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Paracetamol challenge

Fabian Kahl, Andreas Frewer
Background: In 2015 the number of refugees who sought asylum in Germany has increased dramatically. Therefore, the medical care for these refugees faces huge challenges. The treatment of mental illness of refugees is a particular difficult topic. Objective of this study is the acquisition of the outpatient prescriptions of drugs for newly arrived refugees in Erlangen, focused on psychotropic drugs. Methods: Evaluation of all outpatient prescribed drugs (n=1 137), which were prescribed between 10/01/2014 and 09/30/2015 for asylum seekers living in the refugee center in Erlangen, a branch of the "Central Admission Institution" ("ZAE") Zirndorf...
October 17, 2016: Psychotherapie, Psychosomatik, Medizinische Psychologie
Manuela L Ferreira, Andrew McLachlan
Sciatica is a debilitating condition affecting approximately 25 % of the population. Typically, the patient will complain of lower limb pain that is more severe than pain in the lower back, usually accompanied by numbness and motor weakness. Most international guidelines recommend pharmacological management for the pain relief of sciatica, including paracetamol, non-steroidal anti-inflammatory drugs, opioid analgesics, anticonvulsants, and corticosteroids, among others. However, the evidence for most of these pharmacological options is scarce, and the majority of clinical trials exclude older patients...
October 13, 2016: Drugs & Aging
S N Thiyahiny, M G Sathiadas, K Sanchayan, C Vamadevan, R Balasubramaniam, S Sri Ranganathan
INTRODUCTION: Challenges in rational use of medicines (RUM) in children are different from that of adults. In Sri Lanka, data on RUM in children are limited. OBJECTIVE: To assess the current status and to investigate effectiveness of an intervention in improving RUM in children. METHODS: Non-randomised controlled before and after study design was employed. Study settings were one paediatric unit in two Teaching Hospitals one for intervention (IU) and the other as a control (CU) unit...
2016: Ceylon Medical Journal
J J Wong, P Côté, D A Sutton, K Randhawa, H Yu, S Varatharajan, R Goldgrub, M Nordin, D P Gross, H M Shearer, L J Carroll, P J Stern, A Ameis, D Southerst, S Mior, M Stupar, T Varatharajan, A Taylor-Vaisey
: We conducted a systematic review of guidelines on the management of low back pain (LBP) to assess their methodological quality and guide care. We synthesized guidelines on the management of LBP published from 2005 to 2014 following best evidence synthesis principles. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane, DARE, National Health Services Economic Evaluation Database, Health Technology Assessment Database, Index to Chiropractic Literature and grey literature. Independent reviewers critically appraised eligible guidelines using AGREE II criteria...
October 6, 2016: European Journal of Pain: EJP
A Rajeev, N Tumia, K Karn, S Kashyap, D Mayne
Pain control plays a key role in joint-replacement -surgery. As a surgeon the challenge is to reduce pain to an acceptable level in the post-operative period. The aim of the study was to assess the efficacy of bolus -local anaesthesia, infusion in to the surgical site and nerve blocks with femoral nerve catheter and its functional outcome. A prospective audit of 114 patients undergoing total knee arthroplasty were carried out.The patients were divided in to three groups : Group 1 (n = 27) received a bolus injection of 20 ml 0...
August 2016: Acta Orthopaedica Belgica
B Peters, E G P M de Bont, J W L Cals
Amoxicillin and paracetamol are the two most widely prescribed and recommended medicines in children. Due to lack of scientific evidence of the most effective dosage, dosing instructions of both medicines are often unclear. In this article we challenge general practitioners, paediatricians, child-health clinic physicians, ENT specialists, pharmacists and guideline committees to critically evaluate the current dosing instructions of these two medicines. The Netherlands paediatric formulary, the Kinderformularium, should become the primary formulary for children in the Netherlands, but it has to be more in line with daily practice, and basic dosing instructions should be less ambiguous: (a) dosing instructions based on body weight instead of age; b) in case of pain, paracetamol should be given 60 mg/kg/day in four divided doses; (c) in case of common uncomplicated infections, amoxicillin should be given orally 60 mg/kg/day in two divided doses; (d) the following should be mentioned on the antibiotic prescription: the daily dose, the number of divided doses, the duration of therapy, the indication for the prescription, and the child's weight...
2016: Nederlands Tijdschrift Voor Geneeskunde
Mariana Rossi, Piero Gasparotto, Michele Ceriotti
Molecular crystals often exist in multiple competing polymorphs, showing significantly different physicochemical properties. Computational crystal structure prediction is key to interpret and guide the search for the most stable or useful form, a real challenge due to the combinatorial search space, and the complex interplay of subtle effects that work together to determine the relative stability of different structures. Here we take a comprehensive approach based on different flavors of thermodynamic integration in order to estimate all contributions to the free energies of these systems with density-functional theory, including the oft-neglected anharmonic contributions and nuclear quantum effects...
September 9, 2016: Physical Review Letters
Hongtao Lu, Zhiliang Zhu, Hua Zhang, Jianyao Zhu, Yanling Qiu, Linyan Zhu, Stephan Küppers
Acetaminophen can increase the risk of arsenic-mediated hepatic oxidative damage; therefore, the decontamination of water polluted with coexisting acetaminophen and arsenic gives rise to new challenges for the purification of drinking water. In this work, a three-metal layered double hydroxide, namely, Cu-Zn-Fe-LDH, was synthesized and applied as a heterogeneous Fenton-like oxidation catalyst and adsorbent to simultaneously remove acetaminophen (Paracetamol, PR) and arsenic. The results showed that the degradation of acetaminophen was accelerated with decreasing pH or increasing H2O2 concentrations...
September 28, 2016: ACS Applied Materials & Interfaces
Ania Carsin, Joana Vitte, Pascal Demoly, Jean-Christophe Dubus
No abstract text is available yet for this article.
October 2016: Annals of Allergy, Asthma & Immunology
Inés Tofé Valera, María Pilar Jaraba Caballero, María Dolores Ruiz González, María Victoria Rodríguez Benítez, María José Parraga Quiles
No abstract text is available yet for this article.
August 4, 2016: Revista Española de Cardiología
G Hughes, R M Pemberton, P R Fielden, J P Hart
A reagentless glutamate biosensor was applied to the determination of glutamate released from liver hepatocellular carcinoma cells (HepG2) in response to toxic challenge from various concentrations of paracetamol. A screen printed carbon electrode (SPCE) containing the electrocatalyst Meldola's Blue (MB-SPCE) served as the electron mediator for the oxidation of NADH. A mixture of the enzyme glutamate dehydrogenase (GLDH), cofactor nicotinamide adenine dinucleotide (NAD(+)) and the biopolymer chitosan (CHIT) were drop-coated onto the surface of the transducer (MB-SPCE) in a simple one step fabrication process...
August 24, 2016: Analytica Chimica Acta
Diana Pérez-Alzate, Natalia Blanca-López, Inmaculada Doña, José A Agúndez, Elena García-Martín, José A Cornejo-García, James R Perkins, Miguel Blanca, Gabriela Canto
In subjects with non-steroidal anti-inflammatory drugs (NSAIDs)- exacerbated respiratory disease (NERD) symptoms are triggered by acetyl salicylic acid (ASA) and other strong COX-1 inhibitors, and in some cases by weak COX-1 or by selective COX-2 inhibitors. The mechanism involved is related to prostaglandin pathway inhibition and leukotriene release. Subjects who react to a single NSAID and tolerate others are considered selective responders, and often present urticaria and/or angioedema and anaphylaxis (SNIUAA)...
2016: Frontiers in Pharmacology
Gaetano Piccinocchi, Roberto Piccinocchi
Treatment of chronic pain is challenging. The Arkys project was initiated in Italy to assist general practitioners (GPs) in the management of chronic pain. The main objective of this study was to determine the usefulness of Arkys for selecting new therapeutic strategies. An online interactive questionnaire for assessing pain and guiding therapeutic decisions was made available to GPs participating to Arkys. The GPs were invited to complete the questionnaire for each patient who presented moderate-severe chronic pain, and to decide on a new analgesic treatment based on the information provided by the questionnaire...
April 26, 2016: Clinics and Practice
Bo Lund Krogsgaard Chawes
Asthma and allergies are today the most common chronic diseases in children and the leading causes of school absences, chronic medication usage, emergency department visits and hospitalizations, which affect all members of the family and represent a significant societal and scientific challenge. These highly prevalent disorders are thought to originate from immune distortion in early childhood, but the etiology and heterogeneity of the disease mechanisms are not understood, which hampers preventive initiatives and makes treatment inadequate...
August 2016: Danish Medical Journal
Cosima Hirschberg, Changquan Calvin Sun, Jukka Rantanen
Characterization of particulate systems (powders) is one of the remaining scientific challenges. Evaluation of powder behaviour is often empirical and the decision-making processes are experience-based. There is a need for development of analytical instrumentation enabling more fundamental understanding of powder behaviour. Flowability and tabletability, two key factors in commercial scale manufacturing of tablets with direct compression (DC) approach, were analysed for formulations containing increasing amounts of several model active pharmaceutical ingredients (APIs)...
September 5, 2016: Journal of Pharmaceutical and Biomedical Analysis
Richard W Simpson, John H Wlodarczyk
OBJECTIVE: To evaluate the efficacy and safety of transdermal buprenorphine in patients with diabetic peripheral neuropathic pain (DPNP). RESEARCH DESIGN AND METHODS: This multicenter, randomized, double-blind, placebo-controlled, parallel-group trial enrolled patients with type 1 or type 2 diabetes and stable glycemic control who had been experiencing moderate to severe DPNP for at least 6 months on maximal tolerated conventional therapy. Patients were randomly assigned to receive buprenorphine (5 μg/h) or placebo patches...
September 2016: Diabetes Care
Nancy A Dreyer, Stella Cf Blackburn, Shahrul Mt-Isa, Jonathan L Richardson, Simon Thomas, Maja Laursen, Priscilla Zetstra-van der Woude, Anna Jamry-Dziurla, Valerie Hliva, Alison Bourke, Lolkje de Jong-van den Berg
BACKGROUND: Little is known about the effects of human fetal exposure when a new drug is authorized unless it was specifically developed for use in pregnancy. Since many factors may contribute to adverse fetal effects, having comprehensive information about in utero exposures will enhance our ability to make correct determinations about causality. OBJECTIVE: The objective of the study was to assess the extent to which women, recruited without the intervention of health care professionals (HCPs), will provide information, suitable for research purposes, via the Internet or by phone on some potential risk factors in pregnancy...
July 2015: JMIR Public Health and Surveillance
Sara E Rostas, Christopher C McPherson
Management of the patent ductus arteriosus (PDA) represents an ongoing challenge in the care of extremely premature neonates. Determining the optimal treatment strategy requires careful consideration of the potential risks and benefits of available therapies. Surgical ligation results in reliable ductal closure, but may result in numerous short-term complications and have a negative impact on long-term outcome. Intravenous indomethacin was the first pharmacologic agent widely utilized for PDA closure. Intravenous indomethacin effectively closes the ductus arteriosus and prevents pulmonary hemorrhage and severe intraventricular hemorrhage, but fails to mitigate short-term morbidities and improve long-term outcomes...
2016: Current Pediatric Reviews
Philip Sarges, Joshua M Steinberg, James H Lewis
Numerous publications contributed to the expanding knowledge base about drug-induced liver injury (DILI) in 2015. New findings from the US Drug Induced Liver Injury Network (DILIN) in their most recently updated registry include a 1- to 3-week delay in the appearance of acute DILI from short-course antibiotics such as cefazolin. They corroborated the finding that acute DILI in patients with underlying liver disease was far more severe and potentially fatal than in patients without liver disease. The only drug that seemed to have an increased risk of hepatotoxicity in these patients was azithromycin...
September 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Hosein Kimiaei Asadi, Mahshid Nikooseresht, Lida Noori, Fatholah Behnoud
BACKGROUND: Tonsillectomy is one of the most common surgeries in children and posttonsillectomy pain and agitation management is a great challenge for anesthesiologists. OBJECTIVES: The aim of this study was to compare the efficacy of a single dose of ketamine combined with paracetamol with paracetamol alone in the management of postoperative pain in tonsillectomy. MATERIALS AND METHODS: In this study, the subjects were randomly allocated into the two groups: the ketamine and control...
February 2016: Anesthesiology and Pain Medicine
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