salicylates and Respiratory-Tract-Diseases

A poor therapeutic response may be explained by incomplete or erroneous diagnostic assessment, by failure to employ optimal drug doses and combinations, or by inadequate attention to the non-pharmacologic aspects of management. Poor compliance and counterproductive patient attitudes may need to be addressed. These problems and the approach to asthma concomitant with other diseases are discussed.

Topics: Asthma; Diabetes Complications; Diagnosis, Differential; Dyspnea, Paroxysmal; Female; Gastroesophageal Reflux; Heart Diseases; Humans; Hyperventilation; Occupational Diseases; Patient Compliance; Physician-Patient Relations; Pregnancy; Pregnancy Complications; Respiratory Tract Diseases; Respiratory Tract Infections; Salicylates; Sleep Wake Disorders; Surgical Procedures, Operative; Sympathomimetics; Theophylline; Thyroid Diseases

Aspirin exacerbated respiratory disease (AERD) is comprised of aspirin/acetylsalicylic acid (ASA) sensitivity, bronchial asthma, and nasal polyposis. Treatment of this condition is challenging and may include topical/systemic steroids, endoscopic sinus surgery, and/or aspirin desensitization.. A prospective crossover pilot study (n = 10) was conducted in which patients were randomized into either of 2 groups with 6 weeks of regular diet (R) or 6 weeks of a low salicylate diet (LS).. The study was conducted in a tertiary otolaryngology clinic.. Patients with AERD were enrolled in the study.. Subjective (Sino-nasal Outcome Test-22 [SNOT-22], Nasal Sinus Symptom Scale [NSSS], and the Asthma Control Questionnaire-7 [ACQ-7]) and objective outcome instruments (Peri-Operative Sinus Evaluation [POSE] and Lund-Kennedy Endoscopic Score [LKES]) were used to evaluate patients at baseline, 6 weeks (at crossover), and 12 weeks.. Wilcoxon rank sum tests demonstrated that patients on the low salicylate diet had improved scores compared to their regular diet when evaluated by 4 of the 5 outcome measures (SNOT-22 pLS = 0.0059, NSSS pLS = 0.0195, LKES pLS = 0.0039, POSE pLS = 0.005).. Results of the pilot study indicate that implementation of a low salicylate diet improves the nasal symptoms and nasal endoscopy findings of individuals with AERD. Further research is required to support these findings.

Topics: Adult; Aged; Aspirin; Asthma; Cross-Over Studies; Desensitization, Immunologic; Drug Hypersensitivity; Female; Humans; Male; Middle Aged; Nasal Polyps; Pilot Projects; Prospective Studies; Respiratory Tract Diseases; Rhinitis; Salicylates; Single-Blind Method; Sinusitis

Topics: Adult; Aged; Anti-Inflammatory Agents; Clinical Trials as Topic; Double-Blind Method; Female; Feprazone; Humans; Imidazoles; Male; Middle Aged; Phenylbutazone; Random Allocation; Respiratory Tract Diseases; Salicylates

Respiratory symptoms are over-represented in inflammatory bowel disease. There are similarities between the epidemiology of inflammatory bowel disease and that of respiratory conditions for which an adverse influence of salicylate has been identified. Natural salicylates exist within our diet.. To determine whether a lower intake of dietary salicylates is associated with less active inflammatory bowel disease and fewer concurrent respiratory symptoms.. Respiratory status, inflammatory bowel disease activity, quality of life, and dietary habits were established in 73 patients with Crohn's disease and 69 with ulcerative colitis, using a self-administered questionnaire and peak expiratory flow rate readings. Harvey-Bradshaw and Simple Birmingham/Royal Free Colitis indices, an internally validated respiratory score, and estimated weekly dietary salicylate intake, were calculated for each patient.. There was at least one respiratory symptom in 63.4% of patients. The commonest underlying respiratory diagnosis was asthma. Respiratory impairment was similar in ulcerative colitis and Crohn's disease; 56.3% of Crohn's disease patients with an active respiratory diagnosis had other extra-intestinal manifestations. The dietary salicylate intake was independent of respiratory status, but inversely correlated with ulcerative colitis activity (dietary salicylate intake 37.0mg versus 21.4mg for low and higher Simple Birmingham/Royal Free Colitis index, respectively; p<0.02). A similar association was not seen in Crohn's disease.. Respiratory impairment is common in inflammatory bowel disease. Higher intake of dietary salicylates is associated with less active colitis and possibly causally so.

Topics: Adolescent; Adult; Asthma; Comorbidity; Diet; Female; Humans; Inflammatory Bowel Diseases; Male; Respiratory Tract Diseases; Salicylates

Topics: Comorbidity; Diet; Humans; Inflammatory Bowel Diseases; Respiratory Tract Diseases; Salicylates

Topics: Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Child, Preschool; Female; Humans; Imidazoles; Infant; Male; Respiratory Tract Diseases; Salicylates

Topics: Adult; Aged; Anti-Inflammatory Agents; Female; Humans; Imidazoles; Male; Middle Aged; Peptide Hydrolases; Respiratory Tract Diseases; Salicylates

Between February and May 1984, we conducted a pilot study to examine the methods for a larger study of a previously reported relation between Reye's syndrome and medications. Thirty patients with Reye's syndrome, whose diagnosis was confirmed by an expert panel, and 145 controls were matched for age, race (black or not black), and antecedent illness (respiratory infection, chickenpox, or diarrhea) and selected from the same hospital, emergency room, or school, or identified by random digit dialing. Significantly more cases (93 per cent, 28 of 30) than members of each of the four control groups or all controls combined (46 per cent, 66 of 145) had received salicylates during matched antecedent illnesses (odds ratio of all 30 cases vs. all controls = 16.1; lower 95 per cent confidence limit = 4.6). The prevalence and mean severity score of signs, symptoms, and selected events during the antecedent illness tended to be lower among cases than controls. Thus, differences in the severity of this illness between cases and controls did not explain differences in medication exposures. This pilot study suggests an association between Reye's syndrome and the use of salicylates during an antecedent illness.

Topics: Acetaminophen; Adolescent; Chickenpox; Child; Child, Preschool; Emergencies; Female; Humans; Infant; Male; Pilot Projects; Respiratory Tract Diseases; Reye Syndrome; Salicylates; Therapeutic Equivalency; Time Factors

Twenty three sporadic cases of Reye's syndrome diagnosed according to widely accepted criteria were seen between 1979 and 1982. The patients were younger than those reported from North America (median age 9 months), girls were twice as common as boys, and the syndrome presented twice as frequently in the summer 6 months. The annual incidence was 1.4 cases/100 000 among children aged less than 4 years. The prodrome consisted of upper respiratory symptoms in 61% of the children and even less specific features in more than 25%; two patients had varicella. Six of the 23 patients presented after a prodrome of less than 24 hours with 'acute collapse', simulating 'near miss' cot death associated with profound hypoglycaemia, and in four of these there was an unfavourable outcome. Intensive care methods including judicious fluid restriction coupled with 'prophylactic' hyperventilation (87%), direct monitoring of intracranial pressure (70%), and barbiturate coma (52%) achieved neurologically intact survival in 74% of patients. Failure to recognise the syndrome early enough or to manage it appropriately resulted in four deaths. To help reduce overall mortality in the United Kingdom paediatricians have a duty to acquaint family doctors and emergency department staff of the earliest clinical features of Reye's syndrome and of the need for immediate hospital referral.

Topics: Blood Glucose; Brain Diseases; Child, Preschool; Consciousness; Diarrhea; Female; Fever; Humans; Infant; Infant, Newborn; Intracranial Pressure; Male; Prognosis; Respiration, Artificial; Respiratory Tract Diseases; Reye Syndrome; Salicylates

Topics: Acid-Base Equilibrium; Adult; Alkalosis; Carbon Dioxide; Female; Humans; Kidneys, Artificial; Respiratory Tract Diseases; Salicylates; Suicide; Tubocurarine

Topics: Balneology; Baths; Camphor; Disease Management; Humans; Respiratory System; Respiratory Tract Diseases; Salicylates

Topics: Acetates; Benzoates; Camphor; Expectorants; Humans; Oils; Respiration Disorders; Respiratory System; Respiratory Tract Diseases; Salicylates

Topics: Benzoates; Humans; Respiratory System; Respiratory Tract Diseases; Salicylates