scholarly journals Clinical safety of ibuprofen in pediatric practice

2021 ◽  
Vol 16 (6) ◽  
pp. 418-424
Author(s):  
T.P. Borysova
Keyword(s):  
Gastrointestinal Tract ◽  
Side Effects ◽  
Community Acquired Pneumonia ◽  
Low Birth Weight Infants ◽  
Clinical Safety ◽  
Over The Counter ◽  
High Profile ◽  
Increased Risk ◽  
Discontinuation Of Treatment ◽  
History Of

The article presents a review of the literature on the side effects of ibuprofen in children. The international guidelines recommend ibuprofen as an antipyretic and analgesic drug in pediatrics. The drug is characterized by a high profile of efficacy and safety in the treatment of children with fever, mild to moderate pain. Ibuprofen in over-the-counter doses has a low probability of serious side effects from the gastrointestinal tract and kidneys. Side effects of ibuprofen are transient and resolve after discontinuation of treatment. Circumstances associated with a higher risk of adverse events are highlighted. The use of ibuprofen is contraindicated in children with dehydration, which is associated with a risk of acute kidney damage. Caution should be exercised when prescribing ibuprofen to children with community-acquired pneumonia due to the risk of purulent complications. Ibuprofen should not be prescribed to patients with chickenpox to avoid bacterial superinfections. Ibuprofen should be used with caution in children with diseases of the gastrointestinal tract, liver, renal failure, hemorrhagic syndrome, anticoagulant therapy. Ibuprofen is allowed in children with bronchial asthma unless a personal or family history of aspirin-induced asthma. Caution should be exercised when treating premature infants or low birth weight infants due to the reduction in nephron mass and, therefore, the increased risk of renal damage. Ibuprofen should not be used in patients who are sensitive to this drug or other non-steroidal anti-inflammatory drugs. Ibuprofen should be taken in the minimum effective dose and discontinued as soon as possible — no more than 3 days for fever and 5 days for pain.

Cowden’s disease: a rare cause of oral papillomatosis

2002 ◽  
Vol 116 (3) ◽  
pp. 221-223 ◽  
Author(s):  
Marissa Botma ◽  
Derrick I. Russell ◽  
Robin A. Kell
Keyword(s):  
Gastrointestinal Tract ◽  
Female Patient ◽  
Autosomal Dominant ◽  
Past History ◽  
Breast Malignancy ◽  
Autosomal Dominant Condition ◽  
Increased Risk ◽  
Cowden’S Disease ◽  
History Of ◽  
Dominant Condition

Cowden’s disease is a rare autosomal dominant condition with characteristic mucocutaneous papillomatous lesions. These lesions are mucocutaneous markers for increased risk of malignancies in the thyroid, breast and the gastrointestinal tract. We discuss the case of a 50-year-old female patient who presented with oral and cutaneous papillomoas and a past history of breast malignancy. Important management aspects of these patients are considered.

scholarly journals Book Review: Vaccines: History, Science, and Issues

2018 ◽  
Vol 57 (4) ◽  
pp. 307
Author(s):  
Amanda Sprochi
Keyword(s):  
United States ◽  
Eighteenth Century ◽  
Side Effects ◽  
Action Potential ◽  
Mechanism Of Action ◽  
The United States ◽  
High Profile ◽  
History Of ◽  
Autism Disorder

Vaccines and vaccination in the United States have become topics of dispute in some circles in the last two decades, since Andrew Wakefield published a high-profile and now thoroughly discredited study in Lancet linking vaccines to autism disorder. Tish Davidson’s book, Vaccines: History, Science, and Issues, takes a look at the history of vaccines and vaccinations, their mechanism of action, potential side effects, and development and use. She also documents the anti-vaccine (anti-vaxxer) movement, which began in the eighteenth century and has found renewed adherents in the present day. Davidson’s research is scientific, meticulous, and dispassionate in its coverage of both vaccine proponents and detractors. 

Pulmonary Complications of Sickle Cell Anemia

Chest Imaging ◽  
2019 ◽  
pp. 141-145
Author(s):  
Constantine Raptis
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Community Acquired Pneumonia ◽  
Pulmonary Complications ◽  
Acute Chest Syndrome ◽  
Globin Chain ◽  
Cell Disease ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
History Of

“Sickle cell disease” describes the spectrum of pathology in patients with at least one HbS chain and one other abnormal β‎ globin chain. Although patients with sickle cell disease often present with a simple community acquired pneumonia, acute chest syndrome must be considered in patients presenting with chest pain and fever, as it carries an increased risk of mortality, especially in adults. A few other entities, including rib infarction and subdiaphragmatic pathologies, can mimic the symptoms of acute chest syndrome. Finally, the findings of sickle cell disease on chest radiography will be discussed. Radiologists must be familiar with these findings in order to accurately interpret imaging studies, especially when the history of sickle cell is not provided.

Abstract P215: Sleep Medication and Incident Stroke: The REGARDS Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Megan E Petrov ◽  
Virginia J Howard ◽  
Dawn O Kleindorfer ◽  
Michael Grandner ◽  
Jennifer R Molano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Racial Differences ◽  
Stroke Risk ◽  
Medication Use ◽  
Older Individuals ◽  
Vascular Events ◽  
Over The Counter ◽  
Sleep Medication ◽  
Increased Risk ◽  
History Of

Introduction: Preliminary evidence suggests sleep medications are associated with risk of vascular events; however, the long-term association with stroke risk is understudied. The aim of this study was to investigate the relation between sleep medication use and incident stroke. Methods: Within the REasons for Geographic And Racial Differences in Stroke study, 21,678 black and white participants (≥45 years) with no history of stroke were studied. Participants were recruited from 2003–2007. From 2008–2010, participants self-reported their prescription and over-the-counter sleep medication use over the past month. Suspected stroke events were identified on 6-month telephone contact, and associated medical records retrieved and physician adjudicated. Proportional hazards analysis was used to the estimate hazard ratios for incident stroke associated with sleeping medication use (0, 1–14, and 15+ days per month) controlling for sociodemographics, stroke risk factors, mental health symptoms, and sleep apnea risk. Results: At baseline, 9.6% of the sample used prescription sleep medication and 11.1% used over-the-counter sleep aids. Over an average follow-up of 3.3±1.0 years, 297 stroke events occurred. Over-the-counter sleeping medication use was associated (p = 0.014) with increased risk for incident stroke, with a 46% increased risk for use between 1 and 14 days a month (HR = 1.46; 95% CI: 0.99 - 2.15) and a 65% increased risk for use on 15 or more days (HR = 1.65; 95% CI: 0.96 - 2.85). There was no significant association with prescription sleep medications (p = 0.80). Discussion: Over-the-counter sleep medication use may independently increase the risk of stroke beyond other risk factors in middle-aged to older individuals with no history of stroke.

scholarly journals Something to Sweat About: Two Cases of Dupilumab-Induced Hyperhidrosis and Bromhidrosis

2020 ◽  
Vol 11 ◽  
pp. 215265672092770
Author(s):  
Marija Rowane ◽  
Reimus Valencia ◽  
Jason Schend ◽  
Devi Jhaveri ◽  
Robert Hostoffer
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Case Reports ◽  
Immunosuppressive Agents ◽  
Safety Data ◽  
Injection Site Reactions ◽  
Improved Outcomes ◽  
Increased Risk ◽  
History Of ◽  
Allergic Contact

Introduction Atopic dermatitis (AD, eczema) is familial chronic inflammatory skin disease of complex etiology and increasing prevalence. Dupilumab is an IL-4 receptor subunit alpha (IL-4Rα) antagonist that is the first Food and Drug Administration-approved biological therapy for moderate-to-severe adult AD inadequately controlled with topical therapies. Adverse effects reported in the literature include injection site reactions, conjunctivitis, headache, and nasopharyngitis. Objective We report the first cases of hyperhidrosis and bromhidrosis as side effects from dupilumab (Dupixent®) for the treatment of AD. Case Reports Case 1 is a 20-year-old woman with controlled allergic rhinitis and severe AD reported axillary hyperhidrosis with bromhidrosis, comparable to sweat from high-intensity exercise, with no relief from several different over-the-counter antiperspirants. Case 2 is a 61-year-old woman with history of chronic asthma, allergic contact dermatitis, allergic rhinitis, and AD noticed markedly increased sweating with bromhidrosis that was reminiscent of her menopausal symptomology, about 3 months after initiating dupilimab. Discussion Traditional immunosuppressive agents and corticosteroids have limited efficacy, numerous side effects, and increased risk of infection. The safety profile and efficacy of the newly approved IL-4Rα antagonist dupilumab may be favorable to oral immunosuppressants, but its use remains limited to severe recalcitrant cases, due to financial implications and lack of long-term safety data and comparative head-to-head trials. Conclusion We report improved outcomes with dupilumab, in addition to unpublished cases of bromhidrosis and hyperhidrosis in 2 patients with AD. This report of additional complications may inspire further clinical research and assist clinicians in considering the option of dupilumab for uncontrolled AD, despite aggressive traditional treatment.

Bisphosphonate Related Osteonecrosis of the Jaws: A Review

2011 ◽  
Vol 28 (4) ◽  
pp. 277-281 ◽  
Author(s):  
Kevin Stepaniuk
Keyword(s):  
Veterinary Medicine ◽  
Side Effects ◽  
Oral Surgery ◽  
Osteonecrosis Of The Jaws ◽  
Dog Model ◽  
Increased Risk ◽  
History Of

Bisphosphonate use has increased in veterinary medicine over the last decade. During this time, bisphosphonate related osteonecrosis of the jaws (BRONJ) in human patients has been identified. Only recently was a dog model for BRONJ developed for human oral surgery and medicine. Veterinary patients treated with bisphosphonates may be at an increased risk for BRONJ. There has been little, to no, investigation of potential long term side-effects of bisphosphonate use in veterinary patients; potential sequelae are unknown. The history of bisphosphonates, their use, and BRONJ in veterinary patients are discussed.

scholarly journals Successful Management of Hyperthyroidism With Lithium and Radioiodine in a Patient With Previous Methimazole-Induced Agranulocytosis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A958-A958
Author(s):  
Esther H Fantin ◽  
Iuri Martin Goemann
Keyword(s):  
Side Effects ◽  
Neutrophil Count ◽  
Previous History ◽  
Antithyroid Drug ◽  
Laboratory Evaluation ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Increased Risk ◽  
Definitive Therapy ◽  
History Of

Abstract Introduction: Antithyroid drug (ATD) therapy is the first-line treatment of Graves’ hyperthyroidism. Agranulocytosis, although rare, is a life-threatening condition associated with ATD therapy. For patients who recovered from ATD-induced agranulocytosis, surgery or radioiodine (RAI) therapy are adequate options to restore the patient’s euthyroid state. Here we report a case of ATD-related agranulocytosis where lithium therapy was used before RAI to control thyrotoxicosis and prevent worsening of hyperthyroidism. Case Report: A 74-year-old female with a previous history of hypertension presented with a 2-month history of weight loss (12 lbs), palpitations and shortness of breath. She was afebrile with a heart rate of 110, a blood pressure of 149/80, a fine tremor and a moderate diffuse goiter. She had a normal eye exam. Laboratory evaluation demonstrated TSH <0.01 uIU/mL (0.35-5.5), FT4 3.11 ng/dL (0.51-1.65) and TSH receptor antibody (TRAb) 40 (<1,0 U/L), consistent with thyrotoxicosis due to Graves’ disease. She was started on methimazole (MMI) 15mg and metoprolol. After four weeks, symptoms resolved and thyroid function tests (TFT) improved. However, after two months of treatment, she was hospitalized for fever, diarrhea and abdominal pain. White blood cell count (WBC) was 650/μL, and neutrophil count was 90/μL. A diagnosis of gastroenteritis and agranulocytosis was made and MMI was stopped. After seven days, symptoms resolved, the neutrophil count was 2200/ul and TFT were acceptable (FT4 1.25, ng/dL TT3 1.67 ng/ml, TSH < 0.02 uIU/mL). She was discharged without ATDs and a RAI dose of 20 mCi was scheduled. However, RAI therapy had to be postponed due to COVID-19 pandemic restrictions. After 3 weeks, TFT worsened and therapy with lithium carbonate 300 mg TID was started as the patient refused thyroidectomy. Lithium was initiated 12 days before RAI therapy and was maintained 7 days after the procedure. No side effects associated with lithium treatment were reported. TFT 7 days after RAI were FT4 1.43, ng/dL TT3 2.05 ng/ml and TSH < 0.02 uIU/mL. One month later, the patient was euthyroid without need for thyroid medication and remains on follow up. Discussion: Serum thyroid hormone (TH) concentrations usually increase after RAI therapy for Graves’ disease, a worrisome fact in patients with increased risk for cardiovascular complications. Previous studies report that pre-RAI treatment with lithium prevents changes in serum TH concentrations and enhances RAI therapy’s effectiveness. Here, treatment with lithium was used to control thyrotoxicosis and prevent further increase in TH levels associated with RAI therapy. Lithium is particularly suitable for patients with ATD-related side effects before definitive therapy (radioiodine or thyroidectomy). The antithyroid effect of lithium in this setting should be further studied.

Mediastinal Emphysema in an Adolescent With Anorexia Nervosa and Self-Induced Emesis

PEDIATRICS ◽  
1988 ◽  
Vol 81 (1) ◽  
pp. 134-136 ◽  
Author(s):  
Kim J. Overby ◽  
Iris F. Litt
Keyword(s):  
Anorexia Nervosa ◽  
Gastrointestinal Tract ◽  
Esophageal Perforation ◽  
Radiographic Evaluation ◽  
Increased Risk ◽  
Purging Behavior ◽  
Life Threatening ◽  
History Of ◽  
Boerhaave Syndrome ◽  
Upper Gastrointestinal

A case of asymptomatic pneumomediastinum in a 14-year-old girl with anorexia nervosa and self-induced emesis is reported to emphasize the atypical aspects of this case and the importance of differentiating benign from potentially life-threatening sources of mediastinal air. Individuals who engage in purging behavior are not only at increased risk for both alveolar (primary pneumomediastinum) and esophageal perforation (Boerhaave syndrome) but may also obscure or delay the diagnosis by denying symptoms and/or previous emesis. Because esophageal perforation is serious, the presence of free mediastinal air in a patient with a known or suspected history of emesis should provoke prompt radiographic evaluation of the upper gastrointestinal tract.

scholarly journals Safety of selective non-steroidal anti-inflammatory drugs: analysis of the last years data

The Clinician ◽  
2020 ◽  
Vol 14 (1-2) ◽  
pp. 91-99
Author(s):  
N. A. Shostak ◽  
A. A. Klimenko ◽  
N. A. Demidova ◽  
D. A. Anichkov
Keyword(s):  
Heart Failure ◽  
Gastrointestinal Tract ◽  
Side Effects ◽  
Adverse Events ◽  
Gastrointestinal Complications ◽  
Increased Risk ◽  
Inflammatory Drugs ◽  
Cox 2 ◽  
Anti Inflammatory ◽  
Cox 2 Inhibitors

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used pain relievers. However, their use often threatens with serious undesirable effects, associated mainly with damage to cardiovascular system (CVS), gastrointestinal tract, kidneys and liver. Contraindications to NSAIDs prescription are clearly regulated, algorithms for their personalized appointment are determined taking into account risk factors for cardiovascular and gastrointestinal adverse events. The severity of NSAIDs side effects is mainly due to the selectivity to cyclooxygenase-2 (COX-2), as well as the physicochemical properties of various drugs. Cardiovascular adverse events differ among various NSAIDs both within commonly used drugs and among COX-2 inhibitors. It is well known that NSAIDs selective for COX-2 are safer in terms of the effect on the gastrointestinal tract than non-selective drugs. A meta-analysis showed that relatively selective COX-2 inhibitors (meloxicam, etodolac) were associated with a comparable risk of developing symptomatic ulcers and ulcers identified by endoscopy, and safety and tolerability profiles of the drugs were similar.All NSAIDs are associated with cardiovascular toxicity, however, different drugs have significant risk differences. The mechanism of NSAIDs cardiovascular adverse effects is associated with an increase of blood pressure, sodium retention, vasoconstriction, platelet activation, and prothrombotic state. It has been shown that the risk of cardiovascular adverse events when taking COX-2 inhibitors (celecoxib, etoricoxib) significantly increases. According to a study of more than 8 million people, it was found that the risk of myocardial infarction was increased in patients taking ketorolac. Further, highest to lowest risk authors list indomethacin, etoricoxib, rofecoxib (not currently used), diclofenac, a fixed combination of diclofenac with misoprostol, piroxicam, ibuprofen, naproxen, celecoxib, meloxicam, nimesulide and ketoprofen. When taking NSAIDs, the risk of heart failure decompensation increases, and it turned out to be the greatest for ketorolac, etoricoxib, and indomethacin. Meloxicam, aceclofenac, ketoprofen almost did not increase heart failure risk. It should be noted that when using the drugs (except for indomethacin and meloxicam), there is a tendency to increase the total cardiovascular and renal risks with increasing doses. Thus, it is obvious that a very careful approach is required when choosing NSAIDs. If there is an increased risk of gastrointestinal complications associated with NSAIDs, selective NSAIDs are preferred, with both coxibs and traditional selective NSAIDs showing the best safety profile in the studies. To minimize cardiovascular side effects specialists should consider the risk level of cardiovascular complications, as well as results of large clinical studies where particular NSAIDs are compared.

Vitamin A: dietologist’s position

2020 ◽  
pp. 49-57
Author(s):  
S. V. Orlova ◽  
E. A. Nikitina ◽  
L. I. Karushina ◽  
Yu. A. Pigaryova ◽  
O. E. Pronina
Keyword(s):  
Immune Response ◽  
Urinary Tract ◽  
Gastrointestinal Tract ◽  
Vitamin A ◽  
Developed Countries ◽  
Therapeutic Practice ◽  
The Past ◽  
Increased Risk ◽  
Mucous Membranes

Vitamin A (retinol) is one of the key elements for regulating the immune response and controls the division and differentiation of epithelial cells of the mucous membranes of the bronchopulmonary system, gastrointestinal tract, urinary tract, eyes, etc. Its significance in the context of the COVID‑19 pandemic is difficult to overestimate. However, a number of studies conducted in the past have associated the additional intake of vitamin A with an increased risk of developing cancer, as a result of which vitamin A was practically excluded from therapeutic practice in developed countries. Our review highlights the role of vitamin A in maintaining human health and the latest data on its effect on the development mechanisms of somatic pathology.

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