salicylates and Chronic-Disease

Collagenous colitis is a cause of chronic diarrhea. This updated review was performed to identify therapies for collagenous colitis that have been assessed in randomized controlled trials (RCTs).. The primary objective was to assess the benefits and harms of treatments for collagenous colitis.. We searched CENTRAL, the Cochrane IBD Group Specialized Register, MEDLINE and EMBASE from inception to 7 November 2016.. We included RCTs comparing a therapy with placebo or active comparator for the treatment of active or quiescent collagenous colitis.. Data were independently extracted by two authors. The primary outcome was clinical response or maintenance of response as defined by the included studies. Secondary outcome measures included histological response, quality of life and the occurrence of adverse events. Risk ratios (RR) and 95% confidence intervals (CI) were calculated for dichotomous outcomes. The Cochrane risk of bias tool was used to assess bias. The overall quality of the evidence was assessed using the GRADE criteria.. Low quality evidence suggests that budesonide may be effective for inducing and maintaining clinical and histological response in patients with collagenous colitis. We are uncertain about the benefits and harms of therapy with bismuth subsalicylate, Boswellia serrata extract, mesalamine with or without cholestramine, prednisolone and probiotics. These agents and other therapies require further study.

Topics: Bismuth; Boswellia; Budesonide; Cholestyramine Resin; Chronic Disease; Colitis, Collagenous; Diarrhea; Glucocorticoids; Humans; Mesalamine; Organometallic Compounds; Plant Extracts; Prednisolone; Probiotics; Randomized Controlled Trials as Topic; Salicylates

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

Chronic diarrhea is a frequent and challenging problem in clinical medicine. In a considerable subgroup of these, no underlying cause is identified and this is referred to as functional diarrhea. A consensus definition for functional diarrhea is based on loose stool consistency and chronicity and absence of coexisting irritable bowel syndrome. Underlying pathophysiology includes rapid intestinal transit, which may be worsened by stress or be triggered by a preceding infectious gastroenteritis. Diagnostic work-up aims at exclusion of underlying organic disease. Treatment starts with dietary adjustments, aiming at decreasing nutrients that enhance transit and stool and at identifying precipitating food items.

Topics: Antidepressive Agents, Tricyclic; Antidiarrheals; Bismuth; Carbon; Cholestyramine Resin; Chronic Disease; Clonidine; Diarrhea; Humans; Octreotide; Organometallic Compounds; Oxides; Probiotics; Receptors, Opioid; Salicylates; Serotonin 5-HT3 Receptor Antagonists; Thiorphan

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

Collagenous colitis is a disorder that is recognized as a cause of chronic diarrhea. Treatment has been based mainly on anecdotal evidence. This review was performed to identify therapies for collagenous colitis that have been proven in randomized trials.. To determine effective treatments for patients with clinically active collagenous colitis.. Relevant papers published between 1970 and June 2006 were identified via the MEDLINE and PUBMED databases. Manual searches from the references of identified papers, as well as review papers on collagenous or microscopic colitis were performed to identify additional studies. Abstracts from major gastroenterological meetings were searched to identify research submitted in abstract form only. Finally, the Cochrane Controlled Trials Register and the Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialized Trials Register were searched for other studies.. Seven randomized trials were identified. One trial studied bismuth subsalicylate (published in abstract form only), one trial studied Boswellia serrata extract (published in abstract form only), one trial studied probiotics, one trial studied prednisolone, and 3 trials studied budesonide for the therapy of collagenous colitis.. Data were extracted independently by each author onto 2x2 tables (treatment versus placebo and response versus no response). For therapies assessed in one trial only, p-values were derived using the chi-square test. For therapies assessed in more than one trial, summary test statistics were derived using the Peto odds ratio and 95% confidence intervals. Data were combined for analysis only if the outcomes were sufficiently similar in definition.. There were 9 patients with collagenous colitis in the trial studying bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks). Those randomized to active drug were more likely to have clinical (p = 0.003) and histological (p = 0.003) improvement than those assigned to placebo. Eleven patients were enrolled in the trial studying prednisolone (50 mg daily for 2 weeks). There was a trend towards clinical response in patients on active medication compared to placebo (p = 0.064). The effect of prednisolone on histologic improvement was not studied. Thirty-one patients were enrolled in the Boswellia serrata extract trial. Clinical improvement was noted in 44% of patients who received active treatment compared to 27% of patients who received placebo (p = 0.32). Twenty-nine patients were enrolled in the probiotics trial. Clinical improvement was noted in 29% of patients who received probiotics compared to 13% of patients who received placebo (p = 0.635). A total of 94 patients were enrolled in 3 trials studying budesonide (9 mg daily or in a tapering schedule for 6 to 8 weeks). The pooled odds ratio for clinical response to treatment with budesonide was 12.32 (95% CI 5.53-27.46), with a number needed to treat of 2 patients. There was significant histological improvement with treatment in all 3 trials studying budesonide therapy. Budesonide also appears to improve patients' quality of life.. Budesonide is effective for the treatment of collagenous colitis. The evidence for benefit with bismuth subsalicylate is weaker. The effectiveness of prednisolone, Boswellia serrata extract, probiotics and other therapies for induction or maintenance of remission of collagenous colitis is unknown and requires further study.

Topics: Anti-Inflammatory Agents; Bismuth; Budesonide; Chronic Disease; Colitis, Collagenous; Diarrhea; Humans; Organometallic Compounds; Probiotics; Randomized Controlled Trials as Topic; Salicylates

Collagenous colitis is a disorder that is recognized as a cause of chronic diarrhea. Treatment has been based mainly on anecdotal evidence. This review was performed to identify therapies for collagenous colitis that have been proven in randomized trials.. To determine effective treatments for patients with clinically active collagenous colitis.. Relevant papers published between 1970 and June 2005 were identified via the MEDLINE and PUBMED databases. Manual searches from the references of identified papers, as well as review papers on collagenous or microscopic colitis were performed to identify additional studies. Abstracts from major gastroenterological meetings were searched to identify research submitted in abstract form only. Finally, the Cochrane Controlled Trials Register and the Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialized Trials Register were searched for other studies.. Six randomized trials were identified. One trial studied bismuth subsalicylate (published in abstract form only), one trial studied Boswellia serrata extract (published in abstract form only), one trial studied prednisolone, and 3 trials studied budesonide in the therapy of collagenous colitis.. Data were extracted independently by each author onto 2x2 tables (treatment versus placebo and response versus no response). For therapies assessed in one trial only, p-values were derived using the chi-square test. For therapies assessed in more than one trial, summary test statistics were derived using the Peto odds ratio and 95% confidence intervals. Data were combined for analysis only if the outcomes were sufficiently similar in definition.. There were 9 patients with collagenous colitis in the trial studying bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks). Those randomized to active drug were more likely to have clinical (p = 0.003) and histological (p = 0.003) improvement than those assigned to placebo. Eleven patients were enrolled in the trial studying prednisolone (50 mg daily for 2 weeks). There was a trend towards clinical response in patients on active medication compared to placebo (p = 0.064). The effect of prednisolone on histologic improvement was not studied. Thirty-one patients were enrolled in the Boswellia serrata extract trial. Clinical improvement was noted in 44% of patients who received active treatment compared to 27% of patients who received placebo (p = 0.32). A total of 94 patients were enrolled in 3 trials studying budesonide (9 mg daily or in a tapering schedule for 6 to 8 weeks). The pooled odds ratio for clinical response to treatment with budesonide was 12.32 (95% CI 5.53 - 27.46), with a number needed to treat of 2 patients. There was significant histological improvement with treatment in all 3 trials studying budesonide therapy. Budesonide also appears to improve patients' quality of life.. Budesonide is effective for the treatment of collagenous colitis. The evidence for benefit with bismuth subsalicylate is weaker. The effectiveness of prednisolone and Boswellia serrata extract and other therapies for induction or maintenance of remission of collagenous colitis is unknown and requires further study.

Topics: Anti-Inflammatory Agents; Bismuth; Budesonide; Chronic Disease; Colitis; Collagen; Diarrhea; Humans; Organometallic Compounds; Randomized Controlled Trials as Topic; Salicylates

Collagenous colitis is a disorder that is recognized as a cause of chronic diarrhea. Treatment has been based mainly on anecdotal evidence. This review was performed to identify therapies for collagenous colitis that have been proven in randomized trials.. To determine effective treatments for patients with clinically active collagenous colitis.. Relevant papers published between 1970 and August 2003 were identified via the MEDLINE and PUBMED databases. Manual searches from the references of identified papers, as well as review papers on collagenous or microscopic colitis were performed to identify additional studies. Abstracts from major gastroenterological meetings were searched to identify research submitted in abstract form only. Finally, the Cochrane Controlled Trials Register and the Cochrane Inflammatory Bowel Disease Group Specialized Trials Register were searched for other studies.. Five randomized trials were identified. One trial studied bismuth subsalicylate (published in abstract form only), one trial studied prednisolone, and 3 trials studied budesonide in the therapy of collagenous colitis.. Data were extracted independently by each author onto 2x2 tables (treatment versus placebo and response versus no response). For therapies assessed in one trial only, p-values were derived using the chi-square test. For therapies assessed in more than one trial, summary test statistics were derived using the Peto odds ratio and 95% confidence intervals. Data were combined for analysis only if the outcomes were sufficiently similar in definition.. There were 9 patients with collagenous colitis in the trial studying bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks). Those randomized to active drug were more likely to have clinical (p=0.003) and histological (p=0.003) improvement than those assigned to placebo. Eleven patients were enrolled in the trial studying prednisolone (50 mg daily for 2 weeks). There was a trend towards clinical response in patients on active medication compared to placebo (p=0.064). The effect of prednisolone on histologic improvement was not studied. A total of 94 patients were enrolled in 3 trials studying budesonide (9 mg daily or in a tapering schedule for 6 to 8 weeks). The pooled odds ratio for clinical response to treatment with budesonide was 12.32 (95% CI 5.53-27.46), with a number needed to treat of 2 patients. There was significant histological improvement with treatment in all 3 trials studying budesonide therapy.. Budesonide is effective for the treatment of collagenous colitis. The evidence for benefit with bismuth subsalicylate is weaker. Prednisolone may be effective for treatment of collagenous colitis, but only a single very small study has been reported. The effectiveness of these and other therapies for induction or maintenance of remission (as opposed to producing clinical or histological improvement) of collagenous colitis is unknown.

Topics: Anti-Inflammatory Agents; Bismuth; Budesonide; Chronic Disease; Colitis; Collagen; Diarrhea; Humans; Organometallic Compounds; Randomized Controlled Trials as Topic; Salicylates

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

Collagenous colitis is a disorder that is recognized as a cause of chronic diarrhea. Treatment has been based mainly on anecdotal evidence. This review was performed to identify therapies for collagenous colitis that have been proven in randomized trials.. To determine effective treatments for patients with clinically active collagenous colitis.. Relevant papers published between 1970 and October 2002 were identified via the MEDLINE, PUBMED, and EMBASE databases. Manual searches from the references of identified papers, as well as review papers on collagenous or microscopic colitis were performed to identify additional studies. Abstracts from major gastroenterological meetings were searched to identify research submitted in abstract form only. Finally, the Cochrane Controlled Trials Register and the Cochrane Inflammatory Bowel Disease Group Specialized Trials Register were searched for other studies.. Four randomized trials were identified. One trial studied bismuth subsalicylate (published in abstract form only), and 3 trials (1 published in abstract form only) studied budesonide in the therapy of collagenous colitis.. Data were extracted independently by each author onto 2x2 tables (treatment versus placebo and response versus no response). For therapies assessed in one trial only, p-values were derived using the chi-square test. For therapies assessed in more than one trial, summary test statistics were derived using the Peto odds ratio and 95% confidence intervals. Data were combined for analysis only if the outcomes were sufficiently similar in definition.. There were 9 patients with collagenous colitis in the trial studying bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks). Those randomized to active drug were more likely to have clinical (p=0.003) and histological (p=0.003) improvement than those assigned to placebo. A total of 94 patients were enrolled in 3 trials studying budesonide (9 mg daily for 6 to 8 weeks). The pooled odds ratio for clinical response to treatment with budesonide was 12.32 (95% CI 5.53-27.46), with a number needed to treat of 2 patients. There was significant histological improvement with treatment in all 3 trials studying budesonide therapy.. Budesonide is effective in the treatment of collagenous colitis. The evidence for bismuth subsalicylate is weaker, but still important. The roles of these and other therapies in inducing or maintaining remission (as opposed to clinical or histological improvement) of collagenous colitis are unknown.

Topics: Anti-Inflammatory Agents; Bismuth; Budesonide; Chronic Disease; Colitis; Diarrhea; Humans; Organometallic Compounds; Salicylates

Collagenous colitis is a disorder that is recognized as a cause of chronic diarrhea. Treatment has been based mainly on anecdotal evidence. This review was performed to identify therapies for collagenous colitis that have been proven in randomized trials.. To determine effective treatments for patients with clinically active collagenous colitis.. Relevant papers published between 1970 and April 2003 were identified via the MEDLINE and PUBMED databases. Manual searches from the references of identified papers, as well as review papers on collagenous or microscopic colitis were performed to identify additional studies. Abstracts from major gastroenterological meetings were searched to identify research submitted in abstract form only. Finally, the Cochrane Controlled Trials Register and the Cochrane Inflammatory Bowel Disease Group Specialized Trials Register were searched for other studies.. Four randomized trials were identified. One trial studied bismuth subsalicylate (published in abstract form only), and 3 trials studied budesonide in the therapy of collagenous colitis.. Data were extracted independently by each author onto 2x2 tables (treatment versus placebo and response versus no response). For therapies assessed in one trial only, p-values were derived using the chi-square test. For therapies assessed in more than one trial, summary test statistics were derived using the Peto odds ratio and 95% confidence intervals. Data were combined for analysis only if the outcomes were sufficiently similar in definition.. There were 9 patients with collagenous colitis in the trial studying bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks). Those randomized to active drug were more likely to have clinical (p=0.003) and histological (p=0.003) improvement than those assigned to placebo. A total of 94 patients were enrolled in 3 trials studying budesonide (9 mg daily or in a tapering schedule for 6 to 8 weeks). The pooled odds ratio for clinical response to treatment with budesonide was 12.32 (95% CI 5.53-27.46), with a number needed to treat of 2 patients. There was significant histological improvement with treatment in all 3 trials studying budesonide therapy.. Budesonide is effective in the treatment of collagenous colitis. The evidence for bismuth subsalicylate is weaker, but still important. The roles of these and other therapies in inducing or maintaining remission (as opposed to clinical or histological improvement) of collagenous colitis are unknown.

Topics: Anti-Inflammatory Agents; Bismuth; Budesonide; Chronic Disease; Colitis; Collagen; Diarrhea; Humans; Organometallic Compounds; Randomized Controlled Trials as Topic; Salicylates

Nonopioid and adjuvant analgesics encompass a huge range of heterogenous drugs that differ chemically and mechanistically. These drugs generally are prescribed for mild-to-moderate pain, as coanalgesics for severe pain, or to target specific pain-generating mechanisms. This article provides an overview of some of the more commonly used nonopioid and adjuvant analgesics used to treat chronic pain, including salicylates, acetaminophen, nonsteroidal anti-inflammatory drugs, tricyclic antidepressants, anticonvulsants, N-Methyl-D-Aspartate receptor antagonists, lidocaine, skeletal muscle relaxants, and topical analgesics.

Topics: Acetaminophen; Analgesics, Non-Narcotic; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Anticonvulsants; Antidepressive Agents, Tricyclic; Chemotherapy, Adjuvant; Chronic Disease; Drug Monitoring; Humans; Lidocaine; Neuromuscular Agents; Nursing Assessment; Pain; Pain Measurement; Patient Selection; Receptors, N-Methyl-D-Aspartate; Salicylates; Treatment Outcome

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: Bismuth; Body Water; Breath Tests; Child, Preschool; Chronic Disease; Diagnosis, Differential; Diarrhea, Infantile; Dicyclomine; Dietary Carbohydrates; Fruit; Gastrointestinal Motility; Humans; Infant; Infant, Newborn; Intestinal Diseases, Parasitic; Lactose Intolerance; Loperamide; Malabsorption Syndromes; Myoelectric Complex, Migrating; Organometallic Compounds; Salicylates

Topics: Bismuth; Campylobacter Infections; Chronic Disease; Dose-Response Relationship, Drug; Gastritis; Humans; Organometallic Compounds; Salicylates

The potential for hepatic injury associated with the therapeutic use of salicylates and acetaminophen has recently attracted considerable attention. About 300 cases have been reported in which elevated transaminase levels or other evidence of hepatic injury developed following treatment with salicylates. Review of the spectrum of abnormalities reveals a group of patients (4 percent) with symptomatic liver damage in whom progressive or chronic liver disease is a possibility with continued use of the drug. In a few patients in this group, jaundice developed; several had abnormal prothrombin times; 11 (70 percent) had transaminase values in excess of 500 units; and five patients (30 percent) had encephalopathy and/or Reye's syndrome. In several reports liver damage has also been associated with the use of acetaminophen in therapeutic or near-therapeutic dosages. Of 18 patients, nine appeared to have ingested acetaminophen in amounts approaching overdose. Of the remaining nine patients, six were alcoholics. In the entire group, only five patients did not have a history of alcohol abuse; in three, glutathione depletion was suggested as a possible explanation for hepatotoxicity. The association with alcoholism or glutathione depletion suggests that host susceptibility may play a critical role. In two patients, long-term use of acetaminophen resulted in liver injury suggestive of chronic active hepatitis, possibly on the basis of an idiosyncratic reaction. In a study of chronic liver disease, acetaminophen half-life was prolonged (168 percent) without accumulation at 4 g a day over five days. In a double-blind, two-week, cross-over study, no clinical or laboratory evidence of adverse effects was found. There is, therefore, no evidence that chronic liver disease increases the risk of hepatotoxicity following the administration of acetaminophen in therapeutic doses. Thus, acetaminophen is the preferred antipyretic analgesic in patients with liver disease. Salicylates should be avoided since many of the adverse effects associated with these drugs are similar to the complications of chronic liver disease.

Topics: Acetaminophen; Alcohol Drinking; Animals; Anti-Inflammatory Agents, Non-Steroidal; Chemical and Drug Induced Liver Injury; Chronic Disease; Humans; Liver Diseases; Salicylates

Urticaria represents a wide variety of conditions characterized by urticarial papules, wheals, and angioedema. The number of potential causes of urticaria is legion, but a diligent search by careful history and examination is indicated. Laboratory testing depends upon the specific situation, but routine screening examinations are not cost effective. Histamine from mast cells plays an important role in urticaria. Multiple factors, such as aspirin and other nonsteroidal anti-inflammatory agents, direct histamine-releasing agents (including benzoates), tartrazine and other azo dyes, and perhaps blockers of beta 2-adrenergic activity and H2 receptors, adversely influence histamine release either directly or indirectly. Vasodilation is also detrimental. Treatment of both acute and chronic urticaria necessitates removal of the patient from aggravating factors as well as the cause of the outbreak (if one can be found), along with effective antihistaminic agents and perhaps beta 2-adrenergic agonists. Treatment of specific entities within the urticarial group is briefly outlined in this article.

Topics: Chronic Disease; Coloring Agents; Diet; Histamine Release; Humans; Physical Stimulation; Salicylates; Skin; Sunlight; Temperature; Urticaria; Vasculitis

The pharmacologic properties, clinical efficacy and tolerability of the newer non-steroidal anti-rheumatic drugs are compared. Guidelines for a prescribing policy are given in which a safety-first approach is adopted. Propionic acid derivatives or newer drugs with similar properties are proposed as initial therapy to control symptoms of rheumatoid arthritis or osteoarthrosis. Special problems such as compliance in chronic disease, treatment of ulcer patients with anti-rheumatic drugs, therapy in the elderly, treatment for juvenile rheumatoid arthritis and treatment during pregnancy are considered.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Carbazoles; Chronic Disease; Diclofenac; Diflunisal; Humans; Indomethacin; ortho-Aminobenzoates; Osteoarthritis; Phenylbutazone; Piroxicam; Rheumatic Diseases; Salicylates; Thiazines; Tolmetin

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

Topics: Anti-Inflammatory Agents; Antineoplastic Agents; Arthritis, Rheumatoid; Chronic Disease; Glucocorticoids; Gold; Humans; Immunosuppressive Agents; Indomethacin; Injections, Intra-Arterial; Penicillamine; Pyrazoles; Salicylates

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Analgesics; Anti-Inflammatory Agents; Antimalarials; Arthritis, Rheumatoid; Child; Chronic Disease; Female; Flufenamic Acid; Gold; Humans; Immunosuppressive Agents; Indomethacin; Infant; Long-Term Care; Male; Mefenamic Acid; Middle Aged; Muscles; Oxyphenbutazone; Phenylbutazone; Physical Therapy Modalities; Prednisone; Rehabilitation; Salicylates

Dandruff is a common scalp disorder affecting almost half of the post-pubertal population of any ethnicity and both genders. It is one of the major reasons for patients to consult a dermatologist and it is the cause of significant psychological and social distress.. The aim of this open study was to evaluate the benefit of a 4-week treatment with a shampoo containing 0.1% lipohydroxyacid (LHA) and 1.3% salicylic acid on the scalp condition and on the quality of life of 275 volunteers with seborrheic dermatitis (SD) (n = 226) or light-to-moderate scalp psoriasis (SP) (n = 49).. The clinical benefit of the treatment was assessed by scoring the following parameters, i.e., severity of the dermatosis, scaling, itching, excoriations, and superficial burning sensation. The impact on the quality of life was assessed using the Scalpdex, a questionnaire specially developed by Chen et al. for patients with scalp dermatitis, which includes 23 questions regarding the symptoms, functioning and emotions affected by scalp dermatosis.. The shampoo used in this study was well tolerated. After a 4-week treatment, dermatologists noticed a significant clinical improvement of all the scalp parameters evaluated (i.e., the composite lesional score was improved in 91% and 77% of the patients with SD or SP respectively). The symptoms, functioning and emotions scores of quality of life were also significantly improved in relation to the improvement of scalp condition.. This study not only allowed a better understanding of the SD and SP patient's profile but also demonstrated that the shampoo evaluated is a convenient, efficient, safe, and well-tolerated cosmetic treatment of SD and light-to-moderate SP improving greatly the quality of life of the treated patients.

Topics: Administration, Cutaneous; Adult; Chronic Disease; Dermatitis, Seborrheic; Female; Hair Preparations; Humans; Keratolytic Agents; Male; Middle Aged; Psoriasis; Quality of Life; Salicylates; Scalp Dermatoses; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome

Topics: Actihaemyl; Adult; Anti-Inflammatory Agents, Non-Steroidal; Choline; Chronic Disease; Drug Combinations; Female; Gels; Humans; Male; Middle Aged; Ointments; Recurrence; Remission Induction; Salicylates; Stomatitis, Aphthous; Stomatitis, Herpetic; Time Factors

Many clinical trials have shown the effectiveness of platelet-antiaggregant drugs in the treatment of obliterative peripheral arteriopathy, both locally and in the system, by improving the claudication symptoms and by preventing major cardiovascular events. In this study we evaluated the effectiveness of a 24-week treatment with triflusal, a comparatively new inhibitor of platelet aggregation, in patients affected by chronic peripheral arteriopathy, comparing twice-daily oral doses of 300 mg triflusal with twice-daily placebo doses. The percentages of successes (defined as a 40% increase of total walking distance over the basal control) were 63.6% in the triflusal group (35/55 patients) and 22.5% in the placebo group (14/62 patients). Patients treated with triflusal showed a more important increase in total walking distance and in pain-free walking distance over the basal values than those treated with placebo, together with an improvement of the symptomatology correlated with claudication. Moreover, in the triflusal group there was an increase in the peak-flow recorded through strain-gauge plethysmography. In conclusion, triflusal significantly increased both the distance which could be walked and the clinical symptoms, presumably by improving microperfusion.

Topics: Adult; Aged; Chronic Disease; Double-Blind Method; Female; Humans; Male; Middle Aged; Peripheral Vascular Diseases; Platelet Aggregation Inhibitors; Salicylates

Gastritis caused by Helicobacter pylori (HP) is common in patients with nonulcer dyspepsia (NUD), but an etiologic relationship between the histologic lesion and clinical symptoms is unproven. HP is inhibited by bismuth subsalicylate (BSS), a traditional remedy for dyspeptic complaints. The aim of this study was to assess the short- and long-term effects of BSS on HP, gastritis, and symptoms in patients with NUD. One hundred twenty-six patients with NUD who were shown to be infected with H. pylori (HP+) were enrolled. There was a two-week placebo run-in period to eliminate placebo responders. Fifty patients remained symptomatic and were randomly assigned to therapy with either BSS liquid or a matching placebo. EGD, biopsy, and clinical evaluations were performed at entry, at week 5 (end of therapy), at week 9 (four weeks after therapy), or at time of symptomatic relapse. Twenty-seven patients received placebo and 23 patients received BSS. BSS suppressed H. pylori in 15/23 patients (65%) and eradicated it in one patient, whereas the placebo had no effect on H. pylori. Gastritis improved during therapy with BSS but relapsed by week 9. There was no significant change in level of dyspeptic symptoms during or after treatment, although one month after the end of treatment, the patients in the BSS group consistently had lower symptom scores and fewer symptomatic days for all symptoms measured. The study confirms that BSS given for three weeks suppresses but does not usually eradicate H. pylori. Such short-term suppression of H. pylori heals gastritis but does not result in clinical improvement.

Topics: Adult; Bismuth; Chronic Disease; Double-Blind Method; Dyspepsia; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Leukocyte Count; Organometallic Compounds; Salicylates; Treatment Outcome

Salicylic acid has been widely used in the topical treatment of psoriasis. Chemically it is closely related to paraaminobenzoic acid. Following in vitro studies indicating that salicylic acid might exhibit relevant UVB absorption, we found that salicylic acid had a clinically pronounced filter effect when applied prior to UVB exposure. The duration of photoprotection after application was more than 12 h, sometimes exceeding 24 h. In a prospective, randomized, double-blind, left-right comparison study in patients with psoriasis between emollients with and without salicylic acid, salicylic acid was shown to decrease the clearing rate significantly.

Topics: Administration, Cutaneous; Adult; Aged; Chronic Disease; Double-Blind Method; Emollients; Erythema; Female; Humans; Infant, Newborn; Male; Middle Aged; Prospective Studies; Psoriasis; Salicylates; Salicylic Acid; Ultraviolet Therapy

An open trial with diflunisal (500 mg twice daily) in 766 outpatients consulting their doctor for low back pain, was carried out as part of the project "Back Pain 1981" in Finland. Of the patients (mean age 41 years), 460 had acute lumbago, 144 sciatica and 162 had chronic low back pain as a clinical diagnosis. In each diagnostic group there was a control group of patients receiving no drug therapy. Of the patients 65 percent were men and 35 percent women and the groups did not differ from this distribution in any diagnosis. The efficacy of the treatment was evaluated using four criteria: change of pain at rest and during exercise, patient's evaluation of the efficacy of the treatment, and the need for any supportive treatment. Side-effects of the drug therapy were registered. In all diagnostic groups the relief of pain both at rest and during exercise was greater in patients receiving diflunisal than in the controls. The greatest difference was found in lumbago. The patient's evaluation did not differ between the groups. The drug therapy diminished the need for supportive physical therapy. The frequency of side-effects was 8.6%. They led to the discontinuation of medication in 14 cases (3%). No severe side-effects were found. Diflunisal therapy for the relief of low back pain is therefore considered to be indicated in outpatient care.

Topics: Adolescent; Adult; Aged; Back Pain; Chronic Disease; Clinical Trials as Topic; Diflunisal; Female; Humans; Male; Middle Aged; Salicylates; Sciatica; Sex Factors

Twenty-nine infants and children, age 2-70 months with chronic diarrhea, were admitted to a double-blind, parallel clinical trial. The subjects were randomly assigned to receive either a bismuth subsalicylate liquid or a placebo liquid formulation. Treatment was given for 7 days with dosage varied according to age. Analysis of the results showed that the subjects in the bismuth subsalicylate-treated group gained significantly more weight (p less than 0.05), had significantly fewer (p less than 0.01) and firmer (p less than 0.01) stools with less water content (p less than 0.01) during the course of the study than did the placebo-treated group. Response to treatment, as graded by nursing staff, family, and physicians was moderate to excellent in 86% of the treated group while none of the placebo group received such a rating (p less than 0.01). No differences were noted between stool weights or bile acid excretion.

Topics: Bismuth; Body Weight; Child, Preschool; Chronic Disease; Clinical Trials as Topic; Defecation; Diarrhea, Infantile; Double-Blind Method; Drug Administration Schedule; Female; Humans; Infant; Male; Organometallic Compounds; Prospective Studies; Random Allocation; Salicylates

Topics: Adolescent; Adult; Aged; Anthracenes; Anthralin; Chronic Disease; Clinical Trials as Topic; Coal Tar; Drug Combinations; Female; Humans; Male; Middle Aged; Ointments; Psoriasis; Salicylates; Salicylic Acid; Urea

Benorylate (4-acetamidophenyl 2-acetoxybenzoate) is a new esterified aspirin preparation whose antirheumatic properties are reported to be as good as those of aspirin. Gastrointestinal blood loss, measured with (51)Cr-labelled red cells, during benorylate therapy was compared with that during therapy with soluble aspirin in 15 subjects, a simplified crossover procedure being used. Mean blood loss during benorylate therapy was 1.7 ml/day which was significantly less than that during therapy with soluble aspirin (5.1 ml/day; P <0.001). In 12 of the 15 patients blood loss with benorylate was less than 2.5 ml/day. Benorylate appears to be a definite improvement on current formulations of aspirin and should be a useful drug for the treatment of patients with chronic rheumatic disorders.

Topics: Acetanilides; Acetates; Adult; Aged; Analgesics; Chromium Isotopes; Chronic Disease; Clinical Trials as Topic; Feces; Female; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Occult Blood; Rheumatic Diseases; Salicylates; Solubility

Topics: Acetates; Arthrodermataceae; Bacitracin; Candida; Chronic Disease; Clinical Trials as Topic; Dermatomycoses; Drug Resistance, Microbial; Humans; Manganese; Nails; Neomycin; Phenanthrolines; Polymyxins; Quinolines; Salicylamides; Salicylates; Skin; Skin Diseases, Infectious; Sulfates

Topics: Adult; Arthritis, Rheumatoid; Chronic Disease; Female; Gold; Humans; Indomethacin; Male; Middle Aged; Prednisolone; Salicylamides; Salicylates

Topics: Aged; Antidiarrheals; Bismuth; Chronic Disease; Colitis, Microscopic; Diagnosis, Differential; Diarrhea; Female; Humans; Intestinal Mucosa; Organometallic Compounds; Salicylates

Bismuth subsalicylate (BSS) is the active ingredient in over-the-counter antacid and antidiarrheal medications. Coagulopathy in the setting of acetylsalicylic acid toxicity is well documented but not in setting of bismuth subsalicylate overuse. We present a case report of coagulopathy from BSS poisoning in a patient with underlying cirrhosis. The patient's high prothrombin time suggests inhibition of vitamin K-dependent coagulation factors. The patient had decreased factor V activity, which is responsible for converting prothrombin to thrombin. Patients with cirrhosis often have hypoprothrombinemia which may be exacerbated by salicylate-induced coagulopathy. Given the widespread use of BSS products, physicians should recognize coagulopathy as a possible manifestation of toxicity especially in patients with underlying liver disease.

Topics: Bismuth; Blood Coagulation Disorders; Chronic Disease; Female; Humans; International Normalized Ratio; Liver Cirrhosis; Middle Aged; Organometallic Compounds; Salicylates

Pharmacological salicylates are known to trigger respiratory exacerbations in patients with Non-Steroidal Exacerbated Respiratory Disease (N-ERD), a specific phenotype of Chronic Rhinosinusitis (CRS) and asthma. The impact of dietary sources of salicylates across subgroups of CRS is not well understood. The hypothesis is that in patients with nasal polyps present, there is likely to be a higher incidence of symptom exacerbation due to dietary salicylates regardless of any known response to pharmacological salicylate.. The Chronic Rhinosinusitis Epidemiology Study (CRES) was a questionnaire-based case-control study which sought to characterise the UK CRS population in terms of sociological, economic and medical factors. Using specific questions to examine participant responses relating to symptom exacerbation from food groups thought to be high in salicylate content, this analysis of the CRES database sought to compare an estimate of the prevalence of dietary sensitivity due to food with higher potential salicylate content across patients with CRS with (CRSwNPs) and without nasal polyposis (CRSsNPs) and with allergic fungal rhinosinusitis (AFRS).. The CRSwNPs group were significantly more likely than controls to report symptom exacerbation due to ingestion of food groups with higher potential dietary salicylate content. The same trend was observed amongst CRSsNPs participants to a lesser degree. Reported response to the individual specific food groups wine, nuts, spicy foods, fruit and vegetables demonstrated that a statistically significant proportion of CRSwNPs and AFRS participants reported sensitivity to wine.. This analysis suggests that there is an association between symptom exacerbation in response to food products with higher potential salicylate content, specifically wine, in CRS patients both with and without nasal polyposis when compared to controls, but especially in the CRSwNPs and AFRS phenotypes. Further studies are needed to detail if this relationship represents a causal relationship to dietary salicylate. The data present the possibility that a wider group of CRS patients may elicit salicylate sensitivity than those with known N-ERD.

Topics: Case-Control Studies; Chronic Disease; Diet; Epidemiologic Studies; Humans; Nasal Polyps; Rhinitis; Salicylates; Sinusitis; United Kingdom

Topics: Chronic Disease; Cosmetics; Dermatitis, Allergic Contact; Edema; Erythema; Eyelid Diseases; Facial Dermatoses; Female; Humans; Middle Aged; Pruritus; Salicylates

Chronic salicylate poisoning is often seen in elderly patients as a result of an unintended overdosage, a change in metabolism or kidney function. The symptoms are often unspecific. This case report is about a 55-year-old man who was unconscious when admitted to hospital, and who died three hours after admission. An autopsy and a toxicological test showed a deadly level of salicylate in his blood. Afterwards, his wife told that he had complained about a sudden hearing loss, and that his behaviour had changed prior to his death. It is important to keep this diagnosis in mind when treating especially elderly patients.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Chronic Disease; Fatal Outcome; Humans; Male; Middle Aged; Salicylates

Chronic salicylate poisoning is often seen in elderly patients as a result of an unintended overdosage, a change in metabolism or kidney function. The symptoms are often unspecific. This case report is about a 55-year-old man who was unconscious when admitted to hospital, and who died three hours after admission. An autopsy and a toxicological test showed a deadly level of salicylate in his blood. Afterwards, his wife told that he had complained about a sudden hearing loss, and that his behaviour had changed prior to his death. It is important to keep this diagnosis in mind when treating especially elderly patients.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Chronic Disease; Fatal Outcome; Humans; Male; Middle Aged; Salicylates

We determined the in vitro susceptibility of clinical isolates of Helicobacter pylori to ZnCl, compared its sensitivity to bismuth subsalicylate (BSS) and clarithromycin (CLR) that are used for the treatment of H. pylori infection and its activity at different gastric pH. One hundred sixteen clinical isolates of H. pylori strains were chosen. Agar gel dilution method was used to determine the susceptibility of H. pylori isolates to ZnCl 40 μg/ml, BSS 20 μg/ml, and CLR 2 μg/ml. Suspension of 10(9) bacteria/μl was streaked on the blood agar plate. The control consisted of H. pylori incubated without ZnCl, BSS, and CLR. One hundred ten H. pylori strains (95%) were susceptible to ZnCl 40 μg/ml compared to 114 (98%) to BSS 20 μg/ml (p=0.002) and 92 (79%) to CLR 2 μg/ml (p=0.602). H. pylori isolates from patients with nonulcer dyspepsia and from peptic ulcer were equally susceptible to ZnCl 40 μg/ml (90/96 vs. 26/26, p=0.208). H. pylori associated with chronic gastritis and chronic active gastritis were equally susceptible to ZnCl. H. pylori demonstrated susceptibility to ZnCl in vitro. H. pylori susceptibility to ZnCl 40 μg/ml was greater than BSS and comparable to CLR. ZnCl may be used in the treatment of H. pylori infection.

Topics: Adult; Aged; Anti-Bacterial Agents; Bismuth; Chlorides; Chronic Disease; Clarithromycin; Drug Resistance, Bacterial; Dyspepsia; Female; Gastric Juice; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Hydrogen-Ion Concentration; Male; Microbial Sensitivity Tests; Middle Aged; Organometallic Compounds; Peptic Ulcer; Salicylates; Zinc Compounds

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

Aspirin (acetylsalicylate) is an inexpensive drug that is used extensively to reduce cardiovascular disease risk. Emerging evidence suggests that aspirin reduces the risk of other chronic diseases such as certain forms of cancer. Salicylate may contribute to the disease reduction effects. It is present naturally in fruits and vegetables and individuals with a low intake of these foods may be 'salicylate deficient'. This deleterious state may constitute a significant public health threat. Interventions to prevent deficiency, such as low-dose aspirin programmes, could have substantial beneficial health impacts around the world.

Topics: Alzheimer Disease; Aspirin; Cardiovascular Diseases; Chronic Disease; Fruit; Humans; Neoplasms; Public Health; Salicylates; Vegetables

Topics: Age Factors; Aged; Anti-Inflammatory Agents, Non-Steroidal; Choline; Chronic Disease; Humans; Pain; Salicylates; Time Factors

Helicobacter pylori (H. pylori) infection has been linked to gastric cancer. The factors that promote carcinogenesis remain unknown. Epidermal growth factor (EGF) has been shown to be a potent epithelial mitogen and oncoprotein when sustained over expression occurs. Our aim was to compare gastric mucosal levels of EGF and its receptor (EGFR) among controls, H. pylori infected subjects, and subjects following H. pylori eradication using quantitative flow cytometric analysis.. Patients referred for evaluation of dyspepsia underwent EGD and six antral biopsies were performed (two each for rapid urease testing (RUT), histopathology, and flow cytometry). Controls were those found to be H. pylori negative while subjects had confirmed infection. The study patients were treated, then had repeat EGD with biopsies.. There were 17 controls and 28 cases. Mean EGF and EGFR values were 2.69 and 2.46 for controls and 4.67 and 4.64 for subjects. Subjects' mean EGF was 73% higher (p = .035) and EGFR was 88% higher (p = 0.029) than controls. After treatment, the subjects' mean values declined 55% (p = 0.0001) for EGF and 40% (p = 0.002) for EGFR. Three subjects had persistent infection and showed no change in their EGF/EGFR levels. No difference was found among factor levels with respect to endoscopic findings.. Both EGF and EGFR from gastric antral biopsies are increased nearly 2-fold in infection with H. pylori. Infection eradication reduces levels of both factors to those of controls. One major pathogenic mechanism for gastric mucosal hyperproliferation and possibly carcinogenesis related to H. pylori may be the over expression of EGF and increased receptor density of EGFR on gastric mucosal cells.

Topics: Adult; Antacids; Anti-Bacterial Agents; Anti-Ulcer Agents; Biopsy; Bismuth; Chronic Disease; Drug Therapy, Combination; Epidermal Growth Factor; ErbB Receptors; Female; Flow Cytometry; Gastric Mucosa; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Omeprazole; Organometallic Compounds; Prospective Studies; Salicylates

Microscopic colitis is a syndrome consisting of chronic watery diarrhea, a normal or near-normal gross appearance of the colonic lining, and a specific histological picture described as either lymphocytic colitis or collagenous colitis. Since its initial descriptions a quarter of a century ago, microscopic colitis has become a frequent diagnosis in patients with chronic diarrhea. Understanding of the cause and pathogenesis of microscopic colitis remain incomplete, but potentially important clues have been discovered that shed light on predisposing factors. In particular, specific HLA-DQ genotypes may be permissive for the development of microscopic colitis, and suggest a linkage to the pathogenesis of celiac sprue. Although the differential diagnosis of chronic watery diarrhea is broad, the diagnosis of microscopic colitis is straightforward, involving endoscopic inspection of the colonic mucosa and proper pathologic interpretation of biopsy specimens. As the limitations of drugs ordinarily used for other forms of inflammatory bowel disease are being recognized, new approaches, such as the use of bismuth subsalicylate, are being evaluated. The prognosis of patients with microscopic colitis syndrome remains good, and symptomatic improvement can be expected in most patients.

Topics: Adult; Bismuth; Chronic Disease; Colitis; Colonoscopy; Diagnosis, Differential; Diarrhea; Female; Humans; Inflammatory Bowel Diseases; Intestinal Mucosa; Organometallic Compounds; Pancreatic Neoplasms; Prognosis; Salicylates; Vipoma

Teeth with induced chronic periradicular periodontitis in dogs were root canal treated. After the biomechanical preparation, using K files and 5.25% sodium hypochlorite as the irrigant solution, all root canals were dressed with an antibacterial dressing based on calcium hydroxide, which was left in place for 7 days. After this time, the root canals were obturated with lateral condensation of cold gutta-percha with either a calcium hydroxide root canal filling material (Sealapex) or a zinc oxide-eugenol sealer (Fill Canal). After 270 days, histopathological analysis showed better apical and periapical repair in the teeth obturated with Sealapex (P < 0.05).

Topics: Animals; Barium Sulfate; Bismuth; Borates; Calcium Hydroxide; Chronic Disease; Dogs; Drug Combinations; Eugenol; Periapical Periodontitis; Resins, Synthetic; Root Canal Filling Materials; Salicylates; Zinc Oxide

Systemic inflammatory response syndrome (SIRS) is characterized by body temperature abnormalities, tachypnea or hyperventilation, tachycardia, and leukocytosis or leukopenia. Although it is typically associated with a serious infection and referred to as sepsis, SIRS can stem from noninfectious causes, as well. We report the cases of four patients with toxic serum levels of salicylate (33.5 to 67.6 mg/dL) and SIRS, and we discuss mechanisms responsible for SIRS. Our patients showed temperature disturbances (35.5 degrees C to 39.8 degrees C), noncardiogenic pulmonary edema, and mixed acid base disturbances. Other abnormalities included coagulopathy (disseminated intravascular coagulation), encephalopathy, and hypotension. All four patients recovered from SIRS, probably due to early recognition and treatment; only one patient did not survive the hospitalization. Chronic salicylate toxicity should be considered as a cause of SIRS in the absence of a source of infection, since survival appears to be dependent on prompt diagnosis and management.

Topics: Acid-Base Imbalance; Adult; Anti-Arrhythmia Agents; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Chronic Disease; Disseminated Intravascular Coagulation; Female; Fever; Humans; Hypotension; Male; Middle Aged; Pulmonary Edema; Salicylates; Salicylic Acid; Systemic Inflammatory Response Syndrome

Physicians should question their elderly patients and those who know their life-styles and habits best (ie, family, friends, caretakers) regarding use of over-the-counter medications. Salicylates are commonly used by the elderly, and long-term unsupervised use may lead to salicylate toxicity that can cause delirium. In the southern United States, BC and Goody's Headache Powders are widely marketed and used, and their overuse can produce salicylate intoxication.

Topics: Aged; Aged, 80 and over; Chronic Disease; Delirium; Female; Humans; Middle Aged; Nonprescription Drugs; Salicylates

The interactions of selezen (imidazole salicylate) with human blood components were studied by equilibrium dialysis. These interactions were limited to the binding of salicylate to human serum albumin (HSA). The binding was saturable and involved several classes of binding sites with different association constants. A competition study indicated that salicylic acid at high concentration was able to displace warfarin and digitoxin but not glibenclamide from their HSA sites. On the other hand, selezen serum binding was decreased in renal impaired patients and this result was probably linked to the decreases in HSA concentration. So the use of small dosage regimens of selezen to these patients can be proposed. The same recommendation may be done for cirrhotic patients, where the decrease of selezen binding percentage was observed and due to both hypoalbuminemia and hyperbilirubinemia.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Blood Proteins; Chronic Disease; Dialysis; Erythrocytes; Humans; Imidazoles; Kidney Failure, Chronic; Liver Diseases; Salicylates; Salicylic Acid

We report two cases of patients with 3-yr histories of upper gastrointestinal symptoms, hyperplastic gastric polyps, and active chronic gastritis. Biopsies retrospectively stained with Giemsa revealed the persistent presence of Helicobacter pylori (HP) in gastric biopsies of both patients throughout the 3 yr. After treatment with amoxicillin and bismuth subsalicylate, both became asymptomatic, one demonstrating disappearance and recurrence of the gastric polyps in conjunction with the HP. These cases demonstrate 3 yr of hyperplastic gastric polyps associated with HP and active gastritis.

Topics: Aged; Amoxicillin; Bismuth; Campylobacter Infections; Chronic Disease; Female; Gastritis; Helicobacter pylori; Humans; Hyperplasia; Middle Aged; Neoplasm Recurrence, Local; Organometallic Compounds; Polyps; Salicylates; Stomach; Stomach Neoplasms

Topics: Adolescent; Amoxicillin; Bismuth; Campylobacter Infections; Child; Child, Preschool; Chronic Disease; Gastritis; Humans; Infant; Organometallic Compounds; Salicylates

Copper (II)2(3,5-Diisopropylsalicylate)4(H2O)2 has been found to have antiinflammatory, antiulcer, anticonvulsant, anticancer, anticarcinogenic, antimutagenic, and radiation recovery activities and it prevents reperfusion injury. To study pharmacokinetic parameters accounting for these pharmacological effects the double labeled 67Cu(II)2(carboxy-14C-3,5-diisopropylsalicylate)4 complex was synthesized and used to obtain these parameters. Treatment of mice with 1 mumol of this complex revealed that 67Cu was distributed to blood, liver, kidney, intestine, lung, thymus, femur, muscle, spleen, brain, urine, and feces within 0.5 hr and patterned changes in 67Cu content of these tissues and excreta were found throughout the 96 hr term of this study.

Topics: Animals; Biological Availability; Chemical Phenomena; Chemistry; Chronic Disease; Copper; Mice; Organ Specificity; Salicylates

We reviewed the clinical profile of adults with chronic salicylate intoxication by evaluating the experience of our community teaching hospital between 1977 and 1987. Data on similar patients reported was obtained from an English-language literature search using MEDLINE (1966-88) and bibliographic reviews of textbooks and review articles. We also examined the impact of education and incentive on increasing the awareness and ability of physicians to diagnose the disorder. Chronic salicylate intoxication was defined by 1) a compatible clinical syndrome; 2) a serum level in the toxic range; and 3) improvement with withdrawal of the drug. Patients with chronic salicylism represent a cross-section of an elderly population. Our review suggests that diminished body mass, concurrent administration of drugs and conditions which exacerbate renal insufficiency may predispose to salicylate intoxication; however, few specific precipitants of chronic salicylism were recognized. Salicylate intoxication should be considered in all elderly patients with delirium and/or dementia.

Topics: Activities of Daily Living; Aged; Aged, 80 and over; Chronic Disease; Confusion; Creatinine; Female; Humans; Male; Middle Aged; Salicylates

37 patients with epigastric pain and chronic erosive gastritis underwent an open controlled therapeutic trial with bismuthsubsalicylate (BS). Group A (21 patients) was treated with BS, liquid, 4 X 314 mg for three weeks, group B (16 patients) with BS tablets, 3 X 300 mg for two weeks. A significant reduction of symptoms (p less than 0.001) and endoscopically assessed chronic erosions (p less than 0.001) was achieved in both groups. Campylobacter pylori was detected in 89% of the patients before treatment, but was absent in 78% of the patients after treatment. The histological grading of antral mucosa showed a significant reduction (p less than 0.001) of polymorphonuclear cell (PML) infiltration after two and three weeks treatment respectively. While in group A PML cells had disappeared from gastric mucosa in all but two patients, in group B 50% of the patients had some degree of PML cell infiltration left in the antral mucosa. This study confirms the beneficial effect of BS in the treatment of C. pylori associated active chronic gastritis and reemphasizes the pathogenetic role of C. pylori in this disease.

Topics: Adult; Bismuth; Campylobacter; Chronic Disease; Female; Gastritis; Gastroscopy; Humans; Male; Middle Aged; Organometallic Compounds; Pyloric Antrum; Salicylates; Stomach

In a prospective open study 21 patients with upper abdominal complaints and chronic active gastritis as well as endoscopically proven erosions were treated with bismuth subsalicylate (4 X 30 ml/day, corresponding to 4 X 314 mg Bi3+) for three weeks. In 20 patients (95%) Campylobacter pylori (CP) was found in at least two of three examinations (culture, CLO quick-test, special histology). After the treatment 17 of 21 patients (81%) were CP negative, and the clinical symptoms had gradually disappeared. The histologically demonstrated degree of activity had regressed significantly after the three-week treatment; in 90% of patients the inflammatory process had completely abated. These results demonstrate that bismuth subsalicylate is highly effective in the acute treatment of CP-associated chronic erosive gastritis.

Topics: Adult; Aged; Biopsy; Bismuth; Campylobacter; Campylobacter Infections; Chronic Disease; Drug Evaluation; Female; Gastric Mucosa; Gastritis; Gastroscopy; Humans; Male; Microscopy, Electron; Microscopy, Electron, Scanning; Middle Aged; Organometallic Compounds; Salicylates

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Chronic Disease; Humans; Imidazoles; Male; Pipemidic Acid; Prostatitis; Random Allocation; Salicylates; Suppositories

Colloidal bismuth subcitrate (CBS) precipitates in an acid environment, adheres to mucus, blocks pepsin activity, retards hydrogen-ion back diffusion and stimulates prostaglandin synthesis. The average healing rate after 4 weeks' treatment with CBS is 78% in duodenal ulcer versus 67% with cimetidine. A direct comparison with ranitidine gives healing rates of 78% (CBS) as opposed to 78% with ranitidine. The corresponding figures in gastric ulcer are 68% (CBS) and 54% (cimetidine). The percentage of relapse-free patients is substantially higher after CBS ulcer healing than after H2-blockers. Bismuth subsalicylate eliminates Campylobacter pylori in 71% after 4-weeks' therapy. Parallel to this elimination a decrease and normalization of the acute inflammatory process can be seen in antral mucosa.

Topics: Anti-Ulcer Agents; Bismuth; Campylobacter Infections; Chronic Disease; Duodenal Ulcer; Gastritis; Humans; Organometallic Compounds; Peptic Ulcer; Salicylates; Stomach Ulcer

Topics: Chronic Disease; Food Additives; Humans; Salicylates; Sulfites; Tartrazine; Urticaria

The effect of ultraviolet-A (UV-A) irradiation in combination with 'short contact' dithranol treatment was studied in ten patients with chronic plaque psoriasis. Increasing concentrations of dithranol were applied daily to the psoriatic plaques on both sides of the body. One side was irradiated with UV-A daily. There was no difference in the rate of clearance between the two sides. The effectiveness of 'short contact' dithranol was confirmed.

Topics: Adolescent; Adult; Anthracenes; Anthralin; Chronic Disease; Drug Administration Schedule; Drug Combinations; Female; Humans; Male; Middle Aged; Psoriasis; Salicylates; Ultraviolet Therapy

Topics: Amino Acids; Child, Preschool; Chronic Disease; Diagnosis, Differential; Fatty Liver; Humans; Male; Microscopy, Electron; Mitochondria, Liver; Reye Syndrome; Salicylates

Topics: Ankle Joint; Arthritis, Rheumatoid; Cartilage Diseases; Cartilage, Articular; Chronic Disease; Foot Deformities, Acquired; Hallux Valgus; Humans; Joint Dislocations; Metatarsophalangeal Joint; Orthotic Devices; Physical Exertion; Salicylates; Shoes; Toes

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

As the problem of chronic urticaria is frustrating both to the physician and patient, an attempt to study its aetiology was made. 100 cases of chronic urticaria was studied in 1979. Patients having daily urticaria for more than 6 weeks, were included. There were 52 males and 48 females. A detailed history of the pattern of urticaria, drugs, physical causes, diet and illnesses were asked for, followed by physical examination. Each were then screened through a Diagnostic Tray including basic haematological tests, urinalysis, stools analysis, physical allergy tests, food provocation battery and further special tests. 17 patients had physical urticaria, cold (6), pressure (5), delayed dermographism (1), cholinergic (4), solar (1). 4 patients had severe reactions with aspirin, one with tetracycline; one had undiagnosed thyrotoxicosis. 36 of all the patients had a positive test on provocation with the food battery: aspirin (13), preservatives (3), colour dyes (6), yeast (1) and others (15). It has been suggested that these are not the immediate cause but are aggravating factors. 48% of patients showed dermographism. The number of idiopathic cases about 77% is consistent with the findings of others. We feel that an attempt to exclude treatable causes has brought reassurance to many of the patients. Long term antihistamine therapy was given in these cases.

Topics: Adolescent; Adult; Candidiasis; Child, Preschool; Chronic Disease; Coloring Agents; Drug Hypersensitivity; Female; Food Additives; Food Hypersensitivity; Humans; Infections; Male; Physical Stimulation; Salicylates; Time Factors; Urticaria

Salicylate (SA) binding to albumin in purified human serum albumin (HSA) solutions was found to be predictably dependent on the concentrations of albumin and total SA. The influence of the presence of other ligands on SA binding in HSA solutions was measured and, in the case of bound fatty acids, free fractions of SA were increased by up to 100%. In sharp contrast, the free fraction of SA present in sera from patients with arthritis who were on long-term aspirin (ASA) therapy was roughly twice that found in HSA solutions. A correlation between serum concentrations of free SA and albumin was evident in sera from one group of children with juvenile rheumatoid arthritis (r = -0.75) but was not seen in sera from the other patients. This would indicate that in vivo, the albumin level is not the sole, or, in some patients, even the dominant determinant of the free fraction of SA. Additional factors such as fatty acids and other hydrophobic ligands, both endogenous and exogenous, should be studied further, especially in adults.

Topics: Adult; Arthritis; Arthritis, Juvenile; Child; Chronic Disease; Fatty Acids; Humans; Protein Binding; Salicylates; Serum Albumin

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

The role played by dietary chemical factors in the pathogenesis of chronic idiopathic urticaria (CIU) was assessed in seventy-six patients by challenge Stable remission was first established by using an empirically established 'exclusion diet'. A diet modified to exclude those chemicals giving a positive response to challlenge was demonstrated to be of therapeutic value for time periods of up to 18 months. Re-testing twelve patients at 12 months indicated that most patients positive to salicylate or benzoate challenge retained this pattern of reactivity.

Topics: Adolescent; Adult; Aged; Benzoates; Child; Chronic Disease; Female; Humans; Male; Middle Aged; Penicillins; Remission, Spontaneous; Salicylates; Tartrazine; Urticaria; Yeast, Dried

An open study was carried out in general practice to assess the analgesic effectiveness, tolerance and side-effects of salsalate when given at a dosage of 3 g per day for 6 weeks. Sixty-six patients who were known long-term analgesic users were treated: they included 16 with active inflammatory disease of rheumatoid type, 20 with degenerative joint disease, and 27 with other musculo-skeletal conditions. Three patients were withdrawn during the study because of gastro-intestinal upset. Assessments, using rating scale scores, were made pre-trial and at 2-weekly intervals of joint pain, other musculo-skeletal pain, and duration of morning stiffness. The results showed that there was marked improvement in joint pain and morning stiffness, particularly in those patients with inflammatory joint disease. Improvement in musculo-skeletal discomfort was less evident. Side-effects were reported on 24 occasions, the most frequent being dyspepsia. Faecal occult blood tests showed that there were 7 patients with probable blood loss during treatment, 4 of them, however, had no other clinical signs or symptoms of gastrointestinal intolerance.

Topics: Bone Diseases; Chronic Disease; Female; Humans; Male; Middle Aged; Muscular Diseases; Occult Blood; Pain; Salicylates

Exclusion diets may have a practical place in determining the precipitating dietary factors in certain clinical conditions. We present an exclusion diet which is based on the exclusion of food commonly known to cause food allergies, and the exclusion of food which contains salicylates, benzoates, tartrazine, yeast, and penicillin. This provided a basis for challenge with these additives and natural chemicals. Preliminary information in urticaria suggests a use for this diet in some allergic conditions.

Topics: Australia; Benzoates; Chronic Disease; Diet; Humans; Salicylates; Tartrazine; Urticaria

A multicentric follow-up study was conducted in general practice to assess disease characteristics which determine analgesic needs in non-articular rheumatism. Of 127 patients studied, those with chronic conditions such as brachial fibrositis and tennis elbow with a history extending over more than a month tended to require a longer course of treatment than those whose symptoms related to muscles of the trunk and spine. For most patients a one or two week course of Benoral tablets proved adequate in length and efficacy.

Topics: Adult; Chronic Disease; Drug Administration Schedule; Female; Fibromyalgia; Follow-Up Studies; Humans; Male; Middle Aged; Pain; Salicylates

The plasma protein binding of a representative acidic drug, salicylate, and a representative basic drug, quinidine, has been studied in patients with several diseases that are sometimes associated with uraemia or a change in serum albumin level. Decreased plasma protein binding of salicylate was observed in plasma from patients with uraemia and liver disease. Low albumin levels in these patients could only account inpart for the decreased binding. On the other hand, salicylate binding to plasma proteins appeared to be increased in patients with hypoxia. Decreased plasma protein binding of quinidine was observed in some patients with uraemia and in the majority of patients with liver disease.

Topics: Adult; Aged; Blood Proteins; Chronic Disease; Humans; Kidney Failure, Chronic; Liver Diseases; Middle Aged; Protein Binding; Quinidine; Respiratory Insufficiency; Salicylates

The binding of 3 drugs to serum proteins of patients with chronic hepatic disease has been studied by an ultrafilitration technique, and compared to that of normal subjects. The binding of phenylbutazone was reduced in all patients, salicylate in patients with inactive liver disease and sulphadiazine in patients whose disease was active. Analysis of binding data showed a real reduction in the capacity of albumin to bind the drugs in the majority of patients. Addition of bilirubin to normal plasma caused a reduction in sulphadiazine binding, but had no effect on the binding of salicylate or phenylbutazone. The possible causes of this reduction in binding are discussed.

Topics: Adult; Aged; Bilirubin; Blood Proteins; Chronic Disease; Female; Humans; Liver Diseases; Male; Middle Aged; Pharmaceutical Preparations; Phenylbutazone; Protein Binding; Salicylates; Serum Albumin; Sulfadiazine

Topics: Allergens; Antigens, Fungal; Candida; Chronic Disease; Humans; Salicylates; Urticaria

Six patients, not previously treated, with classical seropositive rheumatoid arthritis and highly active synovitis of one or both knee joints were treated with 4 g of 40% benorylate suspension twice daily for a period of 9--14 days prior to synovectomy. Blood samples were taken at scheduled times during administration of the drug. At operation, synovial fluid and tissue samples were taken and their salicylate, paracetamol and benorylate content measured. Plasma levels of salicylate and paracetamol were, in general, significantly higher than the concentration of these metabolites in the synovial fluid. Benorylate was found in the synovial tissues concentrated especially in the highly inflamed synovial villi. It is probable that benorylate and its metabolites penetrate the synovia but further studies are needed to determine if the metabolites are concentrated in the different synovial cell layers in the same way as benorylate itself. It is possible that part of the clinical effect of benorylate is due to its presence in the synovial tissue and that it has a direct effect in vivo on the synovial membrane. It is also possible that the pharmacokinetic properties of benorylate permit it to enter cell layers inaccessible to its metabolites.

Topics: Acetaminophen; Arthritis, Rheumatoid; Chronic Disease; Humans; Salicylates; Synovectomy; Synovial Fluid; Synovial Membrane

Twenty patients with definite or classical rheumatoid arthritis and chronic knee effusions were each given an oral dose of 4 g benorylate as the 40% suspension. Synovial fluid and plasma samples were obtained up to 9 hours after drug administration and assayed for their salicylate and benorylate content. A mean peak benorylate plasma level of 2.18 +/- 0.19 mug/ml occurred 30 min after drug administration but declined rapidly and benorylate was virtually undetectable in the plasma 90 min later. The mean peak benorylate synovial fluid level of 0.74 +/- 0.21 mug/ml occurred 3 hours after drug administration but the concentration remained steady for at least a further 9 hours. A mean peak plasma salicylate level of 119 +/- 14.2 mug/ml and mean peak synovial fluid salicylate level of 78 +/- 13.6 mug/ml occurred 3 hours after benorylate administration. Both levels declined slowly over some hours. This study shows that benorylate per se readily enters the synovial fluid in patients with rheumatoid arthritis and continues to accumulate there even when undetectable in the plasma. It is possible that the lipophilic nature of the benorylate molecule facilitates its uptake by the inflamed synovial tissue.

Topics: Arthritis, Rheumatoid; Chronic Disease; Humans; Salicylates; Synovial Fluid

The uncontrolled, long-term (18 months), widespread (almost 3/4 total body skin surface), application of a concentrated (10%) salicylic acid ointment in a 62 year old psoriatic female led to chronic percutaneous salicylism. Salicylic acid levels in the urine (200 mg %) and serum (223 mg %), the highest values ever recorded in this type of intoxication, contrasted with the discrete clinical picture. The acute and chronic percutaneous salicylism is discussed with a review of the literature. It is warned against the uncontrolled use of topicals containing salicylic acid.

Topics: Administration, Topical; Chronic Disease; Female; Half-Life; Humans; Kinetics; Middle Aged; Ointments; Psoriasis; Salicylates; Self Medication

Topics: Adult; Aged; Allergens; Animals; Antibodies; Antigens; Aspirin; Asthma; Chronic Disease; Drug Hypersensitivity; Female; Humans; Immune Sera; Immunization, Passive; Immunodiffusion; Immunoglobulins; Macaca mulatta; Male; Middle Aged; Radioimmunoassay; Salicylates; Skin Tests

Topics: Administration, Topical; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Chronic Disease; Deodorants; Drug Combinations; Hexachlorophene; Humans; Inflammation; Mouth Mucosa; Postoperative Complications; Propylene Glycols; Salicylates; Samarium

Topics: Adolescent; Anemia; Arthritis, Juvenile; Body Height; Child; Child, Preschool; Chronic Disease; Drug Therapy, Combination; Elasticity; Female; Fever; Growth; Humans; Male; Pain; Prednisone; Salicylates; Sex Characteristics; Stress, Mechanical

Topics: Betamethasone; Chronic Disease; Humans; Lupus Erythematosus, Systemic; Male; Middle Aged; Ointments; Salicylates

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Juvenile; Child; Chronic Disease; Humans; Salicylates; Uveitis, Anterior

Topics: Adrenal Cortex Hormones; Adult; Arthritis; Cartilage, Articular; Chondrocalcinosis; Chronic Disease; Diagnosis, Differential; Female; Gout; Humans; Knee; Male; Middle Aged; Phenylbutazone; Prognosis; Pubic Symphysis; Radiography; Salicylates; Synovial Fluid; Synovial Membrane; Synovitis; Wrist

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Behcet Syndrome; Chronic Disease; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Lupus Erythematosus, Systemic; Male; Middle Aged; Recurrence; Salicylates; Thromboangiitis Obliterans; Thrombophlebitis

Topics: Adrenal Cortex Hormones; Chronic Disease; Humans; Indomethacin; Osteoarthritis; Phenylbutazone; Salicylates; Spondylitis, Ankylosing

Topics: Administration, Topical; Chronic Disease; Dermatologic Agents; Drug Combinations; Female; Humans; Hydrocortisone; Male; Ointments; Petrolatum; Psoriasis; Salicylates; Time Factors

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: Acetanilides; Analgesics; Arthritis, Rheumatoid; Blood Sedimentation; Chronic Disease; Edema; Female; Finger Joint; Fingers; Humans; Male; Middle Aged; Muscle Contraction; Nausea; Pain; Physical Exertion; Salicylates; Suspensions

Topics: Agglutination Tests; Anemia, Hypochromic; Antibodies; Antifungal Agents; Antigens; Candidiasis, Cutaneous; Candidiasis, Oral; Child; Child, Preschool; Chronic Disease; Female; Humans; Hypersensitivity, Delayed; Imidazoles; Iron; Male; Nutrition Disorders; Ointments; Pyridoxine; Salicylates; Trityl Compounds; Vitamin A

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

Topics: Alkylating Agents; Analgesics; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antimalarials; Antimetabolites; Arthritis, Rheumatoid; Chronic Disease; Enzymes; Glucocorticoids; Gold; Humans; Immunosuppressive Agents; Indoles; Mefenamic Acid; Physical Therapy Modalities; Pyrazoles; Salicylates

Topics: Adrenal Cortex Hormones; Adult; Antineoplastic Agents; Arthritis, Juvenile; Chronic Disease; Female; Gold; Humans; Prognosis; Salicylates

Topics: Adrenal Cortex Hormones; Anti-Inflammatory Agents; Antimalarials; Arthritis, Juvenile; Child; Child, Preschool; Chronic Disease; Gold; Humans; Immunosuppressive Agents; Indomethacin; Salicylates

Topics: Adult; Aged; Chronic Disease; Dermatitis, Atopic; Dermatitis, Contact; Drug Synergism; Eczema; Female; Flumethasone; Fluorine; Glucocorticoids; Humans; Lupus Erythematosus, Discoid; Male; Middle Aged; Ointments; Pregnanes; Psoriasis; Salicylates

Topics: Adrenal Cortex Hormones; Age Factors; Aged; Arthritis, Rheumatoid; Chronic Disease; Female; Gold; Hospitalization; Humans; Indomethacin; Male; Middle Aged; Rest; Salicylates

Topics: Adult; Arthritis; Arthritis, Rheumatoid; Chronic Disease; Exudates and Transudates; Female; Humans; Male; Salicylates; Synovial Fluid

Topics: Arthritis, Rheumatoid; Chronic Disease; Cortisone; Flufenamic Acid; Gold; Humans; Indoles; Mefenamic Acid; Physical Therapy Modalities; Salicylates

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: Adrenal Cortex Hormones; Antimalarials; Antineoplastic Agents; Arthritis, Rheumatoid; Aspirin; Chronic Disease; Gold Colloid, Radioactive; Humans; Immunosuppressive Agents; Indomethacin; Pyrazoles; Rheumatic Diseases; Salicylates; Ultrasonic Therapy

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

Topics: Chronic Disease; Diverticulum; Gastrointestinal Hemorrhage; Gastrointestinal Neoplasms; Genetic Diseases, Inborn; Hematologic Diseases; Hernia, Diaphragmatic; Hookworm Infections; Humans; Hysteria; Occult Blood; Salicylates

Topics: Adrenal Cortex Hormones; Arthritis, Rheumatoid; Chronic Disease; Gold; Humans; Indomethacin; Salicylates

Topics: Adolescent; Adult; Child; Chronic Disease; Female; Griseofulvin; Hair Removal; Humans; Middle Aged; Ointments; Salicylates; Sulfur; Tinea Capitis

Topics: Arthritis, Juvenile; Chronic Disease; Humans; Methods; Physical Therapy Modalities; Prognosis; Salicylates

Topics: Arthritis, Juvenile; Child; Child, Preschool; Chronic Disease; Female; Glucocorticoids; Humans; Hydroxychloroquine; Indomethacin; Male; Phenylbutazone; Salicylates; Synovitis

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Autoantibodies; Chloramphenicol; Chronic Disease; Eczema; Humans; Immunotherapy; Ointments; Oxytetracycline; Penicillin Resistance; Penicillins; Salicylates; Skin Diseases, Infectious; Staphylococcal Infections; Streptomycin; Tars; Zinc

Topics: Adrenal Cortex Hormones; Ambulatory Care; Arthritis, Rheumatoid; Chloroquine; Chronic Disease; Family Practice; Gold; Gout; Humans; Mineral Waters; Physical Therapy Modalities; Prednisone; Rheumatic Diseases; Salicylates; Spondylitis, Ankylosing

Topics: Chronic Disease; Hashimoto Disease; Humans; Salicylates; Sodium Salicylate; Thyroiditis

Topics: Chronic Disease; Cortisone; Myocarditis; Recurrence; Rheumatic Heart Disease; Salicylates

Topics: Acid-Base Equilibrium; Blood; Carbon Dioxide; Chronic Disease; Emphysema; Humans; Hypoxia; Pulmonary Emphysema; Salicylates

Topics: Arthritis, Gouty; Blood; Chronic Disease; Gout; Humans; Probenecid; Salicylates; Sodium Salicylate; Uric Acid

Topics: Chronic Disease; Colitis; Humans; Salicylates; Salicylic Acid

Topics: Chronic Disease; Colitis; Colitis, Ulcerative; Humans; Salicylates