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aspirin and Reye syndrome

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181. Pediatrics, Chicken Pox or Varicella (Follow-up)

be used with topical diphenhydramine; toxicity may occur from systemic absorption if it is applied to the entire body. Because of the association of varicella and aspirin therapy leading to Reye syndrome, acetaminophen is recommended for use for the reduction of fever. Studies have also tried to find an association between ibuprofen and risk of fasciitis; the results have not been conclusive. Previous Next: Antiviral Therapy The routine use of acyclovir or valacyclovir in healthy children (...) bacterial infections, especially group A streptococcal superinfections, which may evolve rapidly into necrotizing fasciitis and toxic shock syndrome Previous References Hall S, Maupin T, Seward J, Jumaan AO, Peterson C, Goldman G, et al. Second varicella infections: are they more common than previously thought?. Pediatrics . 2002 Jun. 109(6):1068-73. . Rockley PF, Tyring SK. Pathophysiology and clinical manifestations of varicella zoster virus infections. Int J Dermatol . 1994 Apr. 33(4):227-32

2014 eMedicine Emergency Medicine

182. Pediatrics, Kawasaki Disease (Treatment)

the use of aspirin in children with KD as part of their treatment regimen. [ ] Patients who remain on long-term, low-dose aspirin should receive an annual influenza vaccine and be vaccinated against varicella. Additionally, the risks of developing Reye syndrome during an active infection with influenza or varicella should be addressed. Clopidogrel (Plavix) may be briefly substituted for aspirin in patients who develop influenza or varicella. This agent can also be used in patients allergic to aspirin (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTY1MzY3LXRyZWF0bWVudA== processing > Kawasaki Disease Treatment & Management Updated: Jul 30, 2018 Author: Tina K Sosa, MD; Chief Editor: Russell W Steele, MD Share Email Print Feedback Close Sections Sections Kawasaki Disease Treatment Approach Considerations The principal goal of treatment for KD is to prevent coronary artery aneurysms and other cardiac complications. The mainstays of treatment for KD are IVIG and aspirin. [ , , ] All patients with KD should be admitted to the hospital for administration of IVIG

2014 eMedicine Emergency Medicine

183. Pediatrics, Chicken Pox or Varicella (Treatment)

be used with topical diphenhydramine; toxicity may occur from systemic absorption if it is applied to the entire body. Because of the association of varicella and aspirin therapy leading to Reye syndrome, acetaminophen is recommended for use for the reduction of fever. Studies have also tried to find an association between ibuprofen and risk of fasciitis; the results have not been conclusive. Previous Next: Antiviral Therapy The routine use of acyclovir or valacyclovir in healthy children (...) bacterial infections, especially group A streptococcal superinfections, which may evolve rapidly into necrotizing fasciitis and toxic shock syndrome Previous References Hall S, Maupin T, Seward J, Jumaan AO, Peterson C, Goldman G, et al. Second varicella infections: are they more common than previously thought?. Pediatrics . 2002 Jun. 109(6):1068-73. . Rockley PF, Tyring SK. Pathophysiology and clinical manifestations of varicella zoster virus infections. Int J Dermatol . 1994 Apr. 33(4):227-32

2014 eMedicine Emergency Medicine

184. Toxicity, Salicylate (Overview)

. Repackaging has decreased children's accessibility to lethal amounts, and salicylate's association with Reye syndrome has significantly decreased its use. Still, more than 10,000 tons of aspirin are consumed in the United States each year. Aspirin or aspirin-equivalent preparations (in milligrams) include children's aspirin (80-mg tablets with 36 tablets per bottle), adult aspirin (325-mg tablets), methyl salicylate (eg, oil of wintergreen; 98% salicylate), and Pepto-Bismol (236 mg of non-aspirin (...) to moderate pain. Aspirin is used as an antipyretic and as an anti-inflammatory agent for the treatment of soft tissue and joint inflammation and vasculitides such as acute rheumatic fever and Kawasaki disease. Aspirin is also used to treat acute coronary syndrome. Low-dose aspirin helps to prevent thrombosis. Acetylsalicylic acid is colorless or white in crystalline, powder, or granular form. The chemical is odorless and is soluble in water. Salicylate is available for ingestion as tablets, capsules

2014 eMedicine Emergency Medicine

185. Pediatrics, Chicken Pox or Varicella (Overview)

rate. Before universal vaccination, most varicella-related deaths in the United States were from associated encephalitis, pneumonia, secondary bacterial infection, and Reye syndrome. (See Complications.) In addition, significant concerns have been raised about the association of varicella with severe invasive group A . [ ] The disease can be serious in neonates, depending on the timing of infection in the mother. Varicella during pregnancy can cause various adverse outcomes for mother and infant (...) , depending on the stage of pregnancy. Neonatal varicella mortality rates can reach 30%. Previous Next: Patient Education Families of children with chickenpox should be instructed to bathe the child regularly to reduce itching and prevent secondary infection. To prevent scratching, which can lead to secondary infection and scarring, the child’s fingernails should be kept short, mittens or socks may be worn on the hands at night, and medication for itching can be given as needed. Aspirin-containing

2014 eMedicine Emergency Medicine

186. Toxicity, Acetaminophen (Overview)

. Next: Background Extensive medical use of acetaminophen began in 1947. Initially in the United States, acetaminophen was available by prescription only. In 1960, this changed to an over-the-counter (OTC) status. The availability of acetaminophen in OTC preparations and the contraindication of aspirin-containing products for pediatric use (due to the association between aspirin and Reye syndrome), have made acetaminophen one of the most commonly used analgesic-antipyretic medications in current (...) acetaminophen should stop using the drug and seek immediate medical care. A review of the medical literature showed the painkiller poses the risk for three rare but potentially fatal skin disorders: Stevens-Johnson syndrome, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis. [ , ] An intravenous (IV) formulation of acetaminophen (Ofirmev) was approved by the FDA in 2011 for inpatient use in children older than 2 years to treat fever and pain. [ ] Although this article focuses

2014 eMedicine Emergency Medicine

187. Ammonia

to help investigate the cause of changes in behaviour and consciousness. It may be requested with other tests such as , , and and to help diagnose the cause of a coma or to help support the diagnosis of Reye’s syndrome or hepatic encephalopathy. An ammonia blood test may also be requested to help detect and evaluate the severity of a urea cycle defect. Some doctors use the ammonia test to monitor the effectiveness of treatment of hepatic (liver) encephalopathy, but there is not widespread agreement (...) the presence of Reye’s syndrome in children and adolescents with symptoms. Increased ammonia concentrations in the blood may also suggest a previously undiagnosed enzymatic defect of the urea cycle. In children and adults, elevated ammonia levels may also indicate liver or kidney damage. Frequently, an illness will act as a trigger, increasing ammonia levels to the point that an affected patient has difficulty removing the ammonia. Normal concentrations of ammonia do not rule out the possibility of hepatic

2012 Lab Tests Online UK

188. Randomized Controlled Trial of LAIV vs TIV Vaccines in Schools

to Grade 8, from 10 elementary schools will participate in this study. Criteria Children in schools randomized to LAIV cannot receive this vaccine if they have any of the following contraindications: severe asthma (defined as currently on oral or high-dose inhaled glucocorticosteriods or active wheezing) or medically attended wheezing in the 7 days prior to vaccination; receiving aspirin or aspirin-containing therapy because of the association of Reye's syndrome with aspirin and wild-type influenza (...) infection; or immune-compromising conditions due to underlying disease and/or therapy, as the vaccine contains live attenuated virus. These children will receive TIV instead, unless they have a contraindication to receiving TIV. Children in schools assigned to TIV cannot receive this vaccine if they have any of the following contraindications: an anaphylactic reaction to a previous dose; an anaphylactic reaction to any of the vaccine components, with the exception of egg; or Guillain-Barré Syndrome (GBS

2013 Clinical Trials

189. Targeting Inflammation to Treat Cardiovascular Aging

or investigational medical device within 30 days prior to screening, or requirement for any investigational agent prior to completion of all scheduled study assessments. History of recent chicken pox, shingles or influenza (ie., risk of Reye's syndrome) Recent flu-like symptoms within the past 2 weeks Pregnant or breastfeeding at screening, or planning to become pregnant (self or partner) at any time during the study. A urinary pregnancy test will be done on all females. If test is positive, the subject (...) free radicals vs. protective antioxidants). Our hypothesis predicts that chronic inhibition of inflammation with Salsalate, an FDA-approved anti-inflammatory drug similar to aspirin that is used to treat rheumatoid arthritis pain and known to inhibit the 'master' regulator of inflammation in the cell (i.e., nuclear factor kappa B), will improve cardiovascular function in older adults. In addition, the investigators hypothesize that the mechanism for the improvement in cardiovascular function during

2013 Clinical Trials

190. Inflammation Inhibition in Prediabetic Humans

days prior to screening, or requirement for any investigational agent prior to completion of all scheduled study assessments. History of recent chicken pox, shingles or influenza (ie., risk of Reye's syndrome) Recent flu-like symptoms within the past 2 weeks Pregnant or breastfeeding at screening, or planning to become pregnant (self or partner) at any time during the study. A urinary pregnancy test will be done on all females. If test is positive, the subject will be excluded. Women with history (...) for developing overt diabetes unless aggressive lifestyle (weight loss, exercise) or pharmacological interventions are employed. Interestingly, data in recent years has linked obesity and diabetes to chronic inflammation of the blood vessels and brain areas that regulate blood pressure. Therefore, the current study will test whether a commonly used aspirin-like anti-inflammatory drug called salsalate, will improve blood vessel health and nervous system dysfunction in adults with prediabetes. Eligible

2013 Clinical Trials

191. Vascular Dysfunction in Human Obesity Hypertension

of any investigational product or investigational medical device within 30 days prior to screening, or requirement for any investigational agent prior to completion of all scheduled study assessments. History of recent chicken pox, shingles or influenza (ie., risk of Reye's syndrome) Recent flu-like symptoms within the past 2 weeks Pregnant or breastfeeding at screening, or planning to become pregnant (self or partner) at any time during the study. A urinary pregnancy test will be done on all females (...) anti-inflammatory drugs (NSAIDS) such as aspirin, indomethacin, naproxen, acetaminophen (Tylenol), ibuprofen (Advil, Motrin) and not able or willing to go off of for 2 weeks prior and during the study Taking cox-2 inhibitors (Celebrex, Vioxx, etc) or allopurinol (Zyloprim, Lopurin, Allopurin) Taking blood thinners such as coumadin (Warfarin), enoxaparin (Lovenox); clopidogrel (Plavix); dipyridamole (Persantine); heparin; Taking diabetic medications (Metformin, glyburide, insulin, etc

2013 Clinical Trials

192. Dengue

to risk of (as well as Reye Syndrome risk) Daily monitoring of and Hospitalization indications Infants, elderly and pregnant women Serious comorbidity ( , unreliable social situation) Findings suggestive of impending severe Dengue Severe Dengue management Aggressive supportive care initial protocol NS or LR 5-7 cc/kg/h for 1-2 hours then 3-5 ml/kg/h for 2-4 hours then 2-3 ml/kg/h X. Course Incubation: 3-15 days (typically 4-8 days) Usually benign and self-limited course lasting <7 days XI. Prevention (...) hemorrhagic fever, which causes bleeding from your nose, gums, or under your skin. It can also become dengue shock syndrome, which causes massive bleeding and shock. These forms of dengue are life-threatening. There is no specific treatment. Most people with dengue recover within 2 weeks. Until then, drinking lots of fluids, resting and taking non-aspirin fever-reducing medicines might help. People with the more severe forms of dengue usually need to go to the hospital and get fluids. To lower your risk

2015 FP Notebook

193. Pharmacokinetic Comparison of Intradermal Versus Sub-cutaneous Insulin and Glucagon Delivery in Type 1 Diabetes

history of MEN 2A, MEN 2B, neurofibromatosis, or von Hippel-Lindau disease) History of adverse reaction to glucagon (including allergy) besides nausea and vomiting History of adrenal disease or tumor Hypertension (blood pressure > 160/100 mm/Hg at screening or day of study visit History of allergy to aspirin or any history of aspirin intolerance, including Reye's syndrome, or gastric ulcer or bleeding associated with salicylates. Blood dyscrasia or bleeding diathesis, such as hemophilia, Von

2012 Clinical Trials

194. Safety of Lactobacillus Rhamnosus GG Versus Placebo in Elderly Subjects Receiving Live Attenuated Influenza Vaccine

when Reye Syndrome was more common, it had only been reported in 25 adults. In addition, increasing numbers of adults are being placed on low dose aspirin for primary and secondary prevention of cardiovascular disease, some of whom may also have influenza, but there has been no increase in reports or Reye's Syndrome in adults.) Presence of any of the following: Grade 2 or higher abnormal vital signs or abnormalities on physical exam during screening or presence of any wheezing on physical exam (...) be prescribed if clinically indicated) Immune Globulin within the prior 6 months Immune modulating drugs such as Belimumab, azathioprine, mercaptopurine, methotrexate, hydroxychloroquine or leflunomide at any time or any oral or parenteral corticosteroid in the prior 12 months Fingolimod at any time Salicylates at doses higher than 163 mg/day for primary prevention of myocardial infarction. (Reye's Syndrome in adults is extremely rare - to our knowledge the oldest reported patient was aged 61 and as of 1989

2012 Clinical Trials

195. Fever

4 g to avoid toxicity; patients should be warned not to simultaneously take nonprescription cold or flu remedies that contain acetaminophen . Other NSAIDs (eg, aspirin , naproxen ) are also effective antipyretics. Salicylates should not be used to treat fever in children with viral illnesses because use has been associated with Reye syndrome. If temperature is ≥ 41 ° C, other cooling measures (eg, evaporative cooling with tepid water mist, cooling blankets) should also be started. Geriatrics (...) point downward (eg, with antipyretic drugs) initiates heat loss through sweating and vasodilation. The capacity to generate a fever is reduced in certain patients (eg, alcoholics, the very old, the very young). Pyrogens are substances that cause fever. Exogenous pyrogens are usually microbes or their products. The best studied are the lipopolysaccharides of gram-negative bacteria (commonly called endotoxins) and Staphylococcus aureus toxin, which causes toxic shock syndrome. Fever is the result

2013 Merck Manual (19th Edition)

196. Mastocytosis

blockers and should carry a prefilled, self-injecting epinephrine syringe. Aspirin controls flushing but may enhance leukotriene production, thereby contributing to mast cell–related symptoms; it should not be given to children because Reye syndrome is a risk. Cromolyn 200 mg po qid (100 mg qid for children 2 to 12 yr; not to exceed 40 mg/kg/day) may help by preventing mast cell degranulation. Ketotifen 2 to 4 mg po bid is inconsistently effective. No treatment can reduce the number of tissue mast (...) by biopsy of skin lesions and sometimes of bone marrow. Multifocal, dense infiltrates of mast cells are present. Tests may be done to rule out disorders that cause similar symptoms (eg, , pheochromocytoma, carcinoid syndrome, Zollinger-Ellison syndrome); these tests include the following: Serum gastrin level to rule out in patients with ulcer symptoms Urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA) to rule out in patients with flushing Measurement of plasma-free metanephrines or urinary

2013 Merck Manual (19th Edition)

197. Kawasaki Disease (KD)

require additional anticoagulant therapy (eg, warfarin , antiplatelet drugs). Children who receive IVIG therapy may have a lower response rate to live viral vaccines. Thus, measles-mumps-rubella vaccine should generally be delayed for 11 mo after IVIG therapy, and varicella vaccine should be delayed for ≥ 11 mo. If the risk of measles exposure is high, vaccination should proceed, but revaccination (or serologic testing) should be done 11 mo later. A small risk of Reye syndrome exists in children (...) Kawasaki Disease (KD) Kawasaki Disease (KD) - Pediatrics - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER Test your knowledge Cerebral Palsy (CP) Syndromes

2013 Merck Manual (19th Edition)

198. Dengue: The New WHO 2010 Severity Classification

. Do not give acetylsalicylic acid (aspirin), ibuprofen or other non-steroidal anti-inflammatory agents (NSAIDs) as these drugs may aggravate the bleeding in dengue due to capillary fragility. Acetylsalicylic acid (aspirin) may be associated with Reye’s Syndrome. 4. Fresh whole blood or fresh red cells should be given whenever possible. This is because oxygen delivery at tissue level is optimal with high levels of 2,3 di-phosphoglycerate (2,3 DPG). Stored blood loses 2,3 DPG, low levels which may

2012 Emergency Medicine Blog

199. Pilot Study to Determine Effects of Salsalate in Type 1 Diabetes and Painful Peripheral Neuropathy

than 10 alcoholic drinks per week. History of stomach ulcers or bleeding from your bowel. Heart attack, heart bypass surgery, heart failure or a stroke EVER. Current treatment for any cancer (other than basal cell or squamous cell skin cancer). Treatment with lithium. Ever had Reyes' syndrome. Pregnant, nursing, or planning to become pregnant during the time of the study. Allergic to lidocaine or epinephrine (used for numbing skin prior to biopsies). Keloid scarring in the past. Receiving other (...) of contraception during the course of the study (hormonal, IUD, or diaphragm. Willing and able to provide written informed consent for study participation. Exclusion Criteria: Neuropathy from a cause other than diabetes. Allergy to salsalate or similar medications (aspirin, non-steroidal anti-inflammatory medicines like ibuprofen and naproxen). Currently on blood thinning agents such as Coumadin, Heparin, Plavix, Pradaxa, high-dose aspirin (more than 325 mg daily). Any severe low blood sugar episodes

2011 Clinical Trials

200. Kawasaki disease Full Text available with Trip Pro

other indications, aspirin is otherwise normally not recommended for children due to its association with . Because children with Kawasaki disease will be taking aspirin for up to several months, vaccination against and is required, as these infections are most likely to cause Reye's syndrome. High-dose aspirin is associated with anemia and does not confer benefit to disease outcomes. have also been used, especially when other treatments fail or symptoms recur, but in a randomized controlled trial (...) Kawasaki disease Kawasaki disease - Wikipedia Kawasaki disease From Wikipedia, the free encyclopedia Kawasaki disease Other names Kawasaki syndrome, lymph node syndrome, mucocutaneous lymph node syndrome A child showing the characteristic "strawberry tongue" seen in Kawasaki disease Symptoms Fever > 5 days, , rash, , Usual onset < 5 years old Duration ~ 3 weeks Causes Unknown Based on symptoms, , Medication , Prognosis Mortality 0.2% with treatment Frequency 8–124 per 100,000 people under five

2012 Wikipedia

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