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fever and antipyretics in children

Raymond P Lorenzoni, Jaeun Choi, Nadine F Choueiter, Iona M Munjal, Chhavi Katyal, Kenan W D Stern
OBJECTIVE: Kawasaki disease is the primary cause of acquired pediatric heart disease in developed nations. Timely diagnosis of Kawasaki disease incorporates transthoracic echocardiography for visualization of the coronary arteries. Sedation improves this visualization, but not without risks and resource utilization. To identify potential sedation criteria for suspected Kawasaki disease, we analyzed factors associated with diagnostically inadequate initial transthoracic echocardiography performed without sedation...
March 9, 2018: Congenital Heart Disease
Nagehan Aslan, Dincer Yildizdas, Didar Arslan, Ozden Ozgur Horoz, Hayri Levent Yilmaz, Sevcan Bilen
Paracetamol is a common antipyretic often used to treat children with fever and pain. With the increasing administration of intravenous (IV) paracetamol, there will be the associated risk of medication dosing errors. We report a case of IV paracetamol overdose in a child with fever during hospital admission. A IV paracetamol dosing error occurred, with delayed recognition resulting in transient hepatotoxicity, with a peak alanine transaminase of 1946 IU/L and aspartate transaminase of 1633 IU/L.
February 28, 2018: Pediatric Emergency Care
Jean Li-Kim-Moy, Nicholas Wood, Cheryl Jones, Kristine Macartney, Robert Booy
BACKGROUND: Comparing post-vaccination fever rates in pediatric influenza vaccine clinical trials is difficult due to variability in how fever is reported. The impact of vaccine-related fever and antipyretic use on trivalent influenza vaccine (TIV) immunogenicity in children is also unclear. METHODS: In this pilot study, we obtained individual-level data provided by GlaxoSmithKline (GSK) from three pediatric clinical trials of GSK versus comparator TIV. We explored a primary study (NCT00764790), the largest trial involving young children (6-35 months, n=3317), and further explored key findings in the two other trials (3-17 years, NCT00980005; 6m-17y NCT00383123)...
February 19, 2018: Pediatric Infectious Disease Journal
Andrea Streng, Christiane Prifert, Benedikt Weissbrich, Andreas Sauerbrei, Ruprecht Schmidt-Ott, Johannes G Liese
BACKGROUND: Limited data on the influenza burden in pediatric outpatients are available, especially regarding direct comparison of the co-circulating (sub)types A(H1N1)pdm09, A(H3N2) and B. METHODS: Children 1-5 years of age, unvaccinated against influenza and presenting with febrile acute respiratory infections (ARI), were enrolled in 33 paediatric practices in Germany from 2013-2015 (January-May). Influenza was confirmed by multiplex PCR from pharyngeal swabs and (sub)typed...
February 5, 2018: Pediatric Infectious Disease Journal
Benjamin Sticher, Julia Bielicki, Christoph Berger
BACKGROUND: In childcare centres, temporary exclusion of ill children, if their illness poses a risk of spread of harmful diseases to others, is a central approach to fight disease transmission. However, not all ill children need to be excluded. Previous studies suggested that childcare centre staff have difficulties in deciding whether or not to exclude an ill child, even when official ill-child guidelines are used. We aimed to describe, quantify and analyse these ambiguities and discuss potential solutions...
January 15, 2018: BMC Health Services Research
I Chornomydz, O Boyarchuk, A Chornomydz
Reye syndrome is a rare but a very dangerous emergency that children and teenagers suffer. This threatening condition occurs during the treatment of fever in the clinical course of viral diseases with drugs containing acetylsalicylic acid and other salicylates. The high mortality rate from this disease is associated with the development of a rapidly progressing toxic encephalopathy and hepatic insufficiency. The etiology and pathogenesis of the Reye syndrome, despite the large number of investigations, is not clear enough...
November 2017: Georgian Medical News
Shmuel Goldberg, Shmuel Heitner, Francis Mimouni, Leon Joseph, Reuben Bromiker, Elie Picard
Laboratory-based studies on the oxyhemoglobin dissociation curve (ODC) suggest that high blood temperature decreases the affinity of hemoglobin for oxygen. The aim of the study was to evaluate the influence of pyrexia on oxygen saturation (SpO2) in children presenting to the emergency department. Normoxemic children with body temperature at or above 38.5 °C were included. Patients with a dynamic respiratory disease were excluded. SpO2 was measured before and after antipyretic treatment. The changes in body temperature and SpO2 were assessed and compared to the changes predicted from the ODC...
November 3, 2017: European Journal of Pediatrics
Emmanuel B Walter, Christoph P Hornik, Lisa Grohskopf, Charles E McGee, Christopher A Todd, Oidda I Museru, Lynn Harrington, Karen R Broder
BACKGROUND: Antipyretics reduce fever following childhood vaccinations; after inactivated influenza vaccine (IIV) they might ameliorate fever and thereby decrease febrile seizure risk, but also possibly blunt the immune response. We assessed the effect of antipyretics on immune responses and fever following IIV in children ages 6 through 47 months. METHODS: Over the course of three seasons, one hundred forty-two children, receiving either a single or the first of 2 recommended doses of IIV, were randomized to receive either oral acetaminophen suspension (n = 59) or placebo (n = 59) (double-blinded) or ibuprofen (n = 24) (open-label) immediately following IIV and every 4-8 h thereafter for 24 h...
October 19, 2017: Vaccine
Abdel-Hady El-Gilany, Fawzia El Sayed Abusaad
OBJECTIVES: To reveal mothers' beliefs about signs and symptoms associated with teething and their treatment practices. POPULATION AND METHODS: A cross-sectional study done in Mansoura District on 457 mothers and their children with one or more erupted teeth. Mothers were interviewed during vaccination session at 25 chosen health facilities. Mothers were asked whether they agree or disagree about 24 signs and symptoms claimed to be associated with teething. RESULTS: Only 1...
October 2017: Saudi Dental Journal
Pier Luigi Calvo, Francesco Tandoi, Tobias B Haak, Andrea Brunati, Michele Pinon, Dominic Dell Olio, Renato Romagnoli, Marco Spada
BACKGROUND: Pediatric acute-liver-failure due to acetaminophen (APAP) administration at therapeutic dosage is rare, while viral infections and metabolic defects are the prevalent causes. Yet, as acetaminophen is routinely used in febrile illnesses, it may be mistakenly held responsible for the acute liver damage. CASE PRESENTATION: An 11 month old boy had been on acetaminophen for 10 days (total dose 720 mg = 72 mg/kg) when he developed acute-liver-failure with encephalopathy...
September 25, 2017: Italian Journal of Pediatrics
Shuvendu Roy, A K Simalti
OBJECTIVE: To assess the dynamics of the onset of antipyretic efficacy of intravenous (IV) acetaminophen vs. oral (PO) acetaminophen in the management of fever in children. METHODS: This observational single-dose study was conducted at Department of Pedriatrics, Army Hospital (Research and Referral), a multispecialty tertiary care center in New Delhi in fever patients to assess the antipyretic efficacy of IV acetaminophen 15 mg/kg/dose vs. PO acetaminophen 15 mg/kg/dose over 6 h...
January 2018: Indian Journal of Pediatrics
Egidio Barbi, Pierluigi Marzuillo, Elena Neri, Samuele Naviglio, Baruch S Krauss
Fever in children is a common concern for parents and one of the most frequent presenting complaints in emergency department visits, often involving non-pediatric emergency physicians. Although the incidence of serious infections has decreased after the introduction of conjugate vaccines, fever remains a major cause of laboratory investigation and hospital admissions. Furthermore, antipyretics are the most common medications administered to children. We review the epidemiology and measurement of fever, the meaning of fever and associated clinical signs in children of different ages and under special conditions, including fever in children with cognitive impairment, recurrent fevers, and fever of unknown origin...
September 1, 2017: Children
Ali Khiveh, Mohammad Hashem Hashempur, Mehrdad Shakiba, Mohammad Hassan Lotfi, Afsaneh Shakeri, SeidKazem Kazemeini, Zohre Mousavi, Marzie Jabbari, Mohammad Kamalinejad, Majid Emtiazy
BACKGROUND: Rheum ribes L. is a plant native to China, Iran, Turkey, India, and a few other countries. Antidiarrheal activity is considered to be one of its important properties according to various systems of traditional medicine. An increasing rate of bacterial resistance to antibiotics has led to treatment failure in some cases of shigellosis in children, and underlines a need for safe, efficient and valid options. OBJECTIVE: The purpose of this study is to evaluate the efficacy of R...
September 2017: Journal of Integrative Medicine
C Fantacci, P Ferrara, F Franceschi, A Chiaretti
OBJECTIVE: We report 2 children with Respiratory Syncytial Virus (RSV) infection complicated with spontaneous pneumopericardium (PP) and pneumomediastinum (PM), one also associated with pneumorrhachis (PR). PATIENTS AND METHODS: Two previously healthy children presented with fever, violent dry cough, dyspnea, and tachypnea. Chest X-ray and CT scans showed sizeable PP and PM in both patients. One of them also presented PR. Children were initially treated with intravenous antibiotics, antipyretics, and a cough sedative...
August 2017: European Review for Medical and Pharmacological Sciences
Yi-Chiao Lee, Ting-Hao Wang, Shih-Yu Chen, Hsiang-Ling Lin, Ming-Yen Tsai
OBJECTIVE: Viral oral ulcers are common presentations in pediatric clinics. Although self-limiting, painful ulcerative lesions and inflamed mucosa can decrease oral intake and lead to dehydration. Despite the widespread use of Chinese herbal medicine (CHM) for pediatric upper respiratory disease in Taiwan, there is little evidence for its effectiveness as an antipyretic or in aiding ulcer healing for children with viral oral ulcers. We report two cases of children who presented with viral oral ulcers to illustrate the potential efficacy of CHM treatment in recovery from herpangina (HA) and herpetic gingivostomatitis (HGS)...
June 2017: Complementary Therapies in Medicine
Maurizio de Martino, Alberto Chiarugi, Attilio Boner, Giovanni Montini, Gianluigi L De' Angelis
Ibuprofen is the most widely used non-steroidal anti-inflammatory drug (NSAID) for the treatment of inflammation, mild-to-moderate pain and fever in children, and is the only NSAID approved for use in children aged ≥3 months. Its efficacy and safety profile have led to its increasing use in paediatric care, even without medical prescription. However, an increase of suspected adverse reactions to ibuprofen has been noted in concomitance with the raised, often medically unsupervised, consumption of the drug...
August 2017: Drugs
C Schuster Bruce, Clare Hoare, Atanu Mukherjee, Siba Prosad Paul
Respiratory tract infections (RTIs), including community-acquired pneumonia (CAP), bronchiolitis, viral-induced wheeze and croup, account for more primary care consultations than any other illness group and are the most likely reason for a parent or carer to contact a health professional. The majority of RTIs in fully immunised children are usually self-limiting. However, in a small percentage of children RTIs may become life threatening and it is crucial that all front-line health professionals are able to recognise and identify these children who are at risk of deterioration...
June 8, 2017: British Journal of Nursing: BJN
Jane W Newburger
Medical therapies in patients with Kawasaki disease (KD) are administered to reduce the prevalence of coronary aneurysms, reduce systemic inflammation, and prevent coronary thrombosis. All patients with acute KD should be treated with intravenous immunoglobulin (IVIG) 2 g/kg, generally administered over 10-12 hours. Aspirin has never been shown to prevent aneurysms, but is given for its anti-inflammatory and antipyretic effects until the patient has been afebrile for ∼2 days, then lowered to an antiplatelet dose...
September 2017: Congenital Heart Disease
Geraldo Duarte, Antonio Fernandes Moron, Artur Timerman, César Eduardo Fernandes, Corintio Mariani Neto, Gutemberg Leão de Almeida Filho, Heron Werner Junior, Hilka Flavia Barra do Espírito Santo, João Alfredo Piffero Steibel, João Bortoletti Filho, Juvenal Barreto Borriello de Andrade, Marcelo Burlá, Marcos Felipe Silva de Sá, Newton Eduardo Busso, Paulo César Giraldo, Renato Augusto Moreira de Sá, Renato Passini Junior, Rosiane Mattar, Rossana Pulcineli Vieira Francisco
From the discovery of the Zika virus (ZIKV) in 1947 in Uganda (Africa), until its arrival in South America, it was not known that it would affect human reproductive life so severely. Today, damage to the central nervous system is known to be multiple, and microcephaly is considered the tip of the iceberg. Microcephaly actually represents the epilogue of this infection's devastating process on the central nervous system of embryos and fetuses. As a result of central nervous system aggression by the ZIKV, this infection brings the possibility of arthrogryposis, dysphagia, deafness and visual impairment...
May 2017: Revista Brasileira de Ginecologia e Obstetrícia
Markus Lundgren, Leigh Johnson Steed, Roy Tamura, Berglind Jonsdottir, Patricia Gesualdo, Claire Crouch, Maija Sjöberg, Gertie Hansson, William A Hagopian, Anette G Ziegler, Marian J Rewers, Åke Lernmark, Jorma Toppari, Jin-Xiong She, Beena Akolkar, Jeffrey P Krischer, Michael J Haller, Helena Elding Larsson
BACKGROUND: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity...
May 16, 2017: BMC Pediatrics
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