective against Campylobacter, probably shortens the disease. Furazolidone, although not dramatically effective, has a spectrum of activity that includes Shigella, enterotoxigenic E. coli, Campylobacter, and Giardia lamblia. It may not be effective in severely ill (hospitalized) patients with diarrhea. The various forms of available therapy can be administered empirically, depending on symptomatology. Mildly ill patients (one to three unformed stools in 24 hours with minimal additional symptoms) probably are best treated with fluids only. Mild to moderately ill persons (three to six unformed stools in 24 hours) can be treated with a drug that acts nonspecifically, such as bismuth subsalicylate or loperamide. Those with severe diseases (six or more unformed stools with moderate to severe associated symptoms), particularly when associated with fever and the passage of bloody mucoid stools, may be given an antimicrobial agent. The antimicrobial drug given will be determined by ancillary laboratory tests (dark-field examination or examination of a wet-mount preparation for motile Campylobacter or stool culture for Shigella, Campylobacter, or Salmonella) or may be administered on an empiric basis. Traveler's diarrhea can be eliminated in selected persons by the administration of a pharmacologic agent. Liquid bismuth subsalicylate is effective in large doses, which may be impr

Topics: Acute Disease; Adult; Anti-Infective Agents; Bismuth; Campylobacter Infections; Child; Child, Preschool; Clinical Trials as Topic; Diarrhea; Diarrhea, Infantile; Drug Combinations; Dysentery, Amebic; Dysentery, Bacillary; Escherichia coli Infections; Giardiasis; Humans; Infant; Kaolin; Loperamide; Narcotics; Organometallic Compounds; Parasympatholytics; Pectins; Salicylates; Salmonella Infections; Travel

Topics: Acute Disease; Adolescent; Adult; Back Pain; Chemical Phenomena; Chemistry; Clinical Trials as Topic; Diflunisal; Double-Blind Method; Female; Humans; Male; Middle Aged; Placebos; Salicylates

Topics: Acute Disease; Arthritis, Rheumatoid; Bone Diseases; Clinical Trials as Topic; Drug Synergism; Humans; Osteoarthritis; Osteochondritis; Osteoporosis; Pain; Penicillins; Placebos; Pleurisy; Prednisolone; Rheumatic Diseases; Rheumatic Fever; Salicylates; Spondylitis

Topics: Acute Disease; Appendicitis; Bismuth; Humans; Salicylates; Tomography, X-Ray Computed

To determine the presence of monocarboxylate transporter (MCT) in human and rabbit corneal epithelium and its role in transcellular fluorescein transportation in the cornea.. The presence of MCTs in human and rabbit corneal epithelium was determined by RT-PCR and immunohistochemistry. Intracellular fluorescein uptake experiment was performed using cultured human corneal epithelial cells (HCECs). The involvement of MCT in fluorescein uptake was determined by addition of MCT inhibitors to HCECs and acute dry eye model on New Zealand albino rabbits by spectrophotometry, corneal impression cytology, and external eye photographs.. MCT-1 and MCT-4 were identified in both human and rabbit corneal epithelia. A longer treatment period and a lower pH value in culture medium increased fluorescein uptake in HCECs. Fluorescein uptake in HCECs was decreased following addition of MCT inhibitors in a concentration-dependent manner. Impression cytology under fluorescent microscopy showed intracellular fluorescein staining in the rabbit cornea with acute dry eye treatment that was decreased following topical treatment of MCT inhibitors.. Fluorescein ingress in corneal epithelial cells is mediated by the MCT family. Further study of MCT-mediated transport on HCECs may potentially benefit differential diagnosis and contribute better understandings of ocular surface disorders.

Topics: 4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid; Acute Disease; Animals; Biological Transport; Cells, Cultured; Dose-Response Relationship, Drug; Dry Eye Syndromes; Epithelium, Corneal; Fluorescein; Fluorescent Dyes; Humans; Hydrogen-Ion Concentration; Immunohistochemistry; Microscopy, Fluorescence; Monocarboxylic Acid Transporters; Muscle Proteins; Rabbits; Real-Time Polymerase Chain Reaction; Salicylates; Symporters

Salicylate poisoning remains a significant public health threat with more than 20,000 exposures reported annually in the United States.. We aimed to establish early predictors of severe in-hospital outcomes in Emergency Department patients presenting with acute salicylate poisoning.. This was a secondary data analysis of adult salicylate overdoses from a prospective cohort study of acute drug overdoses at two urban university teaching hospitals from 2009 to 2013. Patients were included based on confirmed salicylate ingestion and enrolled consecutively. Demographics, clinical parameters, treatment and disposition were collected from the medical record. Severe outcome was defined as a composite occurrence of acidemia (pH <7.3 or bicarbonate <16 mEq/L), hemodialysis, and/or death.. Out of 1997 overdoses screened, 48 patients met inclusion/exclusion criteria. Patient characteristics were 43.8% male, median age 32 (range 18-87), mean initial salicylate concentration 28.1 mg/dL (SD 26.6), and 20.8% classified as severe outcome. Univariate analysis indicated that age, respiratory rate, lactate, coma, and the presence of co-ingestions were significantly associated with severe outcome, while initial salicylate concentration alone had no association. However, when adjusted for salicylate concentration, only age (OR 1.13; 95% CI 1.02-1.26) and respiratory rate (OR 1.29; 95% CI 1.02-1.63) were independent predictors. Additionally, lactate showed excellent test characteristics to predict severe outcome, with an optimal cutpoint of 2.25 mmol/L (78% sensitivity, 67% specificity).. In adult Emergency Department patients with acute salicylate poisoning, independent predictors of severe outcome were older age and increased respiratory rate, as well as initial serum lactate, while initial salicylate concentration alone was not predictive.

Topics: Acidosis; Acute Disease; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Cohort Studies; Drug Overdose; Emergency Service, Hospital; Female; Hospitals, University; Humans; Male; Middle Aged; Prospective Studies; Renal Dialysis; Risk Factors; Salicylates; Sensitivity and Specificity; Severity of Illness Index; Young Adult

The goal of the present study was to examine the neuroprotective and functional significance of targeting both N-methyl-D-aspartate (NMDA) receptor-mediated excitotoxicity and oxidative stress using a dual-acting compound, Neu2000, in rat model of moderate spinal cord injury (SCI). An initial set of experiments was conducted in uninjured rats to study the pharmacokinetic profile of Neu2000 following intraperitoneal and intravenous administration. A second experiment measured free radical production in mitochondria isolated from sham or injured spinal cords of animals receiving vehicle or Neu2000 treatment. A third set of animals was divided into three treatment groups consisting of vehicle treatment, a single dose of Neu2000 (50 mg/kg) administered at 10 min following injury, or a repeated treatment paradigm consisting of a single bolus of Neu2000 at 10 min following injury (50 mg/kg) plus a maintenance dose (25 mg/kg) administered every 24 h for an additional 6 days. Animals were tested once a week for a period of 6 weeks for evidence of locomotor recovery in an open field and kinematic analysis of fine motor control using the DigiGait Image Analysis System. At the end of the testing period, spinal cord reconstruction was performed to obtain nonbiased stereological measures of tissue sparing. The results of this study demonstrate that Neu2000 treatment significantly reduced the production of mitochondrial free radicals and improved locomotor outcomes that were associated with a significant increase in the volume of spared spinal cord tissue.

Topics: Acute Disease; Animals; Antioxidants; Benzoates; Disease Models, Animal; Drug Administration Schedule; Female; Fluorobenzenes; Free Radicals; meta-Aminobenzoates; Mitochondria; Motor Activity; Neuroprotective Agents; Neurotoxins; Oxidative Stress; Rats; Rats, Long-Evans; Recovery of Function; Salicylates; Spinal Cord; Spinal Cord Injuries; Treatment Outcome

UR-1505 is a novel salicylate derivative compound that has been demonstrated to selectively down-regulate T-cell activation. The aim of the present study was to elucidate the mechanisms involved in the intestinal anti-inflammatory effects of UR-1505 in 2 protocols of a dextran sodium sulfate (DSS) model of rat colitis: acute and established colitis.. The first protocol consisted of incorporating DSS into the drinking water at a concentration of 5% (w/v) for 5 days (acute initial colitis). In the second protocol, once the acute colitis had been induced, the concentration of DSS was reduced to 2% (w/v) and maintained for 10 days (established colitis).. The results obtained demonstrated that although UR-1505 did not exert a significant intestinal anti-inflammatory effect in ameliorating the initial steps of the intestinal inflammation induced by DSS, it had a beneficial effect on ongoing inflammation, most probably through inhibiting activation of T lymphocytes, thus avoiding perpetuation of the inflammatory process.. These results suggest that this compound is a good candidate for inducing remission or maintaining therapies in human inflammatory bowel disease (IBD). Moreover, the different results obtained by UR-1505 in these 2 protocols of colitis induction (acute initial colitis versus established colitis) confirm the importance of selection and optimization of the experimental model to evaluate the drugs to be used in IBD therapy.

Topics: Acute Disease; Animals; Anti-Inflammatory Agents, Non-Steroidal; Cells, Cultured; Chronic Disease; Colitis; Dextran Sulfate; Male; Mice; Mice, Inbred BALB C; Rats; Rats, Wistar; Salicylates; T-Lymphocytes

Topics: Acute Disease; Child; Diagnosis, Differential; Humans; Kenya; Malaria, Cerebral; Malaria, Falciparum; Neurotoxicity Syndromes; Salicylates

Metabolic acidosis is associated with most severe malaria deaths in African children, and most deaths occur before maximum antimalarial action is achieved. Thus, specific acidosis treatment may reduce mortality. However, the underlying mechanisms remain poorly understood and no specific interventions have been developed. A detailed characterisation of this acidosis is critical in treatment development. We used the traditional and Stewart's approach to characterise acidosis in consecutive paediatric admissions for malaria and other acute non-surgical conditions to Kilifi District Hospital in Kenya. The overall acidosis prevalence was 21%. Gastroenteritis had the highest prevalence (61%). Both the mean albumin-corrected anion gap and the strong ion gap were high (>13 mmol/l and >0 mmol/l, respectively) in malaria, gastroenteritis, lower respiratory tract infection and malnutrition. Presence of salicylate in plasma was not associated with acidosis but was associated with signs of severe illness (odds ratio 2.11, 95% CI 1.1-4.2). In malaria, mean (95% CI) strong ion gap was 15 (14-7) mmol/l, and lactate, creatinine and inorganic phosphorous explained only approximately 40% of the variability in base excess (adjusted R2 = 0.397). Acidosis may be more common than previously recognised amongst paediatric admissions in Africa and is characterised by the presence of currently unidentified strong anions. In malaria, lactate and ketones, but not salicylate, are associated with acidosis. However, unidentified anions may be more important.

Topics: 3-Hydroxybutyric Acid; Acidosis; Acute Disease; Biomarkers; Child, Preschool; Creatinine; Female; Gastroenteritis; Hospitalization; Humans; Infant; Kenya; Ketones; Lactates; Lung Diseases; Malaria; Male; Malnutrition; Regression Analysis; Salicylates

Topics: Acute Disease; Anticholesteremic Agents; Atorvastatin; Drug Combinations; Heptanoic Acids; Humans; Male; Middle Aged; Pancreatitis; Pyrroles; Salicylates; Treatment Outcome

The effect of valeryl salicylate (VS), an inhibitor of cyclooxygenase-1 (COX-1), was evaluated in arachidonic acid or croton oil-induced ear oedema and carrageenan-induced paw oedema in mice. Ear oedema was induced by topical administration of arachidonic acid (2mg per ear; 20 microliters) or croton oil (1mg per ear; 20 microliters) to the inner surface of the left ear and the change in the ear's thickness was measured with a precision micrometer (Fisher, USA). VS significantly inhibited the arachidonic acid ear oedema after lh at doses of 1.5-45 micrograms per ear; however, only at the dose of 45 micrograms per ear was it able to significantly reduce the croton oil-induced oedema at 6h. Paw oedema was induced by the injection of 25 microliters of 1% carrageenan into the plantar aponeurosis of the right hind paw. The oedema was evaluated at 0.5, 1, 2, 4, 24, 48 and 72h. Previously in our experiments, we observed two peaks in paw oedema formation: one at 2h, in the early phase (0-4h), and the other, occurring at 48h after carrageenan injection, in the late phase (24-72h). The pre-treatment with VS significantly reduced the paw oedema at 2h, the same effect observed with celecoxib and indomethacin treatments. At 24h, VS did not inhibit oedema but significantly increased it mainly at 48h after carrageenan injection. These results showed that VS was pharmacologically active in these models and suggest that COX-1 may participate in the early and late phases of inflammation in the models studied.

Topics: Acute Disease; Animals; Arachidonic Acid; Carrageenan; Celecoxib; Croton Oil; Cyclooxygenase 1; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Cyclooxygenase Inhibitors; Dose-Response Relationship, Drug; Ear, External; Edema; Foot; Indomethacin; Inflammation; Irritants; Isoenzymes; Male; Membrane Proteins; Mice; Prostaglandin-Endoperoxide Synthases; Pyrazoles; Salicylates; Sulfonamides

NMR spectroscopic investigation can be applied to a large variety of xenobiotics in acute poisoning cases (therapeutic agents, pesticides, solvents, alcohols). In a salicylate poisoning case, the three major metabolites of acetylsalicylic acid--salicylic, salicyluric, and gentisic acids--have been detected in crude urine. Valproic acid as glucuronoconjugated form was identified in urine samples from two poisoned patients. Paraquat (Gramoxone) was identified by its two aromatic signals at 8.49 and 9.02 ppm and quantitated in urine of two acutely poisoned patients (985 and 500 micromol/L). In an intentional poisoning case with tetrahydrofuran, this compound was characterized by its resonances at 1.90 and 3.76 ppm, and quantitated at 11.3 and 11.8 mmol/L in serum and urine samples, respectively. Methanol, ethylene glycol, and the corresponding metabolites formate and glycolate were detected in the same spectrum of serum samples from three poisoned patients. Detection and quantitation of many exogenous and endogenous compounds could be achieved by 1H HMR spectroscopy in biological fluids without any hypothesis on the chemical species.

Topics: Acute Disease; Humans; Hydrogen; Magnetic Resonance Spectroscopy; Paraquat; Poisoning; Salicylates; Solvents; Valproic Acid; Xenobiotics

Topics: Acute Disease; Adult; Anti-Inflammatory Agents, Non-Steroidal; Cyclooxygenase Inhibitors; Diagnosis, Differential; Erythema Nodosum; Female; Humans; Penicillins; Rheumatic Fever; Salicylates; Time Factors

We have investigated the relationship between oxygen free radicals and acute rheumatic fever with regard to diagnosis of the disease process. At the time of diagnosis, we measured the levels of reactive oxygen molecules in the plasma, this being a parameter for oxygen free radicals, and discovered the levels to be significantly higher when compared with those measured in a control group (P<0.05). The levels measured in the plasma, however, were not statistically different among patients with and without carditis. We found a progressive decrease in the levels measured in the plasma when patients with acute rheumatic fever were tested on the 15th, 30th and 90th days subsequent to diagnosis. By the 90th day, levels measured in the plasma were still higher, but no longer significantly elevated, when compared with the control group. The present study is preliminary, but raises the possibility that measurement of oxygen free radicals in the plasma could be used as a laboratory test for active state of acute rheumatic fever. Further investigations will be needed, nonetheless, to determine the clinical application of this technique.

Topics: Acute Disease; Adolescent; Anti-Inflammatory Agents; Blood Sedimentation; C-Reactive Protein; Cardiomegaly; Child; Child Welfare; Electrocardiography; Female; Free Radicals; Humans; Male; Oxygen; Prednisolone; Radiography; Rheumatic Fever; Salicylates; Streptolysins; Turkey

Topics: Acute Disease; Bismuth; Child; Child, Preschool; Evidence-Based Medicine; Gastroenteritis; Humans; Infant; Organometallic Compounds; Safety; Salicylates; Treatment Outcome

A 36-year-old woman, hospitalized because of an exacerbation of psoriasis, developed fever, sudden deafness and severe metabolic acidosis after treatment with a 10% salicylic acid containing ointment for four days. The use of salicylic acid on large areas of inflamed skin enhances the risk of transcutaneous resorption and intoxication. High serum concentrations (> 300 mg/l) of salicylic acid deregulate the blood glucose metabolism and cause damage to the inner ear. After timely intervention such symptoms are largely reversible.

Topics: Acute Disease; Adult; Female; Hearing Loss, Sensorineural; Humans; Keratolytic Agents; Ointments; Psoriasis; Salicylates

Drug screens were performed for 434 adult patients who presented to the Parkland Memorial Hospital Emergency Department with suspected acute drug overdose. The screening consisted of analysis of urine by automated high performance liquid chromatography (REMEDi) in combination with qualitative EMIT immunoassays. Selected patients also had ethanol measured in blood, salicylate and acetaminophen measured in serum, and urine specimens analyzed qualitatively for cannabinoids. Most patients (83.4%), regardless of age, race, or gender, had evidence of consumption of at least one drug. The drugs detected most often were ethanol (30.0%) and cocaine (23.7%). At least one of the nine most common drugs-of-abuse (amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, ethanol, opiates, opioids, and phencyclidine) was detected in 64.5% of the specimens, and combinations of these drugs were present in 45.4%. For most drugs, age, gender, ethnicity, time of day, day of week, and indication for screening could not be used to predict the drug screen result.

Topics: Acetaminophen; Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Alcoholic Intoxication; Amphetamines; Analgesics, Non-Narcotic; Barbiturates; Cannabinoids; Chromatography, High Pressure Liquid; Cocaine; Drug Overdose; Enzyme Multiplied Immunoassay Technique; Ethanol; Female; Forecasting; Hallucinogens; Humans; Male; Middle Aged; Narcotics; Phencyclidine; Poisoning; Retrospective Studies; Salicylates; Substance-Related Disorders

This report relates to burns of the feet suffered by a pilgrim to Mecca who walked barefoot in the hot desert sun. He subsequently presented with full-thickness burn injuries to the soles of his feet. When the patient developed acute coronary insufficiency, immediate surgery could not be performed. He was therefore treated conservatively with salicylic acid and Silverol cream. Spontaneous closure of the wounds was achieved in the course of 2 months.

Topics: Acute Disease; Anti-Infective Agents, Local; Burns; Cardiac Output, Low; Foot Injuries; Humans; Islam; Keratolytic Agents; Male; Middle Aged; Salicylates; Salicylic Acid; Saudi Arabia; Silver Sulfadiazine

In this retrospective study, we evaluated the clinical value of screening for salicylates in 347 patients with acute poisoning presenting to the Prince of Wales Hospital, Hong Kong, between January 1992 and June 1993. In 83 patients (24%), ingestion of salicylates was suspected; the incidence of elevated plasma salicylate concentrations (> 0.1 mmol/L) in those who had taken identifiable drugs, unidentifiable drugs but known type, or topical medicaments was 71%, 16% and 61%, respectively. In 264 patients (76%), ingestion of salicylates was not suspected, and of these, 3 had elevated (0.2-0.4 mmol/L) plasma salicylate concentrations. Routine screening for salicylates in all patients with acute poisoning in Hong Kong appears unnecessary, especially as many authorities consider that 1 of the main indications for treating salicylate poisoning is clinical evidence of toxicity. Restricting plasma measurements to only those suspected of having ingested salicylates would have saved up to 76% of requests. All physicians should be aware of the high salicylate content of some Chinese proprietary topical medicaments.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Poisoning; Retrospective Studies; Salicylates

Topics: Acetaminophen; Acute Disease; Adult; Age Factors; Aged; Child; Humans; Infant; Poisoning; Prognosis; Salicylates; Time Factors

Serum salicylate concentrations were measured in 60 patients with acute phase Kawasaki disease (KD), who were treated with intravenous aspirin (IVASP), to evaluate its anti-inflammatory effect in the treatment of KD. Patients with serum salicylate concentrations > or = 150 micrograms/ml showed shorter durations of fever (7.1 +/- 2.0 vs 10.4 +/- 6.6 days; P < 0.05), shorter durations of positive serum C-reactive protein (14.6 +/- 4.5 vs 22.3 +/- 10.6 days; P < 0.01) and lower incidences of coronary arterial involvements (0/10 vs 6/24; P < 0.05) than did patients with serum salicylate concentrations < 150 micrograms/ml. Significant linear correlations were recognized between daily IVASP dosage and serum salicylate concentrations (r = 0.73; P < 0.01), and between serum salicylate concentrations and serum free salicylate concentrations (r = 0.82; P < 0.01). These correlations did not differ between the presence and absence of coronary arterial involvements. Based on these findings we concluded that a beneficial anti-inflammatory effect in the treatment of KD is achieved when the serum salicylate concentration is > or = 150 micrograms/ml, and that such concentrations could be achieved by increasing the daily IVASP dosage to 100 mg/kg per day or more.

Topics: Acute Disease; Aspirin; Child; Child, Preschool; Coronary Disease; Female; Humans; Infant; Inflammation; Infusions, Intravenous; Male; Mucocutaneous Lymph Node Syndrome; Retrospective Studies; Salicylates; Treatment Outcome

Because patients with Kawasaki disease have low serum concentrations of salicylates despite high doses, and because the free (unbound) drug is responsible for the pharmacologic effects of salicylates, we assessed salicylate protein binding in patients with Kawasaki disease. During the acute phase of the disease, protein binding of salicylate in 36 children with Kawasaki disease was 73 +/- 12%, significantly lower than during the subacute phase (90.4 +/- 8.7%; p less than 0.0005). Mean serum albumin concentration was 29.2 +/- 6.4 gm/L during the acute phase and 36.7 +/- 7.8 gm/L during the subsequent subacute phase (p less than 0.005). Salicylate protein binding was affected independently by both serum albumin and total salicylate levels. During the acute phase of Kawasaki disease, children had an average twofold increase in free salicylate compared with normoalbuminemic control subjects. A nomogram has been devised to derive free salicylate levels from the known total salicylate and serum albumin concentrations.

Topics: Acute Disease; Adult; Carbon Radioisotopes; Child; Humans; Mucocutaneous Lymph Node Syndrome; Protein Binding; Salicylates; Serum Albumin; Ultrafiltration

Topics: Acetaminophen; Acute Disease; Antidepressive Agents, Tricyclic; Barbiturates; Humans; Poisoning; Salicylates; Tranquilizing Agents

The course of 177 consecutive patients with severe salicylate self-poisoning treated in an intensive care unit (ICU) during a period of 15 years is presented. On admission, cerebral depression was observed in 61% respiratory failure was present in 47%, acidosis in 36% and cardiovascular function was impaired in 14%. A mortality rate of 15% was observed, which was proportionally higher in patients more than 40 years old and in patients with delayed diagnosis. Twenty-seven patients died and an autopsy was performed on 26 patients. The main autopsy diagnosis was ulcers of the gastrointestinal tract in 46%, pulmonary oedema in 46%, cerebral oedema in 31% and cerebral haemorrhage in 23%.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Brain Edema; Cerebral Hemorrhage; Child; Child, Preschool; Duodenal Ulcer; Female; Humans; Infant; Intensive Care Units; Male; Middle Aged; Pulmonary Edema; Respiratory Distress Syndrome; Retrospective Studies; Salicylates; Salicylic Acid; Stomach Ulcer; Suicide, Attempted

Topics: Acute Disease; Adult; Burns; Humans; Male; Ointments; Salicylates

We studied gallbladder involvement in 19 patients with Kawasaki syndrome who presented over a 4-year period from 1979 to 1982. Diagnosis and follow-up of gallbladder disease were defined by real-time ultrasound. Complete spontaneous resolution of abdominal symptomatology related to the hydropic gallbladder occurred without complication and did not require surgical intervention. We suggest that the incidence of hydrops of the gallbladder in mucocutaneous lymph node syndrome is higher than commonly appreciated, since diagnosis may be missed unless ultrasound is performed.

Topics: Acute Disease; Child; Child, Preschool; Edema; Female; Fluid Therapy; Gallbladder Diseases; Humans; Male; Mucocutaneous Lymph Node Syndrome; Salicylates; Ultrasonography

Histology or necropsy records of 13 children with accidental or therapeutically induced salicylate intoxication were examined for the presence of hepatic and cerebral pathology findings characteristic of Reye's syndrome. Liver sections stained with haematoxylin and eosin showed intrahepatocytic microvesiculation (10 of 12 children) and absence of significant inflammation or necrosis (10 of 12 children). All 6 specimens of liver tissue stained with oil red O showed intrahepatocytic microvesicular fat with central hepatocytic nuclei distributed either diffusely throughout the lobule or more prominently in the lobular periphery. Liver tissue stained with the periodic-acid/Schiff method showed complete absence of stainable glycogen in 5 of 6 children. 9 of 12 children for whom information was available had cerebral oedema. It is concluded that the light-microscopy hepatic findings and the gross cerebral findings for the majority of these children with salicylate intoxication are the same as those for children with Reye's syndrome.

Topics: Accidents, Home; Acute Disease; Adolescent; Brain; Brain Edema; Child; Child, Preschool; Female; Humans; Infant; Liver; Liver Glycogen; Male; Reye Syndrome; Salicylates; Staining and Labeling

Topics: Acute Disease; Adolescent; Adrenal Cortex Hormones; Adult; Aged; Anti-Inflammatory Agents; Child; Ethanol; Gastrointestinal Hemorrhage; Humans; Middle Aged; Potassium; Salicylates

Salicylate intoxication remains a common problem in Britain; about 10 percent of adult hospital admissions for deliberate self-poisoning involve these drugs. Accidental salicylate poisoning in children has been considerably reduced since the introduction of child-resistant containers. In the United Kingdom, the annual number of salicylate-related deaths has fallen slightly between 1967 and 1980. Diagnosis of salicylate intoxication is made from patient history, circumstantial evidence, and common clinical features (tinnitus, deafness, sweating, hyperventilation), and is confirmed by measurement of the plasma salicylate concentration. Gastric emptying by lavage or emesis is an important part of the management of acute overdose. About 20 percent of adults require forced alkaline diuresis to enhance elimination of salicylate from the body. Hemodialysis and hemoperfusion are seldom indicated. The mortality rate from acute salicylate poisoning in hospital-treated adults is about one percent; death is usually preceded by neurologic features and a dominant metabolic acidosis. Chronic salicylate intoxication may follow the administration of oral therapeutic doses or the use of ointments containing acetylsalicylic acid since metabolic pathways (mainly conjugation with glycine and glucuronic acid) are readily saturated. The incidence of chronic therapeutic intoxication is unknown but appears low and is usually encountered in young children and the elderly. Diagnosis is frequently delayed because of a low index of suspicion, which in turn delays treatment and increases morbidity and mortality rates.

Topics: Acute Disease; Adolescent; Adult; Child, Preschool; Chronic Disease; Diuresis; Hemoperfusion; Humans; Renal Dialysis; Salicylates; United Kingdom

In acute poisoning the main purpose of any therapeutic approach is a rapid removal of the drug or poison from body tissues. This approach suggested to undertake a study for the development of an uncoated activated carbon hemoperfusion column suitable for acute poisoning. Th clearances were significantly superior compared with a similar device manufactured using coated carbon. The microparticle generation, utilizing a spherical type of activated carbon, was undetectable with the adopted measuring method, well below the US and British Pharmacopeas limits and practically equal to a coated carbon column with identical geometry.

Topics: Acute Disease; Adsorption; Animals; Blood Glucose; Blood Urea Nitrogen; Carbon; Creatinine; Hemoperfusion; Humans; Inulin; Particle Size; Phenobarbital; Poisoning; Rabbits; Salicylates; Salicylic Acid; Uric Acid; Vitamin B 12

Topics: Acute Disease; Humans; Reye Syndrome; Risk; Salicylates; Virus Diseases

To evaluate the relative severity of acute vs chronic salicylate poisoning in children, 112 cases (65 acute and 47 chronic) of salicylate poisoning (salicylate concentration greater than or equal to 20 mg/100 ml) admitted to The Children's Hospital Medical Center in Boston and Primary Children's Medical Center in Salt Lake City between the years 1967 and 1978 were analyzed. Hyperventilation (P less than .01), dehydration (P less than .001), and severe central nervous system manifestations (P less than .001) occurred more frequently in the chronic group and remained more frequent (P less than .01) when patients having disease states capable of producing these signs and symptoms were removed from statistical analysis. At three separate salicylate concentration ranges (20 to 39, 40 to 59, and greater than or equal to 60 mg/100 ml) hyperventilation, dehydration, and severe CNS manifestations tended to occur with greater frequency in the chronic group. When severity of salicylate poisoning was categorized based on a combination of signs and symptoms, mild cases occurred more frequently in the chronic group. Finally, systemic acidosis (pH less than 7.32) was found more frequently in the chronic group (P less than .01), more frequently in patients with severe manifestations than in those with mild manifestations, and in patients with dehydration (P less than .01) and severe CNS manifestations (P less than .05). Based on the variables evaluated, chronic salicylism produces a greater morbidity than does acute salicylate poisoning in the pediatric patient.

Topics: Acidosis; Acute Disease; Adolescent; Central Nervous System Diseases; Child; Child, Preschool; Chronic Disease; Dehydration; Female; Humans; Hyperventilation; Infant; Male; Nausea; Salicylates; Vomiting

Topics: Acute Disease; Aged; Dermatitis, Exfoliative; Diflunisal; Female; Humans; Nephritis, Interstitial; Salicylates

Topics: Acute Disease; Adult; Bismuth; Diarrhea; Humans; Organometallic Compounds; Salicylates; Travel

Seventeen patients suffering from an initial attack of acute rheumatic fever were studied during treatment with phenoxymethyl penicillin and salicylates (600 mg orally every 4 or 6 hours). Elevated transaminase (SGOT) levels occurred in nine patients. The SGOT levels were directly related to serum salicylate levels (r = 0.668) and inversely to the serum albumin level (r = -0.418). SGOT response was greater in patients with a serum albumin of less than 3.5 g/dl (P < 0.001). In hypoalbuminemia, the ratio of free salicylate to bound salicylate rises and the free salicylate might be more active and thus more hepatotoxic even at relatively low total serum salicylate levels. In all patients with hypoalbuminemia of less than 3.5 g/dl, close monitoring the SGOT is advisable, especially if the level of total serum salicylate is 15 mg/dl or higher.

Topics: Acute Disease; Adolescent; Aspartate Aminotransferases; Chemical and Drug Induced Liver Injury; Female; Humans; Hypoproteinemia; Male; Protein Binding; Rheumatic Fever; Salicylates; Serum Albumin

Topics: Acute Disease; Female; Humans; Middle Aged; Respiratory Distress Syndrome; Salicylates

An experimental study of the comparative effectiveness of single and mixed ligand chelates as antidotes for acute cadmium poisoning reveals few appreciable differences when the cadmium (as cadmium chloride or acetate) is administered ip. In each case the mixed ligand chelate system showed little or no improvement over the results obtained with the most effective of the individual components. This procedure, using mixed ligand chelate systems, may well be one which is limited to conditions more narrowly similar to those reported by Schubert and Derr (1978). It does not appear to possess the broad range of applicability which might be expected from the equilibrium principles on which it is based. By comparing our data with previous studies it can be seen that Na2CaEDTA is capable of offsetting the lethality of ip cadmium chloride when the latter is administered at rather higher levels that have previously been counteracted by any of the sulfur containing chelating agents tested to date.

Topics: Acute Disease; Animals; Cadmium Poisoning; Chelating Agents; Dimercaprol; Drug Therapy, Combination; Edetic Acid; Female; Ligands; Mice; Salicylates

Topics: Acute Disease; Adult; Barbiturates; Female; Hemoperfusion; Humans; Poisoning; Salicylates

Topics: Acetanilides; Acute Disease; Animals; Anti-Inflammatory Agents; Aspirin; Drug Evaluation, Preclinical; Gastric Mucosa; Lethal Dose 50; Mice; Salicylates; Stomach Ulcer; Time Factors

Three cases of self poisoning with tricyclic antidepressants (TAD) are reported, one of them with a potentially lethal dose. All three cases were treated with physostigmine salicylate (PS) and in two cases there was complete reversal of coma within a few minutes. In striking contrast to the reported high incidence of cardiac arrhythmias no cardiac complications were observed in any of the cases. Therefore we think that the use of PS should be considered when treating cases of TAD poisoning.

Topics: Acute Disease; Antidepressive Agents, Tricyclic; Antidotes; Female; Humans; Physostigmine; Poisoning; Salicylates; Suicide, Attempted

Of 11 patients with acute rheumatic fever, 9 were treated with a total daily salicylate dosage of 3,6 g or less, 1 patient required a total daily dosage of 5,4 g and another required 9,0 g daily. Six of the 11 patients had elevated serum transaminase levels, and all were asymptomatic. The elevated transaminase levels appear to bear a direct relationship to the serum salicylate level, and a serum salicylate level of 19,2 mg/100 ml appears to be the critical point. In 5 out of the 6 patients with elevated transaminases, the serum salicylate level exceeded 19,2 mg/100 ml, while in the 5 patients with normal transaminases the serum salicylate level did not exceed 19,2 mg/100 ml. Also, in 10 of the 11 patients eosinophilia was noted, but this decreased despite continued or increased salicylate administration. A narrow margin thus appears to exist between therapeutic serum salicylate levels and hepatotoxic levels, and serial serum transaminase estimations are advocated in patients on long-term salicylate therapy.

Topics: Acute Disease; Adolescent; Adult; Aspartate Aminotransferases; Chemical and Drug Induced Liver Injury; Eosinophilia; Female; Humans; Male; Rheumatic Fever; Salicylates

Out of 14 cases of poisoning assumed to be due to dextropropoxyphene-containing drugs, propoxyphene and its main metabolite norpropoxyphene could be demonstrated in 11. The concentrations of the drugs were determined shortly after admission and then after 2, 4, 6 and 10 hours (in four cases also after 16 hours). The highest plasma concentration of propoxyphene, 0.74 mug/ml, was found in one case of fatal poisoning. Another patient with a plasma concentration of 0.51 mug/ml showed signs of severe respiratory depression but survived after respirator therapy. In the patients with lower plasma concentrations the poisoning had a benign course. In most cases the plasma concentration of norpropoxyphene exceeded that of propoxyphene even in the first blood sample.

Topics: Acidosis; Acute Disease; Adolescent; Adult; Arrhythmia, Sinus; Aspirin; Barbiturates; Dextropropoxyphene; Drug Combinations; Ethanol; Female; Humans; Male; Middle Aged; Respiration Disorders; Salicylates; Time Factors; Ventricular Fibrillation

Topics: Acute Disease; Adolescent; Adult; Aged; Aspirin; Female; Gastrointestinal Hemorrhage; Hematemesis; Humans; Male; Melena; Middle Aged; Salicylates

Topics: Acute Disease; Adult; Female; Gastroenterostomy; Gastrointestinal Hemorrhage; Humans; Influenza, Human; Peptic Ulcer Hemorrhage; Postoperative Complications; Salicylates

Following intravenous administration of physostigmine salicylate for tricyclic antidepressant poisoning in 21 patients, convulsions occurred in two patients, and severe cholinergic manifestations occurred in two others. Because of these untoward effects and the very short duration of its beneficial action, it is very doubtful that physostigmine has any place in the routine management of tricyclic antidepressant poisoning.

Topics: Acute Disease; Antidepressive Agents; Arousal; Drug Evaluation; Electroencephalography; Humans; Injections, Intravenous; Physostigmine; Poisoning; Salicylates; Seizures; Sympathetic Nervous System; Time Factors

A case of hepatotoxicity and encephalopathy (Reye's syndrome?) associated with salicylate therapy is presented and the aetiology of this syndrome is discussed. Hepatotoxicity developed with salicylate serum concentrations not exceeding therapeutic serum levels. The importance of controlling serum salicylate concentration and transaminase activity particularly during the first fourteen days of therapy is emphasized.

Topics: Acute Disease; Adolescent; Aspirin; Brain Diseases; Chemical and Drug Induced Liver Injury; Female; Humans; Liver; Reye Syndrome; Salicylates

While rheumatic fever is relatively uncommon except where there are poor and crowded living conditions, sporadic acute attacks continue to occur in a family or pediatric medical practice. The physician's role in management of the sore throat in the diagnosis of suspected cases of rheumatic fever and in follow-up for continued prophylaxis is discussed. The frequency of admissions and presenting features of 159 patients with acute rheumatic fever is reviewed. Continued surveillance is required if we are to achieve a further reduction in attack rate and complications.

Topics: Acute Disease; Adolescent; Antistreptolysin; Arthritis, Juvenile; Arthritis, Rheumatoid; Child; Child, Preschool; Diagnosis, Differential; Heart Murmurs; Heart Valve Diseases; Humans; Manitoba; Penicillins; Prednisone; Rheumatic Fever; Rheumatic Heart Disease; Salicylates; Streptococcal Infections; Streptococcus; Time Factors

Topics: Acute Disease; Adult; Anticoagulants; Cortisone; Diagnostic Errors; Drug Synergism; Emergencies; Esophageal and Gastric Varices; Esophagitis; Ethanol; Gastritis; Gastrointestinal Hemorrhage; Gastroscopy; Humans; Peptic Ulcer Hemorrhage; Retrospective Studies; Salicylates

Topics: Acute Disease; Alkaline Phosphatase; Analgesics; Animals; Anti-Inflammatory Agents; Chronic Disease; Heterocyclic Compounds; Kidney; Kidney Diseases; L-Lactate Dehydrogenase; Leucyl Aminopeptidase; Male; Nicotinic Acids; Phenylbutazone; Pyridazines; Rats; Rats, Inbred Strains; Salicylates; Toluidines

Topics: Acute Disease; Adult; Barbiturates; Charcoal; Coma; Emergency Service, Hospital; First Aid; Humans; Intensive Care Units; Poisoning; Psychology; Respiratory Function Tests; Salicylates; Shock; Vomiting

Topics: Acute Disease; Adrenocorticotropic Hormone; Glucocorticoids; Humans; Penicillin G Benzathine; Penicillins; Pyrazoles; Rheumatic Fever; Salicylates; Streptococcal Infections

Topics: Acute Disease; Adolescent; Adult; Aged; Colitis, Ulcerative; Ethanol; Female; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Salicylates; Stress, Physiological

Topics: Acute Disease; Chronic Disease; Crohn Disease; Diarrhea; Female; Gastrointestinal Agents; Humans; Hypnotics and Sedatives; Male; Salicylates; Sulfanilamides; Vitamins

Topics: Acute Disease; Antidotes; Charcoal; Child, Preschool; Copper; Dimercaprol; Edetic Acid; Humans; Mycotoxins; Nicotine; Petroleum; Poison Control Centers; Poisoning; Salicylates; Vomiting

Topics: Acidosis; Acute Disease; Aspirin; Humans; Poisoning; Prognosis; Salicylates

Topics: Acute Disease; Child; Humans; Hypersensitivity; Male; Rheumatic Fever; Salicylates; Stomach Ulcer; Urticaria

Topics: Abdomen; Acute Disease; Appendicitis; Blood Sedimentation; Child; Diagnosis, Differential; Humans; Male; Pain; Recurrence; Rheumatic Fever; Salicylates

Topics: Acute Disease; Amphetamine; Aspirin; Barbiturates; Dialysis; Diuresis; Gastric Lavage; Half-Life; Humans; Hydrogen-Ion Concentration; Intestinal Absorption; Poisoning; Salicylates; Vomiting

Topics: Acute Disease; Adult; Antidepressive Agents; Arrhythmias, Cardiac; Barbiturates; Body Temperature; Carbon Monoxide Poisoning; Child, Preschool; Female; Hospitalization; Humans; Hypnotics and Sedatives; Hypotension; Intensive Care Units; Intubation, Intratracheal; Male; Middle Aged; Poisoning; Rectum; Respiration; Salicylates; Seasons; Tranquilizing Agents; Unconsciousness

Topics: Acute Disease; Child; Hospitalization; Humans; Long-Term Care; Penicillins; Physical Therapy Modalities; Prognosis; Rest; Rheumatic Fever; Salicylates; Steroids

Topics: Acute Disease; Adult; Aged; Boric Acids; Chronic Disease; Ear Diseases; Estrogens; Eustachian Tube; Female; Fluorocarbon Polymers; Hearing Disorders; Humans; Injections; Male; Middle Aged; Neuromuscular Diseases; Postoperative Complications; Pregnancy; Salicylates

Topics: Acute Disease; Adolescent; Adult; Child; Child, Preschool; Female; Fever; Follow-Up Studies; Hemorrhage; Humans; Infant; Infant, Newborn; Leukocytosis; Male; Middle Aged; Otitis Media; Peritonsillar Abscess; Pneumonia; Postoperative Complications; Respiratory Tract Infections; Salicylates; Sex Factors; Sinusitis; Tonsillectomy; Tonsillitis

Topics: Acute Disease; Allopurinol; Chronic Disease; Colchicine; Gout; Humans; Indomethacin; Metabolic Diseases; Phenylbutazone; Salicylates; Uric Acid; Uricosuric Agents

Topics: Acute Disease; Antidotes; Barbiturates; Diuretics; Humans; Poisoning; Salicylates; Tranquilizing Agents

Topics: Acute Disease; Acute Kidney Injury; Humans; Poisoning; Renal Dialysis; Salicylates; Suicide

Topics: Acute Disease; Antidotes; Atropine; Barbiturates; Carbon Monoxide Poisoning; Chlorpromazine; Deferoxamine; England; Gastric Lavage; Heart Massage; Humans; Meperidine; Morphine; Oxygen; Paraldehyde; Phenobarbital; Poisoning; Salicylates; Suicide; Wales

Topics: Acute Disease; Penicillins; Salicylates; Sulfadiazine; Thyroiditis

Topics: Acute Disease; Asthma; Salicylates; Sodium Salicylate

Topics: Acute Disease; Osteomyelitis; Salicylates

Topics: Acute Disease; Communicable Diseases; Rheumatic Fever; Salicylates