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Paracetamol challenge

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https://www.readbyqxmd.com/read/28671222/automation-of-route-identification-and-optimisation-based-on-data-mining-and-chemical-intuition
#1
A A Lapkin, P K Heer, P-M Jacob, M Hutchby, W Cunningham, S D Bull, M G Davidson
Data-mining of Reaxys and network analysis of the combined literature and in-house reactions set were used to generate multiple possible reaction routes to convert a bio-waste feedstock, limonene, into a pharmaceutical API, paracetamol. The network analysis of data provides a rich knowledge-base for generation of the initial reaction screening and development programme. Based on the literature and the in-house data, an overall flowsheet for the conversion of limonene to paracetamol was proposed. Each individual reaction-separation step in the sequence was simulated as a combination of the continuous flow and batch steps...
July 3, 2017: Faraday Discussions
https://www.readbyqxmd.com/read/28663625/a-comparative-study-of-analgesic-efficacy-of-intrathecal-buprenorphine-with-ultrasound-guided-transversus-abdominis-plane-block-for-postcesarean-delivery-analgesia
#2
Prakash Marappa, Manjunath Abloodu Chikkapillappa, Nagaraj Mungasuvalli Chennappa, Vinayak Seenappa Pujari
BACKGROUND: Women undergoing cesarean (CS) delivery present a unique set of challenges to the anesthetist in terms of postoperative pain management. This study was conducted to compare the analgesic efficacy of intrathecal buprenorphine (ITB) with ultrasound-guided transversus abdominis plane (TAP) block in post-CS delivery pain. METHODOLOGY: A prospective randomized comparative study of sixty American Society of Anesthesiologists physical status I and II pregnant patients divided into two groups of thirty each as ITB group and TAP block group after satisfying the inclusion criteria...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28614776/nonsteroidal-anti-inflammatory-drugs-induced-failure-of-lower-esophageal-and-pyloric-sphincter-and-counteraction-of-sphincters-failure-with-stable-gatric-pentadecapeptide-bpc-157-in-rats
#3
S Vitaic, M Stupnisek, D Drmic, L Bauk, A Kokot, R Klicek, A Vcev, K Luetic, S Seiwerth, P Sikiric
The sphincters failure is a part of NSAIDs-toxicity that can be accordingly counteracted. We used a safe stable gastric pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, MW 1419), LD1 not achieved, since successful in inflammatory bowel disease trials, and counteracts esophagitis, sphincters failure, gastrointestinal ulcer and skin ulcer, external and internal fistulas in rats, and particularly counteracts all NSAIDs-lesions. We assessed lower esophageal sphincter and pyloric sphincter pressure (cmH2O) in rats treated with various NSAIDs regimens, at corresponding time points, known to produce stomach, small intestine lesions, hepatotoxicity and encephalopathy...
April 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28588045/assessing-the-impact-of-in-utero-exposures-potential-effects-of-paracetamol-on-male-reproductive-development
#4
REVIEW
Karen R Kilcoyne, Rod T Mitchell
Human male reproductive disorders (cryptorchidism, hypospadias, testicular cancer and low sperm counts) are common and some may be increasing in incidence worldwide. These associated disorders can arise from subnormal testosterone production during fetal life. This has resulted in a focus on in-utero environmental influences that may result in reproductive effects on the offspring in later life. Over recent years, there has been a dramatic increase in the scientific literature describing associations between in-utero environmental exposures (eg, industrial chemicals and pharmaceuticals) and subsequent reproductive outcomes in male offspring...
June 6, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28492168/accidental-intravenous-administration-of-paracetamol-syrup-in-a-child
#5
D El Mazloum, A Boner, A Pietrobelli
OBJECTIVE AND IMPORTANCE: Medication administration errors occur frequently in clinical practice. CLINICAL PRESENTATION: An 18-month-old child presented with vomiting and diarrhea. Due to a rise in temperature, paracetamol syrup was prescribed, but a nurse inadvertently administered the drug IV through the peripheral venous access. INTERVENTION: The child was referred to the pediatric intensive care unit where his clinical condition improved and the risk of peripheral venous and pulmonary embolism was excluded...
December 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28286920/blockade-of-notch-signaling-promotes-acetaminophen-induced-liver-injury
#6
Longfeng Jiang, Michael Ke, Shi Yue, Wen Xiao, Youde Yan, Xiaozhao Deng, Qi-Long Ying, Jun Li, Bibo Ke
Liver injury after experimental acetaminophen treatment is mediated both by direct hepatocyte injury through a P450-generated toxic metabolite and indirectly by activated liver Kupffer cells and neutrophils. This study was designed to investigate the role of Notch signaling in the regulation of innate immune responses in acetaminophen (APAP)-induced liver injury. Using a mouse model of APAP-induced liver injury, wild-type (WT) and toll-like receptor 4 knockout (TLR4 KO) mice were injected intraperitoneally with APAP or PBS...
June 2017: Immunologic Research
https://www.readbyqxmd.com/read/28217067/septo-optic-dysplasia-de-morsier-s-syndrome
#7
Pedro Reis, Joana Mourão
Septo-optic dysplasia (SOD)/de Morsier's syndrome is characterized by optic nerve hypoplasia, pituitary endocrine dysfunction, and midline brain abnormalities. Hypopituitarism, hypothyroidism, hypogonadism, and adrenal insufficiency can lead to severe hypoglycemia, adrenal crisis, seizures, and sudden death. Anesthetic management of SOD was associated with high perioperative mortality. A 9-year-old male child proposed for dental treatments/extractions. Medical history of SOD with hypopituitarism, hypothyroidism, and delayed psychomotor development was observed...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28190750/role-of-diclofenac-sodium-and-paracetamol-on-colonic-anastomosis-an-experimental-rodent-model
#8
Osman Bilgin Gulcicek, Ali Solmaz, Hakan Yigitbas, Candas Ercetin, Erkan Yavuz, Kamil Ozdogan, Aytac Biricik, Asli Kahraman Akkalp, Hafize Uzun, Muge Kutnu, Fatih Celebi, Atilla Celik
BACKGROUND: Despite many advances in surgery and technology, colonic anastomosis remains a challenge after colonic resection. The purpose of this study is to compare the safety of using diclofenac sodium and paracetamol for analgesia in colonic anastomosis on rats. METHODS: Wistar-Hannover rats were randomly allocated to four groups: Group 1, sham-operated group; Group 2, control group; Group 3, diclofenac sodium group; Group 4, paracetamol group. After laparotomy, the left colon was transected and a single-layer anastomosis was made with 5/0 vicryl in Groups 2, 3, and 4...
February 10, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28142397/effects-on-pain-of-a-stepwise-multidisciplinary-intervention-sta-op-that-targets-pain-and-behavior-in-advanced-dementia-a-cluster-randomized-controlled-trial
#9
Marjoleine Jc Pieper, Jenny T van der Steen, Anneke L Francke, Erik Ja Scherder, Jos Wr Twisk, Wilco P Achterberg
BACKGROUND: Pain in nursing home residents with advanced dementia remains a major challenge; it is difficult to detect and may be expressed as challenging behavior. STA OP! aims to identify physical and other needs as causes of behavioral changes and uses a stepwise approach for psychosocial and pharmacological management which was effective in improving challenging behavior. AIM: To assess whether implementation of the stepwise multidisciplinary intervention also reduces pain and improves pain management...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28096254/factors-predicting-antibiotic-prescription-and-referral-to-hospital-for-children-with-respiratory-symptoms-secondary-analysis-of-a-randomised-controlled-study-at-out-of-hours-services-in-primary-care
#10
Ingrid Keilegavlen Rebnord, Hogne Sandvik, Anders Batman Mjelle, Steinar Hunskaar
OBJECTIVES: Acute respiratory infections and fever among children are highly prevalent in primary care. It is challenging to distinguish between viral and bacterial infections. Norway has a relatively low prescription rate of antibiotics, but it is still regarded as too high as the antimicrobial resistance is increasing. The aim of the study was to identify predictors for prescribing antibiotics or referral to hospital among children. DESIGN: Secondary analysis of a randomised controlled study...
January 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/27889114/the-hidden-web-and-the-fentanyl-problem-detection-of-ocfentanil-as-an-adulterant-in-heroin
#11
Pol Quintana, Mireia Ventura, Marc Grifell, Alvaro Palma, Liliana Galindo, Iván Fornís, Cristina Gil, Xoán Carbón, Fernando Caudevilla, Magí Farré, Marta Torrens
BACKGROUND: The popularization of anonymous markets such as Silk Road is challenging current drug policy and may provide a new context for old issues, such as adulteration of heroin with fentanyl derivatives. The aims of this paper are to report the presence of ocfentanil, a novel, potent, non-controlled fentanyl analog, in samples sold as heroin in the hidden web, and to summarize the effects reported by users. METHODS: In 2015, four samples allegedly bought as heroin in cryptomarkets of the hidden web were sent to Energy Control for analysis...
November 23, 2016: International Journal on Drug Policy
https://www.readbyqxmd.com/read/27867510/effect-of-adding-intrathecal-morphine-to-a-multimodal-analgesic-regimen-for-postoperative-pain-management-after-laparoscopic-bariatric-surgery-a-prospective-double-blind-randomized-controlled-trial
#12
Fatma Adel El Sherif, Ahmed Hassan Othman, Ahmad Mohammad Abd El-Rahman, Osama Taha
BACKGROUND: Pain control after bariatric surgery is a major challenge. Our objective was to study the efficacy and safety of intrathecal (IT) morphine 0.3 mg added to bupivacaine 0.5% for postoperative pain after laparoscopic bariatric surgery. METHODS: After local ethics committee approval, 100 morbidly obese patients scheduled for laparoscopic bariatric surgery were enrolled in this study. Patients were randomly assigned into two groups: Group I received IT 0...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27792212/postoperative-analgesia-for-elective-total-knee-arthroplasty-under-subarachnoid-anesthesia-with-opioids-comparison-between-epidural-femoral-block-and-adductor-canal-block-techniques-with-and-without-perineural-adjuvants-a-prospective-randomized-clinical-trial
#13
José R Ortiz-Gómez, Marta Perepérez-Candel, José M Vázquez-Torres, José M Rodriguez-Del Río, Berta Torrón-Abad, Inocencia Fornet-Ruiz, Francisco J Palacio-Abizanda
BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 hours) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm)...
January 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27785937/paracetamol-and-morphine-for-infant-and-neonatal-pain-still-a-long-way-to-go
#14
REVIEW
Manuel A Baarslag, Karel Allegaert, John N Van Den Anker, Catherijne A J Knibbe, Monique Van Dijk, Sinno H P Simons, Dick Tibboel
Pharmacologic pain management in newborns and infants is often based on limited scientific data. To close the knowledge gap, drug-related research in this population is increasingly supported by the authorities, but remains very challenging. This review summarizes the challenges of analgesic studies in newborns and infants on morphine and paracetamol (acetaminophen). Areas covered: Aspects such as the definition and multimodal character of pain are reflected to newborn infants. Specific problems addressed include defining pharmacodynamic endpoints, performing clinical trials in this population and assessing developmental changes in both pharmacokinetics and pharmacodynamics...
January 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27750355/-medical-treatment-of-newly-arrived-refugees-in-erlangen-a-study-of-drug-prescription-rates-focused-on-psychotropic-drugs
#15
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...
April 2017: Psychotherapie, Psychosomatik, Medizinische Psychologie
https://www.readbyqxmd.com/read/27738964/the-challenges-of-treating-sciatica-pain-in-older-adults
#16
REVIEW
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...
November 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27727412/medicines-use-in-hospitalised-children-current-status-and-outcome-after-an-intervention
#17
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
https://www.readbyqxmd.com/read/27712027/clinical-practice-guidelines-for-the-noninvasive-management-of-low-back-pain-a-systematic-review-by-the-ontario-protocol-for-traffic-injury-management-optima-collaboration
#18
REVIEW
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
https://www.readbyqxmd.com/read/27682287/postoperative-pain-relief-and-functional-outcome-following-total-knee-arthroplasty-a-prospective-comparative-audit-of-three-analgesic-regimes
#19
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
https://www.readbyqxmd.com/read/27677236/-amoxicillin-and-paracetamol-dosing-in-children-playing-safe
#20
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
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