salicylates and Postoperative-Complications

Diarrhea is a common clinical feature of inflammatory bowel diseases and may be accompanied by abdominal pain, urgency, and fecal incontinence. The pathophysiology of diarrhea in these diseases is complex, but defective absorption of salt and water by the inflamed bowel is the most important mechanism involved. In addition to inflammation secondary to the disease, diarrhea may arise from a variety of other conditions. It is important to differentiate the pathophysiologic mechanisms involved in the diarrhea in the individual patient to provide the appropriate therapy. This article reviews microscopic colitis, ulcerative colitis, and Crohn's disease, focusing on diarrhea.

Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Antidiarrheals; Bacterial Infections; Biopsy; Bismuth; Blood Cell Count; Blood Chemical Analysis; Body Water; Breath Tests; Budesonide; Cholestyramine Resin; Colitis, Microscopic; Diarrhea; Drug-Related Side Effects and Adverse Reactions; Endoscopy, Gastrointestinal; Feces; Glucocorticoids; Humans; Immunosuppressive Agents; Inflammatory Bowel Diseases; Intestinal Absorption; Intestinal Fistula; Intestinal Mucosa; Intestines; Ion Transport; Malabsorption Syndromes; Medical History Taking; Mesalamine; Organometallic Compounds; Physical Examination; Postoperative Complications; Prednisolone; Salicylates; Sodium; Tumor Necrosis Factor-alpha

Triflusal is an antiplatelet agent structurally related to the salicylate group of compounds, but it is not derived from aspirin (acetylsalicylic acid). Platelet antiaggregant properties of triflusal and its active 3-hydroxy-4-trifluoro-methylbenzoic acid metabolite are primarily mediated by specific inhibition of platelet arachidonic acid metabolism. Triflusal, compared with placebo for 6 months, significantly reduced the incidence of nonfatal myocardial infarction in patients with unstable angina. In patients with peripheral arteriopathy, total and pain free walking distances were markedly improved in triflusal compared with placebo recipients. The cumulative event rate for stroke, ischemic cardiopathy and vascular death was lower, but not significantly different, in patients with atherothrombotic stroke who received triflusal than in aspirin recipients. Differences were significant, and favoured triflusal, in a subgroup of patients with > 70% carotid stenosis. Prophylaxis with triflusal for 6 months after aortocoronary vein grafting reduced the number of new distal anastomosis occlusions and the graft attrition rate more than aspirin or placebo. The incidence of deep vein thrombosis or pulmonary embolism in more than 500 patients undergoing hip surgery was similar for these 3 treatments. The amount of blood transfused was significantly reduced in triflusal compared with aspirin recipients who underwent hip surgery. Risk of haemorrhage was also reduced in ischemic stroke patients receiving triflusal versus aspirin.

Topics: Adult; Angina Pectoris; Animals; Aspirin; Carotid Stenosis; Humans; In Vitro Techniques; Middle Aged; Myocardial Infarction; Platelet Aggregation Inhibitors; Postoperative Complications; Pulmonary Embolism; Randomized Controlled Trials as Topic; Salicylates; Thrombophlebitis

Antiplatelet agents are used for prevention of thromboembolism in surgical patients and in patients with chronic atrial fibrillation. Up to date, however, results of randomized studies comparing antiplatelet agents and oral anticoagulation have not been reported. The aim of this study was to compare the efficacy and safety of triflusal (an antiplatelet agent) versus acenocoumarol for primary prevention of thromboembolism in the early postoperative period after implantation of a bioprosthesis.. In this prospective, multicentric, randomized, open pilot trial, patients were assigned to treatment with triflusal (600mg/d) or acenocoumarol (target INR 2.0-3.0). Study medication was started 24-48h after valve replacement with a bioprosthesis, and continued for 3 months. Four follow-up visits were scheduled: baseline, and at 1, 3 and 6 months thereafter. The primary end-point was a composite of the rate of thromboembolism, severe hemorrhage and valve-related mortality.. A total of 193 patients were included (97 received triflusal and 96 acenocoumarol), with a mean age of 72.5 years. Half were men. Aortic valve replacement was performed in 181 patients (93.8%), mitral valve replacement in 10 patients (5.2%) and double valve replacement in 2 (1.0%). Hospital mortality was 11 (5.7%). Primary outcome was recorded in 9 patients with triflusal (9.4%) and in 10 patients with acenocoumarol (11%). There were nine episodes (4.7%) of thromboembolism, six in the triflusal group and three in the acenocoumarol group, and three episodes of permanent neurological deficits, one in the triflusal group and two in the acenocoumarol group. Severe hemorrhage: nine episodes, six in the acenocoumarol group and three in the triflusal group. None of the observed differences in efficacy were statistically significant. Regarding safety, three patients in triflusal group reported at least one hemorrhage, compared to 10 in acenocoumarol group (P=0.048).. There were no significant differences in efficacy between both groups, however, triflusal showed a significantly lower incidence of bleeding episodes.

Topics: Acenocoumarol; Aged; Anticoagulants; Bioprosthesis; Epidemiologic Methods; Female; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Humans; Male; Platelet Aggregation Inhibitors; Postoperative Complications; Postoperative Hemorrhage; Salicylates; Thromboembolism

Pulmonary embolism (PE) is a serious complication following hip surgery. Trials of antiplatelet thromboprophylaxis indicated a substantial reduction in PE rate, and we prospectively studied the effect of a combination of low-dose heparin and two different antiplatelets. Furthermore, our experience in previous studies suggested that platelet count (PC) levels could be useful to reliably suspect PE at a very early stage, and we prospectively tried to confirm our previous findings. Ours is a prospective study in 459 consecutive patients operated on because of hip fracture (265) or elective hip replacement (194), aimed to determine: 1) whether the benefits of antiplatelets plus heparin on PE outweigh the risks; 2) to assess the clinical usefulness of PC monitoring in these patients, so as to confirm whether PE could be recognized early. It was a prospective, randomized, double-blind study. All patients received unfractioned heparin (7500 IU sc twice daily, starting 2 h before operation). In addition, they received aspirin (200 mg thrice daily, with meals), Triflusal (300 mg thrice daily, with meals), or placebo. Real time B-mode ultrasonography (US) was performed on all patients on the 8-9th day after surgery. Venography was performed in patients with normal US, if clinical symptoms suggested venous thrombosis. Twelve out of the 459 patients (2.6%) had to discontinue prophylaxis, because of major bleeding (6 patients), or gastric intolerance (6 patients). There were no significant differences between groups in either deep vein thrombosis (26 patients (18%) with aspirin, 18 (12%) with Triflusal, 26 (17%) with placebo), or PE development (7 patients (5%) with aspirin, 3 (2%) with Triflusal, 8 (5%) taking placebo).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Aged, 80 and over; Aspirin; Double-Blind Method; Drug Therapy, Combination; Female; Hemorrhage; Heparin; Hip Fractures; Hip Prosthesis; Humans; Male; Middle Aged; Platelet Aggregation Inhibitors; Platelet Count; Postoperative Complications; Prospective Studies; Pulmonary Embolism; Radionuclide Imaging; Salicylates; Thrombophlebitis; Treatment Outcome; Ultrasonography; Vomiting

Topics: Clinical Trials as Topic; Drug Combinations; Drug Evaluation; Humans; Male; Methenamine; Postoperative Complications; Prostatectomy; Salicylates; Urinary Tract Infections

The conservative treatment of ano-rectal fistulae in Crohn's disease is selected according to the clinical activity and chronicity of the underlying disease. While in the acute phase metronidazole is indicated in addition to the standard therapy, an immuno-suppressive treatment with azathrioprine is recommended for the chronic-active course. The long latency of the therapeutic response can be bridged by an intravenous therapy with either cyclosporine ot with high-dose azathropine. The treatment is initiated only after consultation with the surgeon. For the prophylaxis of a post-surgical recurrence, only salicylates are established. Further inter-discipline therapy intended to induce a pre-surgical remission or to maintain a post-surgical remission.

Topics: Crohn Disease; Humans; Immunosuppressive Agents; Metronidazole; Postoperative Complications; Prognosis; Rectal Fistula; Recurrence; Salicylates

Previously, we demonstrated that ketorolac, a nonsteroidal antiinflammatory drug (NSAID), prevented postoperative small bowel ileus in a rodent model. The aim of this study was to evaluate the effect of salsalate, an NSAID without antiplatelet effect, on postoperative ileus alone or in combination with morphine.. Forty-eight rats underwent placement of duodenal catheters and were then randomly assigned to one of eight groups (n = 6). Four groups had standardized laparotomy following drug administration, whereas 4 groups underwent the same treatment without laparotomy: control and morphine animals received 0.1 mL alcohol via the catheter, whereas salsalate and salsalate-plus-morphine animals received salsalate (15 mg/kg) dissolved in 0.1 mL alcohol. The animals also received 0.5 mg/kg morphine (morphine and salsalate plus morphine) or the same volume of saline (control and salsalate) subcutaneously. Transit was measured following the injection of a nonabsorbed marker via the duodenal catheter and is defined as the geometric center (GC) of distribution. An additional 20 rats had serosal electrodes placed on the jejunum, and were assigned to one of four treatment groups (control, salsalate, morphine, and salsalate plus morphine; n = 5 each group). Myoelectric activity was recorded until the reappearance of the migrating myoelectric complex (MMC) following laparotomy.. Laparotomy and morphine independently reduced small bowel transit (P = 0.0006 and 0.006, respectively, by three-way analysis of variance [ANOVA]; GC 4.3 +/- 0.2 control versus 2.2 +/- 0.3 laparotomy versus 3.6 +/- 0.4 morphine), but morphine did not further worsen postoperative transit (GC 2.4 +/- 0.4; P = 0.42). Although salsalate did not alter baseline transit, pretreatment improved postoperative transit (P = 0.0002; GC 3.6 +/- 0.4). This effect was lost with the addition of morphine (GC 2.7 +/- 0.2; P = 0.21). The MMCs returned earlier after laparotomy in salsalate-pretreated rats (63 +/- 18 minutes salsalate versus 160 +/- 12 minutes laparotomy; P < 0.01, one-way ANOVA). However, this effect was also lost in animals receiving morphine (106 +/- 16 min; P > 0.05).. Salsalate improves postoperative small bowel motility in a rodent model; however, this effect is masked by morphine.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Drug Therapy, Combination; Gastrointestinal Motility; Intestinal Obstruction; Male; Morphine; Postoperative Complications; Rats; Rats, Sprague-Dawley; Salicylates

The use of topical salicylate-containing creams and ointments is widespread. A case is presented which implicates the use of one such cream (Aspercreme) as a potential cause of platelet coagulopathy after rhytidectomy.

Topics: Administration, Topical; Aged; Blood Platelet Disorders; Face; Female; Humans; Postoperative Complications; Salicylates; Surgery, Plastic

A group of 15 patients, suffering of chronic ischaemia of the lower limbs, were treated with triflusal, a new antiaggregant and antithrombotic agent, at the dose of 300 mg/day, during the first 90 days after artery by-pass grafting. Clinical exploration of patients included: physical inspection, pulses palpation, intermittent claudication (in metres), arteriography before surgery, and postoperative evolution of oscillometric and Doppler indexes. Determinations of platelet aggregation, induced by ADP, epinephrine and collagen, as well as of prothrombin time, platelet adhesiveness, and of thromboelastography parameters in PRP ane PPP were also carried out. Biochemical and hematological data were determined; gastric tolerance and other side effects were written down. Results show a clear improvement of all patients due to surgery, but with triflusal, it has been possible to maintain a prophylactic effect without thrombosis of the graft or of the distal vessel of patients, during the postoperative period. Actually, lower limbs temperature and pulses were maintained, with a good capillary content and with an improved walking distance. No changes in prothrombin time an platelet adhesiveness, have been observed. Five patients showed a clear hypoaggregant tendency, and thromboelastography in PRP indicates a statistically significant increase of R and K parameters as well as a decrease of am. It must be noticed the absence of gastric, hepatic, renal or metabolic side effects and no haemorrhagic lesions were observed. In conclusion, the treatment of these patients with triflusal prevents the otherwise frequent appearance of postoperative thrombosis in this kind of arterial surgery.

Topics: Adult; Aged; Blood Vessel Prosthesis; Drug Evaluation; Endarterectomy; Female; Fibrinolytic Agents; Humans; Ischemia; Leg; Male; Middle Aged; Postoperative Complications; Salicylates; Thrombosis

Topics: Arterial Occlusive Diseases; Coumarins; Humans; Patient Acceptance of Health Care; Postoperative Complications; Salicylates

Topics: Aged; Female; Hip Joint; Humans; Iontophoresis; Pain Management; Postoperative Complications; Salicylates; Thigh

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

Topics: Adolescent; Aminoglycosides; Anti-Bacterial Agents; Antineoplastic Agents; Deafness; Diuretics; Ear Diseases; Ear, Middle; Female; Hearing Aids; Humans; Iatrogenic Disease; Male; Middle Aged; Postoperative Complications; Radiotherapy; Salicylates

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: Alcoholic Beverages; Anticoagulants; Blood Transfusion; Cortisone; Drug Therapy, Combination; Gastrointestinal Hemorrhage; Hip Joint; Humans; Indomethacin; Joint Diseases; Kidney Diseases; Liver Cirrhosis; Neoplasms; Phenylbutazone; Postoperative Complications; Prospective Studies; Salicylates; Stomach Diseases

Topics: Aged; Bursitis; Calcinosis; Cartilage, Articular; Diagnosis, Differential; Female; Humans; Knee; Ligaments, Articular; Male; Middle Aged; Nerve Compression Syndromes; Osteoarthritis; Osteotomy; Postoperative Complications; Radiography; Salicylates

Topics: Adrenocorticotropic Hormone; Aminobenzoates; Anti-Inflammatory Agents; Dental Pulp Capping; Edema; Enzyme Therapy; Female; Glucocorticoids; Humans; Indomethacin; Inflammation; Male; Mouth Diseases; Muramidase; Nicotinic Acids; Oxyphenbutazone; Postoperative Complications; Pyrazoles; Salicylates; Stomatitis

Topics: Baths; Blood Coagulation; Female; Genital Diseases, Female; Humans; Postoperative Complications; Salicylates; Skin Absorption; Thrombosis

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

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

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Anticoagulants; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Humans; Postoperative Complications; Salicylates

Of a series of 130 patients undergoing operation for peptic ulcer disease at the Vancouver General Hospital, seven patients with personality defects had a disastrous outcome after operation.THE MAIN FEATURES OF THIS POSTGASTRECTOMY SYNDROME WERE REMARKABLY SIMILAR: persistent abdominal pain without demonstrable cause, intermittent and inexplicable nausea and vomiting, continued analgesic drug dependence and marked nutritional deficiencies. The high incidence was surprising and was not confined to any particular socioeconomic group. Such patients fall into three groups: those with true ulcer disease, those with salicylate addiction, and those without positive signs of ulcer but with chronic complaints. A history of a personality defect should warn the surgeon, and operation should be performed only for the complications of true ulcer disease. Though operation may cure the ulcer, the patient is worse off because the resulting physiologic derangements cannot be accepted or handled by him. These patients continue to haunt the surgeon, and the syndrome has been named the "albatross" syndrome.

Topics: Adult; Antisocial Personality Disorder; Female; Gastrectomy; Humans; Male; Middle Aged; Neurotic Disorders; Peptic Ulcer; Postoperative Complications; Psychosomatic Medicine; Salicylates

Topics: Adolescent; Adult; Anesthesia, General; Female; Humans; Male; Middle Aged; Pain; Postoperative Complications; Salicylates; Thiamine

Topics: Adult; Aged; Autoantibodies; Cardiac Surgical Procedures; Female; Fluorescent Antibody Technique; Glucocorticoids; Humans; Male; Middle Aged; Mitral Valve Stenosis; Myocardial Infarction; Myocardium; Myofibrils; Postoperative Complications; Postpericardiotomy Syndrome; Salicylates; Sarcolemma

Topics: Adolescent; Arthritis, Juvenile; Child; Dexamethasone; Female; Humans; Injections, Subcutaneous; Male; Nephrosis, Lipoid; Nicotinic Acids; Pericardium; Postoperative Complications; Rheumatic Heart Disease; Salicylates

Topics: Adolescent; Adrenal Cortex Hormones; Aortic Valve Stenosis; Cardiac Surgical Procedures; Child; Drug Therapy; Electrocardiography; Humans; Mitral Valve Stenosis; Penicillins; Pericarditis; Postoperative Complications; Rheumatic Fever; Rheumatic Heart Disease; Salicylates; Sulfonamides; Thoracic Surgery; Tricuspid Valve Stenosis

Topics: Cardiac Surgical Procedures; Gastrointestinal Hemorrhage; Hemorrhage; Mitral Valve Stenosis; Postoperative Complications; Salicylates; Thoracic Surgery; Toxicology