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aspirin and Reye syndrome

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161. von Willebrand Disease (Treatment)

, Rand ML, Bouskill V, Reyes JT, et al. Idiopathic pulmonary arterial hypertension - a unrecognized cause of high-shear high-flow haemostatic defects (otherwise referred to as acquired von Willebrand syndrome) in children. Br J Haematol . 2018 Aug 23. . Byams VR, Kouides PA, Kulkarni R, et al. Surveillance of female patients with inherited bleeding disorders in United States Haemophilia Treatment Centres. Haemophilia . 2011 Jul. 17 Suppl 1:6-13. . Sanders YV, Giezenaar MA, Laros-van Gorkom BA, Meijer (...) during the first week post partum. Deterrence Advise patients to avoid aspirin-containing compounds. In addition, patients should be wary of any physical activity associated with an increased risk of hemorrhage. Next: Type I von Willebrand disease DDAVP is the treatment of choice for individuals with vWD type I. The infusion of DDAVP into healthy individuals and individuals with vWD type 1 results in a rapid increase in circulating levels of vWF:Ag and FVIII and RCoF activity. Typically, a maximal

2014 eMedicine.com

162. Upper Respiratory Tract Infection (Treatment)

themselves. [ ] Adjunctive therapy for strep pharyngitis includes pain relievers; aspirin should be avoided in children due to risk of Reye syndrome. Corticosteroids are not recommended. [ ] Previous Next: Herpetic or Gonococcal Pharyngitis Specific therapies are available for gonococcal and herpes simplex virus (HSV) pharyngitis. Gonococcal pharyngitis may be difficult to eradicate. Gonococcal therapy is typically a single intramuscular dose of ceftriaxone. Although coincident Chlamydia trachomatis (...) to reduce discomfort due to cough. Avoid aspirin in children with viral illness because aspirin is associated with Reye syndrome. Inhaled cromolyn sodium is used for control of chronic asthma. Data are insufficient to permit evidence-based recommendations regarding the use of inhaled cromolyn sodium to treat URI-related cough in patients without asthma. Fever and discomfort relief Fever may be physiologically helpful in eliminating pathogens from the body. In some individuals, however, fever poses

2014 eMedicine.com

163. Pneumonia, Viral (Overview)

in otherwise healthy children but does occur in immunocompromised children. Complications include secondary bacterial infections, encephalitis, hepatitis, and, with concomitant aspirin use, Reye syndrome. VZV pneumonia also tends be more severe in individuals who smoke. Measles virus virus is a member of the Paramyxoviridae family and the genus Morbillivirus . It is a single-stranded RNA virus contained within a nucleocapsid and surrounded by an envelope. Measles is a respiratory tract virus that causes (...) , below). Six human coronaviruses (HCoVs) have now been identified: HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV-HKU1, SARS-COV (which causes severe acute respiratory syndrome), and MERS-COV (Middle East respiratory syndrome). These HCoVs appear to be established human pathogens with worldwide distribution, causing upper and lower respiratory tract infections, especially in children. Typically, HCoV infection follows a seasonal pattern similar to that of influenza, although Hong Kong researchers found

2014 eMedicine.com

164. Intestinal and Multivisceral Transplantation (Treatment)

omeprazole via NG tube should have granules mixed with an acidic juice. Following administration, the NG tube should be flushed to prevent blockage. Omeprazole (Prilosec) decreases gastric acid secretion by inhibiting the parietal cell H+/K+ ATP pump. In adults, the dose is 20 mg PO/NG bid. The pediatric dose is 0.5 mg/kg PO/NG q12h. Salicylates These agents inhibit prostaglandin synthesis, which prevents formation of platelet-aggregating thromboxane A2. Aspirin (Anacin, Ascriptin, Bayer Aspirin) is used (...) intestinal failure is when oral supplements or dietary modification suffice. Short bowel syndrome (SBS) is present when failure results from intestinal loss and failure to adapt by 1 month. Approximately 10,000-20,000 patients with SBS are treated each year in the United States. The incidence is 1-2 cases per 100,000 persons per year, and this accounts for approximately one third of home PN users. The severity of the disease generally correlates with remnant bowel length and the loss of the ileocecal

2014 eMedicine Surgery

165. Intestinal and Multivisceral Transplantation (Follow-up)

omeprazole via NG tube should have granules mixed with an acidic juice. Following administration, the NG tube should be flushed to prevent blockage. Omeprazole (Prilosec) decreases gastric acid secretion by inhibiting the parietal cell H+/K+ ATP pump. In adults, the dose is 20 mg PO/NG bid. The pediatric dose is 0.5 mg/kg PO/NG q12h. Salicylates These agents inhibit prostaglandin synthesis, which prevents formation of platelet-aggregating thromboxane A2. Aspirin (Anacin, Ascriptin, Bayer Aspirin) is used (...) intestinal failure is when oral supplements or dietary modification suffice. Short bowel syndrome (SBS) is present when failure results from intestinal loss and failure to adapt by 1 month. Approximately 10,000-20,000 patients with SBS are treated each year in the United States. The incidence is 1-2 cases per 100,000 persons per year, and this accounts for approximately one third of home PN users. The severity of the disease generally correlates with remnant bowel length and the loss of the ileocecal

2014 eMedicine Surgery

166. Varicella (Overview)

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 medications should not be used

2014 eMedicine Pediatrics

167. Toxicity, Acetaminophen (Follow-up)

. 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 Pediatrics

168. Toxicity, Acetaminophen (Treatment)

. 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 Pediatrics

169. Varicella (Treatment)

; 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 is recommended by the AAP if it can be given within (...) 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. . Dowell SF, Bresee JS. Severe varicella associated

2014 eMedicine Pediatrics

170. Varicella (Diagnosis)

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 medications should not be used

2014 eMedicine Pediatrics

171. Toxicity, Salicylate (Diagnosis)

. 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 Pediatrics

172. Toxicity, Acetaminophen (Diagnosis)

. 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 Pediatrics

173. Rhinovirus Infection (Follow-up)

appropriate handwashing, avoidance of finger-to-eyes or finger-to-nose contact, and use of nasal tissue. One study suggested that hand cleansers with salicylic acid and pyroglutamic acid prevent the transmission of rhinovirus and reduce the number of patients who become clinically infected. [ ] When a child has a viral illness, aspirin administration should be avoided to prevent Reye syndrome (though this is rare). Previous References Busse WW, Gern JE, Dick EC. The role of respiratory viruses in asthma (...) . 178(7):667-72. . . Gern JE. Rhinovirus and the initiation of asthma. Curr Opin Allergy Clin Immunol . 2009 Feb. 9(1):73-8. . . Martinez FD. The origins of asthma and chronic obstructive pulmonary disease in early life. Proc Am Thorac Soc . 2009 May 1. 6(3):272-7. . . Calvo C, Casas I, García-García ML, Pozo F, Reyes N, Cruz N, et al. Role of rhinovirus C respiratory infections in sick and healthy children in Spain. Pediatr Infect Dis J . 2010 Aug. 29(8):717-20. . Rosenthal LA, Avila PC, Heymann PW

2014 eMedicine Pediatrics

174. Varicella (Follow-up)

; 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 is recommended by the AAP if it can be given within (...) 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. . Dowell SF, Bresee JS. Severe varicella associated

2014 eMedicine Pediatrics

175. 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 Pediatrics

176. 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 Pediatrics

177. Takayasu Arteritis (Follow-up)

arteritis. is treated with antihypertensive agents, and aggressive therapy is necessary to prevent complications. Low-dose aspirin may have a therapeutic effect in large vessel vasculitis. Antiplatelet agents and heparin may prove useful in preventing stroke. Warfarin also has been used. The literature reports a case of improvement in renal and systemic function with low-dose intravenous (IV) heparin therapy (10,000 U/d) followed by oral anticoagulant and antiplatelet agents. Pregnancy Pregnancy (...) with Takayasu's arteritis is impaired and comparable with rheumatoid arthritis and ankylosing spondylitis patients. Clin Rheumatol . 2008 Jul. 27(7):859-65. . Maksimowicz-McKinnon K, Clark TM, Hoffman GS. Limitations of therapy and a guarded prognosis in an American cohort of Takayasu arteritis patients. Arthritis Rheum . 2007 Mar. 56(3):1000-9. . Soto ME, Espinola N, Flores-Suarez LF, Reyes PA. Takayasu arteritis: clinical features in 110 Mexican Mestizo patients and cardiovascular impact on survival

2014 eMedicine.com

178. Viral Infections of the Mouth (Diagnosis)

multiforme. [ ] Patients should be counseled about the routes of infectivity. Medical care for primary HHV-1/HHV-2 The goals of treatment are to make the patient comfortable and to prevent secondary infections or worsening systemic illness. The patient should maintain fluid intake and a balanced diet with the use of liquid food replacement if necessary. Analgesics, such as acetaminophen, may make the patient more comfortable. Aspirin should be avoided in pediatric patients because of the possibility

2014 eMedicine.com

179. Pneumonia, Viral (Overview)

in otherwise healthy children but does occur in immunocompromised children. Complications include secondary bacterial infections, encephalitis, hepatitis, and, with concomitant aspirin use, Reye syndrome. VZV pneumonia also tends be more severe in individuals who smoke. Measles virus virus is a member of the Paramyxoviridae family and the genus Morbillivirus . It is a single-stranded RNA virus contained within a nucleocapsid and surrounded by an envelope. Measles is a respiratory tract virus that causes (...) , below). Six human coronaviruses (HCoVs) have now been identified: HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV-HKU1, SARS-COV (which causes severe acute respiratory syndrome), and MERS-COV (Middle East respiratory syndrome). These HCoVs appear to be established human pathogens with worldwide distribution, causing upper and lower respiratory tract infections, especially in children. Typically, HCoV infection follows a seasonal pattern similar to that of influenza, although Hong Kong researchers found

2014 eMedicine Emergency Medicine

180. Toxicity, Salicylate (Diagnosis)

. 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

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