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Frontiers in Public Health 2023As China amends its "zero COVID" strategy, a sudden increase in the number of infections may overwhelm medical resources and its impact has not been quantified. Specific...
BACKGROUND
As China amends its "zero COVID" strategy, a sudden increase in the number of infections may overwhelm medical resources and its impact has not been quantified. Specific mitigation strategies are needed to minimize disruption to the healthcare system and to prepare for the next possible epidemic in advance.
METHOD
We develop a stochastic compartmental model to project the burden on the medical system (that is, the number of fever clinic visits and admission beds) of China after adjustment to COVID-19 policy, which considers the epidemiological characteristics of the Omicron variant, age composition of the population, and vaccine effectiveness against infection and severe COVD-19. We also estimate the effect of four-dose vaccinations (heterologous and homologous), antipyretic drug supply, non-pharmacological interventions (NPIs), and triage treatment on mitigating the domestic infection peak.
RESULT
As to the impact on the medical system, this epidemic is projected to result in 398.02 million fever clinic visits and 16.58 million hospitalizations, and the disruption period on the healthcare system is 18 and 30 days, respectively. Antipyretic drug supply and booster vaccination could reduce the burden on emergency visits and hospitalization, respectively, while neither of them could not reduce to the current capacity. The synergy of several different strategies suggests that increasing the heterologous booster vaccination rate for older adult to over 90% is a key measure to alleviate the bed burden for respiratory diseases on the basis of expanded healthcare resource allocation.
CONCLUSION
The Omicron epidemic followed the adjustment to COVID-19 policy overloading many local health systems across the country at the end of 2022. The combined effect of vaccination, antipyretic drug supply, triage treatment, and PHSMs could prevent overwhelming medical resources.
Topics: Humans; Aged; Antipyretics; COVID-19; SARS-CoV-2; China; Fever; Policy
PubMed: 38106897
DOI: 10.3389/fpubh.2023.1259084 -
Pediatrics and Neonatology Oct 2020Antipyretics are frequently used in pediatric practice. Both acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to increase the risk of...
BACKGROUND
Antipyretics are frequently used in pediatric practice. Both acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to increase the risk of asthma exacerbation. The study investigated antipyretic use during respiratory infection in children and analyzed the risk of acetaminophen and NSAID for severe asthma exacerbation (AE) in asthmatic children in Taiwan.
METHODS
We used the data from the National Health Insurance Research Database in 2005. There were 27,095 pediatric asthmatic patients having at least one respiratory infection episode, and 27,095 age- and sex-matched non-asthmatic children with respiratory infection served as controls. These patients were divided into groups with acetaminophen use, NSAID cyclooxygenase-1 (COX-1) use, and no antipyretic use. The rate of AE occurrence within the first 7 days after respiratory infection diagnosis was compared among the groups.
RESULTS
During a single episode of respiratory infection, asthmatic patients used fewer antipyretics than controls (48.51% vs. 55.50%, p < 0.001). No difference was observed in the risk of AE occurrence within 7 days after respiratory infection between antipyretic users and antipyretic nonusers (22/13,144 [0.167%] vs. 12/13,951 [0.086%], p = 0.058). Compared with asthmatic children using acetaminophen, those using no antipyretic and COX-1 have lower risks for AE (OR: 0.26, 95% CI: 0.12-0.54, p < 0.001; and OR: 0.14, 95% CI: 0.03-0.61, p = 0.009).
CONCLUSION
In asthmatic children, the rate of AE after a single respiratory infection episode was around 0.144%. The risk of AE was higher in those who took acetaminophen.
Topics: Acetaminophen; Adolescent; Anti-Inflammatory Agents, Non-Steroidal; Antipyretics; Asthma; Child; Child, Preschool; Female; Humans; Male; Respiratory Tract Infections
PubMed: 32331972
DOI: 10.1016/j.pedneo.2020.03.018 -
Medicina (Kaunas, Lithuania) Mar 2019Pharmaceutical literacy skills of parents are crucial for appropriate and safe medication use in pre-school children (ages 1⁻7 years). A recent study on...
Pharmaceutical literacy skills of parents are crucial for appropriate and safe medication use in pre-school children (ages 1⁻7 years). A recent study on pharmacotherapy literacy from Serbia showed that one in five parents have difficulty understanding common information about the use of medicines. Because antipyretics are considered to be the most frequently used group of over-the-counter (OTC) medications during the pre-school period, we aimed to: (i) examine parental practice and expectations in antipyretic medication use, and (ii) analyze associations of parental practice and expectations related to socio-economic status and pharmacotherapy literacy. A cross-sectional survey using a self- report validated specific instrument was conducted with the parents of pre-school children in kindergartens in Belgrade, Serbia. Pharmacotherapy literacy refers to the knowledge and personal skills needed to meet the complex demands of medicine use in both healthcare and non-healthcare settings. A comprehensive literature review, expert-focus group consultation, and pre-testing were employed in 4-item multiple-choice test development to explore practice and expectations related to the use of OTC pediatric antipyretic medicines. The final analytical cohort was comprised of 813 participants, the majority (63.3%) chose a medicine based on a physician's suggestion and only 15.4% of parents reported they would follow the advice of a pharmacist. More than a half of parents (54.1%) would need advice about antipyretic medicine from a pharmacist, firstly in a simpler language. Parents satisfied with the information given by a pharmacist had higher pharmacotherapy literacy, compared to parents with lower levels (OR⁻0.718, 95%CI (0.597⁻0.865), < 0.001). Men had a higher expectation of pharmacists to explain medicine use in a simpler language (OR⁻1.630, 95%CI (1.063⁻2.501), = 0.025), as well as parents with three or more children (OR⁻2.527, 95%CI (1.43⁻4.459), = 0.001). Parents with higher knowledge about medicine use were less likely to ask for simpler information (OR⁻0,707; 95%CI (0,583⁻0,856), < 0,001). Our main finding is that practice in antipyretic OTC medicine use was associated with levels of parental pharmacotherapy literacy. The expectations of pharmacists were higher among parents with lower levels of pharmacotherapy literacy, who expected more information in a simpler and more precise language. This study highlighted the need for pharmacists to identify risks in parental practice and to provide information about medicines to parents of pre-school children in a simpler and more appropriate way.
Topics: Adolescent; Adult; Antipyretics; Child; Child Health; Child, Preschool; Cohort Studies; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Health Literacy; Humans; Infant; Logistic Models; Male; Middle Aged; Multivariate Analysis; Nonprescription Drugs; Parents; Pediatricians; Pharmacists; Self Report; Serbia; Young Adult
PubMed: 30917624
DOI: 10.3390/medicina55030080 -
Anais Da Academia Brasileira de Ciencias Jun 2011Cariniana rubra Miers (Lecythidaceae), popularly known as "jequitibá-vermelho'', is a large Brazilian tree whose bark is used in infusion and decoction for the...
Cariniana rubra Miers (Lecythidaceae), popularly known as "jequitibá-vermelho'', is a large Brazilian tree whose bark is used in infusion and decoction for the treatment of inflammatory conditions. This study aims to assess the anti-inflammatory, antinociceptive, and antipyretic effects of Cariniana rubra methanolic stem bark extract (EM Cr) using experimental animals. Anti-inflammatory activity of EM Cr was tested on carrageenan and dextran-induced rat paw edema, carrageenan-induced pleurisy in rats and acetic acid-increase vascular permeability in mice. Antinociceptive and antipyretic activities were evaluated using acetic acid-induced writhing, formalin and hot-plate tests in mice, as well as brewer's yeast-induced pyrexia in rats. The extract inhibitied carrageenan and dextran-induced edema, reduced exudate volume and leukocyte migration on the carrageenan-induced pleurisy and on the vascular permeability increase induced by acetic acid. The EM Cr inhibited nociception on the acetic acid-induced writhing and in the second phase of formalin test, and decreased rectal temperature. It was, however, inactive against thermal nociception.Phytochemical analysis with EM Cr showed the occurrence of saponins, triterpenes, sterols and phenolic compounds. Phytosterols (β-sitosterol, stigmasterol), pentacyclic triterpenes (α- and β-amyrin as a mixture), arjunolic acid, a phytosterol glycoside (sitosterol 3-O-β-D-glucopyranoside), and triterpenoid saponins (28-β-glucopyranosyl-23-O-acetyl arjunolic acid; 3-O-β-glucopyranosyl arjunolic acid and 28-O-[α-L-Rhamnopyranosyl-(1→2)-β-glucopyranosyl]-23- O-acetyl arjunolic acid) were the main identified compounds. It can be presumed that EM Cr caused their effects by inhibiting the liberation and/or action of different inflammatory mediators. These findings support the traditional use of Cariniana rubra preparations to treat inflammation.
Topics: Analgesics; Animals; Anti-Inflammatory Agents; Antipyretics; Capillary Permeability; Carrageenan; Edema; Lecythidaceae; Mice; Plant Bark; Plant Extracts; Plant Stems; Pleurisy; Rats; Rats, Wistar
PubMed: 21625800
DOI: 10.1590/s0001-37652011005000006 -
Scientific Reports Jul 2015Acetaminophen (APAP) is an effective antipyretic and one of the most commonly used analgesic drugs. Unlike antipyretic non-steroidal anti-inflammatory drugs, APAP...
Acetaminophen (APAP) is an effective antipyretic and one of the most commonly used analgesic drugs. Unlike antipyretic non-steroidal anti-inflammatory drugs, APAP elicits hypothermia in addition to its antipyretic effect. Here we have examined the mechanisms responsible for the hypothermic activity of APAP. Subcutaneous, but not intrathecal, administration of APAP elicited a dose dependent decrease in body temperature in wildtype mice. Hypothermia was abolished in mice pre-treated with resiniferatoxin to destroy or defunctionalize peripheral TRPV1-expressing terminals, but resistant to inhibition of cyclo-oxygenases. The hypothermic activity was independent of TRPV1 since APAP evoked hypothermia was identical in wildtype and Trpv1(-/-) mice, and not reduced by administration of a maximally effective dose of a TRPV1 antagonist. In contrast, a TRPA1 antagonist inhibited APAP induced hypothermia and APAP was without effect on body temperature in Trpa1(-/-) mice. In a model of yeast induced pyrexia, administration of APAP evoked a marked hypothermia in wildtype and Trpv1(-/-) mice, but only restored normal body temperature in Trpa1(-/-) and Trpa1(-/-)/Trpv1(-/-) mice. We conclude that TRPA1 mediates APAP evoked hypothermia.
Topics: Acetaminophen; Acrolein; Animals; Antipyretics; Benzoquinones; Diterpenes; Female; Hypothermia; Hypothermia, Induced; Imines; Injections, Intraperitoneal; Injections, Subcutaneous; Male; Mice, Inbred C57BL; Mice, Mutant Strains; Sensory Receptor Cells; TRPA1 Cation Channel; TRPV Cation Channels; Transient Receptor Potential Channels
PubMed: 26227887
DOI: 10.1038/srep12771 -
PloS One 2018Edible portions of bananas contain high levels of polyphenol oxidase, which catalyzes reactions in the melanin formation pathway. Tyrosine, a physiological substrate of...
Edible portions of bananas contain high levels of polyphenol oxidase, which catalyzes reactions in the melanin formation pathway. Tyrosine, a physiological substrate of polyphenol oxidase, has an analogous structure to acetaminophen. We investigated whether banana extract causes structural changes in acetaminophen and a decrease in its potency. Acetaminophen concentration in banana extract was measured under different conditions to characterize incompatibility. Reaction products in solution were identified using liquid chromatography/electrospray ionization/mass spectrometry (LC/ESI/MS). Acetaminophen potency decreased with time in the presence of banana extract. The reaction proceeded most efficiently in temperatures 30-37°C and neutral to weakly acidic conditions. Molecular ion peaks derived from the oxidized catechol moiety of acetaminophen were identified in LC/ESI/MS spectra. Our findings suggest that incorporation or simultaneous administration of acetaminophen medication and banana juice may result in decreased efficacy of the clinically important drug. This interaction is likely due to the oxidation of acetaminophen by polyphenol oxidase activity in banana pulp. Therefore, we investigated and characterized a novel interaction between bananas and acetaminophen. To establish a safe and effective antipyretic analgesic regimen using acetaminophen, future studies of this interaction are expected to be performed in humans.
Topics: Acetaminophen; Analgesics, Non-Narcotic; Dose-Response Relationship, Drug; Food-Drug Interactions; Fruit and Vegetable Juices; Hydrogen-Ion Concentration; Models, Chemical; Musa; Oxidation-Reduction; Plant Extracts; Species Specificity; Temperature
PubMed: 30312340
DOI: 10.1371/journal.pone.0205612 -
Biomedicine & Pharmacotherapy =... Apr 2020Bai-Hu-Tang (BHT), a Chinese herbal decoction used as an antipyretic agent, results from the combination of Anemarrhena asphodeloides Bunge, Glycyrrhizae, Japonica rice,... (Comparative Study)
Comparative Study
BACKGROUND
Bai-Hu-Tang (BHT), a Chinese herbal decoction used as an antipyretic agent, results from the combination of Anemarrhena asphodeloides Bunge, Glycyrrhizae, Japonica rice, and Gypsum. In our previous study, we identified nanoaggregates in BHT. However, the present study aimed to analyze and elucidate the mechanism of nanoaggregate formation and to investigate its antipyretic effect.
METHODS
A BHT decoction extract was split into 15 groups, and in each group, the extract was further separated into two solutions: Nano-phase and Decoction. The physicochemical properties of these solutions, such as particle size, salinity, conductivity, and surface tension were investigated, and analyzed the 15 groups of by transmission electron microscopy (TEM) and fingerprint chromatography. Furthermore, the antipyretic effect of nanoaggregates was evaluated through enzyme-linked immunosorbent assays, HE staining, Western Blot, and Real-time PCR.
RESULTS
In the 15 groups, the salinity and conductivity results showed a promoting and stabilizing effect towards the Nano-phase formation. Analysis of the surface tension indicated good solubilization of Radix Glycyrrhizae. The TEM analysis of the BHT separated extracts revealed that only in the presence of Japonica rice the Nano-phase is formed. Sixteen common peaks were identified in the BHT fingerprint chromatogram, and the main chemical components were Neomangiferin, Mangiferin, Liquiritin, and Ammonium glycyrrhizinate. Furthermore, BHT and nanoaggregates from Bai-Hu-Tang (N-BHT) groups did not differ in the main chemical components. Additionally, the N-BHT group had the same antipyretic effect compared with the BHT group. However, the pathological analysis indicated that treatment with N-BHT could ameliorate the lung damage in the rat. At the same time, N-BHT group inhibited expression of several proteins, specifically IL-1β, TRPV4, NF-κB, and TNF-α, which agreed with the Real-time PCR results.
CONCLUSION
We identified the key factors that are involved in the nano-phase formation. Also, by Western blot and Real-time PCR methods, we investigated the N-BHT mechanism of antipyretic action. The discovery of the N-BHT formation would provide a new idea of studying traditional Chinese medicine decoction.
Topics: Animals; Antipyretics; Blotting, Western; Disease Models, Animal; Drugs, Chinese Herbal; Fever; Lung; Male; Nanoparticles; Rats; Rats, Sprague-Dawley; Real-Time Polymerase Chain Reaction
PubMed: 31978766
DOI: 10.1016/j.biopha.2020.109826 -
Asian Pacific Journal of Tropical... Nov 2011To investigate Pothos scandens for the in vitro antioxidant and antipyretic activity.
OBJECTIVE
To investigate Pothos scandens for the in vitro antioxidant and antipyretic activity.
METHODS
Preliminary phytochemicals, total phenolics and flavonoid contents were analyzed in leaf, stem and root samples. In vitro antioxidant activity was evaluated by different assays such as 2, 2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging, 2, 2'-azinobis-3-ethylbenzothiazoline-6-sulphonic acid (ABTS•+) radical scavenging, ferric-reducing antioxidant power (FRAP) assay, phosphomolybdenum reduction assay, metal chelating activity, superoxide anion radical scavenging activity, hydrogen peroxide and nitric oxide scavenging assay. The antipyretic activity of root methanol extract was studied by pyrexia induced by brewer's yeast on Wistar albino rats at concentration of 200 and 400 mg/kg using paracetamol as standard drug.
RESULTS
The total phenolics and tannin content were found to be higher in ethanol extract of stem, whereas total flavonoid content was higher in acetone extract of root. The methanol extract of root showed highest free radical scavenging activity in assays namely ABTS assay (8 221.5 μM TE/g extract), FRAP assay [514.4 mM Fe (II)/g extract], hydrogen peroxide (60.3%) and nitric oxide scavenging assays (58.7%). The DPPH assay and superoxide radical assay results revealed that the ethanol extract of root has remarkable free radical scavenging capacity (IC50 0.284 mg/mL and 70.84%). The antipyretic studies on methanol extract of root showed significant reduction of temperature in pyrexia induced rats at 200 and 400 mg/kg doses.
CONCLUSIONS
These findings justify that Pothos scandens can be a valuable natural antioxidant and antipyretic source which seemed to provide potential nutraceuticals for human health.
Topics: Animals; Antioxidants; Antipyretics; Araceae; Disease Models, Animal; Fever; Flavonoids; Free Radical Scavengers; Phenols; Phytotherapy; Plant Extracts; Plant Leaves; Plant Roots; Plant Stems; Rats; Rats, Wistar; Saccharomyces cerevisiae; Tannins; Treatment Outcome
PubMed: 22078952
DOI: 10.1016/S1995-7645(11)60214-9 -
Ethiopian Journal of Health Sciences Apr 2015Ocimum suave willd is one of the plants traditionally used for the treatment of inflammation and related disorders in different parts of Ethiopia. The aim of the current...
BACKGROUND
Ocimum suave willd is one of the plants traditionally used for the treatment of inflammation and related disorders in different parts of Ethiopia. The aim of the current study was to evaluate the analgesic and antipyretic activities of the solvent fractions (n-butanol and water) of O. suave aqueous leaves extract.
MATERIALS AND METHODS
Acetic acid writhing and tail flick tests were used to evaluate the analgesic activity, and yeast-induced fever in mice was used to evaluate the antipyretic activity of the solvent fractions.
RESULTS
Both solvent fractions exhibited inhibitory effect against acetic acid induced writhing at all tested dose levels in a dose dependent manner. The water fraction inhibited writhing by 47.69% at a dose of 200 mg/kg which was comparable to that by ASA, the standard drug. In the tail flick test, 200 mg/kg dose of both solvent fractions showed significant activity (P<0.05) after 0.5h, 1h and 3hrs of their administration. Both n- butanol and water fractions produced significant reduction in yeast induced fever at all doses employed.
CONCLUSION
From these findings, it can be concluded that the n-butanol and water fractions of O. suave aqueous leaves extract have potential analgesic and antipyretic activity in mice.
Topics: 1-Butanol; Acetic Acid; Analgesics; Animals; Antipyretics; Dose-Response Relationship, Drug; Ethiopia; Fever; Inflammation; Mice; Ocimum; Phytotherapy; Plant Extracts; Plant Leaves; Tail; Water; Yeasts
PubMed: 26124621
DOI: 10.4314/ejhs.v25i2.6 -
The Permanente Journal 2012Kawasaki Disease (KD) is the leading cause of acquired cardiovascular disease among children, but management of KD has received relatively little attention. In the US... (Review)
Review
Kawasaki Disease (KD) is the leading cause of acquired cardiovascular disease among children, but management of KD has received relatively little attention. In the US alone, about 5500 cases were estimated in 2009. KD is most common among Asian and Pacific Islander children but can affect all ethnicities and races. Timely and accurate diagnosis remains critical, but difficult: the etiology of KD is unknown, and no accurate diagnostic laboratory test has been developed. Continuing medical education can help physicians, clinicians, and nurse practitioners accurately diagnose and treat KD. A registry specific to KD or a surveillance system may be necessary to increase awareness among health care professionals and to decrease complications related to misdiagnosis.
Topics: Antipyretics; Aspirin; Child, Preschool; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Infant; Japan; Mucocutaneous Lymph Node Syndrome; United States
PubMed: 22745623
DOI: 10.7812/TPP/12.980