-
Gaceta Medica de Mexico 2021Whether fever and antipyretic treatment are related to progression of organ dysfunction (POD) in sepsis is currently not known.
INTRODUCTION
Whether fever and antipyretic treatment are related to progression of organ dysfunction (POD) in sepsis is currently not known.
OBJECTIVE
To evaluate the association of fever and antipyretic treatment with POD in sepsis.
METHODS
Prospective cohort study of patients with sepsis. Maximum axillary temperature (T° Max), antipyretic drugs total dose and daily SOFA score were recorded. POD was defined as an increase ≥ 1 point on the SOFA score. A multivariate logistic regression model was used to evaluate the studied association.
RESULTS
305 patients were included: 163 were women (53.4%), with a SOFA score of 8 points (6-11); 130 participants (42.62%) had T° Max ≥ 38°C, and 76 (24.9%), POD. Mortality in patients with fever was 26.2% vs. 20% (p = 0.21), and with POD, 73.7% vs. 5.7% (p = 0.01). T° Max ≥ 39°C had an OR of 4.96 (95% CI = 1.97-12.47, p = 0.01); and the use of antipyretics, an OR of 1.04 (95% CI: 0.58-1.86, p = 0.88).
CONCLUSIONS
An axillary T° Max ≥ 39°C is a risk factor for POD in sepsis. The use of antipyretics was not associated with POD.
Topics: Antipyretics; Cohort Studies; Female; Humans; Multiple Organ Failure; Prospective Studies; Retrospective Studies; Sepsis
PubMed: 35133331
DOI: 10.24875/GMM.M21000578 -
African Journal of Traditional,... 2011This study investigated the general acute, anti-inflammatory, analgesic and antipyretic effects of methanol extract of Lepidagathis anobrya Nees (Acanthaceae)....
This study investigated the general acute, anti-inflammatory, analgesic and antipyretic effects of methanol extract of Lepidagathis anobrya Nees (Acanthaceae). Carrageenan-induced rat paw edema and croton oil-induced ear edema in rats were used for the evaluation of general acute anti-inflammatory effects. Acetic acid-induced writhing response and yeast-induced hyperpyrexia in mice were used to evaluate the analgesic and antipyretic activities respectively. The extract at doses of 10, 25, 50 and 100 mgkg(-1) for carrageenan test and doses of 0.5 mg/ear for croton oil test induced a significant reduction (p < 0.001) of paw and ear edemas in rats. In the analgesic and antipyretic tests, the extract has shown a significant inhibition of writhes and hyperpyrexia with all the doses used when compared to the untreated control group. These results clearly show the anti-inflammatory, analgesic and antipyretic effects of the methanol extract of Lepidagathis anobrya and give the scientific basis for its traditional use. Further studies are needed to clarify the mechanism of action and the components responsible for these pharmacological effects.
Topics: Acanthaceae; Analgesics; Animals; Anti-Inflammatory Agents; Antipyretics; Carrageenan; Dose-Response Relationship, Drug; Edema; Fever; Inflammation; Lethal Dose 50; Male; Methanol; Mice; Pain Measurement; Phytotherapy; Plant Extracts; Plant Leaves; Plant Stems; Rats
PubMed: 22654220
DOI: 10.4314/ajtcam.v8i4.12 -
BMC Complementary and Alternative... Jan 2017As aerial parts of Rubus ulmifolius contains phytochemicals like flavonoids and tannins. And whereas flavonoids and tannins have antioxidant and antipyretic activity,...
BACKGROUND
As aerial parts of Rubus ulmifolius contains phytochemicals like flavonoids and tannins. And whereas flavonoids and tannins have antioxidant and antipyretic activity, hence, current work is carried out to screen crude methanolic extract of aerial parts of Rubus ulmifolius (Ru.Cr) and crude flavonoids rich extract of Rubus ulmifolius (Ru.F) for possible antioxidant and antipyretic activity. Ru.Cr and Ru.F are also tested for brine shrimps lethality bioassay. Ru.F is tested for the first time for possible antioxidant and antipyretic activity.
METHODS
Preliminary phytochemical screening of Ru.Cr and Ru.F was performed as it provides rapid finger printing for targeting a pharmacological activity. Acute toxicity and Brine shrimps' cytotoxicity studies of Ru.Cr and Ru.F were performed to determine its safe dose range. Antioxidant and antipyretic studies were also performed as per reported procedures.
RESULTS
Ru.Cr tested positive for presence of tannins, alkaloids, flavonoids and steroids. Ru.Cr is safe up to 6 g/kg following oral doses for acute toxicity study. Ru.Cr is safe up to 75 μg/kg (p.o), LC for Ru.Cr and Ru.F are 16.7 ± 1.4 μg/ml 10.6 ± 1.8 μg/ml, respectively (n = 3). Both Ru.Cr and Ru.F demonstrated comparable antioxidant activity using vitamin C as standard (p ≤ 0.05). In test dose of 300 mg of Ru.Cr, rectal temperature was reduced by 74% (p ≤ 0.05) on 4 hour of the administration. More, Ru.F produced 72% reduction in pyrexia (p ≤ 0.05) on 4 hour of administration of paracetamol in Westar rats.
CONCLUSIONS
The current work confirms that aerial parts of Rubus ulmifolius contain flavonoids that are safe up to 6 g/kg (p.o). Crude methanolic extract and flavonoids rich fraction of Rubus ulmifolius have significant antioxidant and antipyretic activity. Further work is required to isolate the pharmacologically active substances for relatively safe and effective antipyretics and antioxidants.
Topics: Animals; Antioxidants; Antipyretics; Artemia; Female; Flavonoids; Male; Mice; Plant Components, Aerial; Plant Extracts; Rats; Rats, Wistar; Rubus
PubMed: 28103863
DOI: 10.1186/s12906-017-1564-z -
BMC Complementary and Alternative... Apr 2015Inflammation and pain underlies several pathological conditions. Synthetic drugs used for the management of these conditions carry severe toxic effects. Globally efforts...
BACKGROUND
Inflammation and pain underlies several pathological conditions. Synthetic drugs used for the management of these conditions carry severe toxic effects. Globally efforts are ongoing to introduce novel medicinal plants to develop effective, economic and innocuous drugs. The current study was aimed at investigating the antipyretic, anti-inflammatory and analgesic activity of methanol extract of A. hydaspica aerial parts (AHM) and its active fraction. Furthermore identification and isolation of polyphenolic compounds was carried out to identify the active principles.
METHODS
Yeast induced pyrexia, Paw edema, acetic acid-induced writhing and hot plate test were carried out in vivo. HPLC-DAD analysis and combination of different chromatographic techniques, involving vacuum liquid chromatography (VLC) and flash chromatography (FC) were carried out for chemical characterization. The structural heterogeneity of flavanols was characterized by ESI- MS, (1)H NMR, (13)C NMR and (2)D NMR spectroscopic analyses, and also by comparison with reported literature.
RESULTS
Oral administration of A. hydaspica methanol extract (AHM) and A. hydaspica ethyl acetate fraction (AHE), showed dose and time dependent decrease in body temperature in yeast induced pyrexia, comparable to standard, Paracetamol. AHM and AHE (150 mg/kg) significantly (p < 0.001) inhibit pain sensation in various pain models, i.e. acetic acid induced writhing and hot plate test. Similarly AHM and AHE demonstrated an anti-inflammatory effect in carrageenan-induced paw edema in rats and 150 mg/kg dose being distinctly more effective (91.92% inhibition). When studied on prostaglandin E2 (PGE2) induced edema in rats, AHM and AHE showed maximum inhibition of edema at 150 mg/kg after 4 h. HPLC chromatogram of AHM revealed the presence of gallic acid, catechin, rutin and caffeic acid. Chromatographic separation and structure characterization of AHE, has led to the identification of three flavan-3-ol derivative including 7-O-galloyl catechin, +catechin and methyl gallate, which have been reported for the first time in A. hydaspica.
CONCLUSION
These results revealed that the presence of bioactive compounds in A. hydaspica might be responsible for the pharmacological activities, confirming the indigenous utility of A. hydaspica against inflammatory disorders.
Topics: Acacia; Acetic Acid; Analgesics; Animals; Anti-Inflammatory Agents; Antipyretics; Carrageenan; Edema; Female; Fever; Flavonoids; Hot Temperature; Inflammation; Male; Pain; Phytotherapy; Plant Extracts; Rats, Sprague-Dawley; Yeasts
PubMed: 25928288
DOI: 10.1186/s12906-015-0658-8 -
The Cochrane Database of Systematic... Feb 2017Febrile seizures occurring in a child older than one month during an episode of fever affect 2% to 4% of children in Great Britain and the United States and recur in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Febrile seizures occurring in a child older than one month during an episode of fever affect 2% to 4% of children in Great Britain and the United States and recur in 30%. Rapid-acting antiepileptics and antipyretics given during subsequent fever episodes have been used to avoid the adverse effects of continuous antiepileptic drugs.
OBJECTIVES
To evaluate primarily the effectiveness and safety of antiepileptic and antipyretic drugs used prophylactically to treat children with febrile seizures; but also to evaluate any other drug intervention where there was a sound biological rationale for its use.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2016, Issue 7); MEDLINE (1966 to July 2016); Embase (1966 to July 2016); Database of Abstracts of Reviews of Effectiveness (DARE) (July 2016). We imposed no language restrictions. We also contacted researchers in the field to identify continuing or unpublished studies.
SELECTION CRITERIA
Trials using randomised or quasi-randomised participant allocation that compared the use of antiepileptic, antipyretic or other plausible agents with each other, placebo or no treatment.
DATA COLLECTION AND ANALYSIS
Two review authors (RN and MO) independently applied predefined criteria to select trials for inclusion and extracted the predefined relevant data, recording methods for randomisation, blinding and exclusions. For the 2016 update a third author (MC) checked all original inclusions, data analyses, and updated the search. Outcomes assessed were seizure recurrence at 6, 12, 18, 24, 36, and 48 months and at age 5 to 6 years in the intervention and non-intervention groups, and adverse medication effects. We assessed the presence of publication bias using funnel plots.
MAIN RESULTS
We included 40 articles describing 30 randomised trials with 4256 randomised participants. We analysed 13 interventions of continuous or intermittent prophylaxis and their control treatments. Methodological quality was moderate to poor in most studies. We found no significant benefit for intermittent phenobarbitone, phenytoin, valproate, pyridoxine, ibuprofen or zinc sulfate versus placebo or no treatment; nor for diclofenac versus placebo followed by ibuprofen, acetaminophen or placebo; nor for continuous phenobarbitone versus diazepam, intermittent rectal diazepam versus intermittent valproate, or oral diazepam versus clobazam.There was a significant reduction of recurrent febrile seizures with intermittent diazepam versus placebo or no treatment, with a risk ratio (RR) of 0.64 (95% confidence interval (CI) 0.48 to 0.85 at six months), RR of 0.69 (95% CI 0.56 to 0.84) at 12 months, RR 0.37 (95% CI 0.23 to 0.60) at 18 months, RR 0.73 (95% CI 0.56 to 0.95) at 24 months, RR 0.58 (95% CI 0.40 to 0.85) at 36 months, RR 0.36 (95% CI 0.15 to 0.89) at 48 months, with no benefit at 60 to 72 months. Phenobarbitone versus placebo or no treatment reduced seizures at 6, 12 and 24 months but not at 18 or 72 month follow-up (RR 0.59 (95% CI 0.42 to 0.83) at 6 months; RR 0.54 (95% CI 0.42 to 0.70) at 12 months; and RR 0.69 (95% CI 0.53 to 0.89) at 24 months). Intermittent clobazam compared to placebo at six months resulted in a RR of 0.36 (95% CI 0.20 to 0.64), an effect found against an extremely high (83.3%) recurrence rate in the controls, which is a result that needs replication.The recording of adverse effects was variable. Lower comprehension scores in phenobarbitone-treated children were found in two studies. In general, adverse effects were recorded in up to 30% of children in the phenobarbitone-treated group and in up to 36% in benzodiazepine-treated groups. We found evidence of publication bias in the meta-analyses of comparisons for phenobarbitone versus placebo (eight studies) at 12 months but not at six months (six studies); and valproate versus placebo (four studies) at 12 months, with too few studies to identify publication bias for the other comparisons.Most of the reviewed antiepileptic drug trials are of a methodological quality graded as low or very low. Methods of randomisation and allocation concealment often do not meet current standards; and treatment versus no treatment is more commonly seen than treatment versus placebo, leading to obvious risks of bias. Trials of antipyretics and zinc were of higher quality.
AUTHORS' CONCLUSIONS
We found reduced recurrence rates for children with febrile seizures for intermittent diazepam and continuous phenobarbitone, with adverse effects in up to 30%. Apparent benefit for clobazam treatment in one trial needs to be replicated to be judged reliable. Given the benign nature of recurrent febrile seizures, and the high prevalence of adverse effects of these drugs, parents and families should be supported with adequate contact details of medical services and information on recurrence, first aid management and, most importantly, the benign nature of the phenomenon.
Topics: Anticonvulsants; Antipyretics; Child; Child, Preschool; Humans; Infant; Randomized Controlled Trials as Topic; Recurrence; Seizures, Febrile
PubMed: 28225210
DOI: 10.1002/14651858.CD003031.pub3 -
Biomolecules Apr 2020This study aimed to investigate the chemical composition, and evaluate the antioxidant, anti-inflammatory, anti-pyretic, and the analgesic properties of methanol... (Comparative Study)
Comparative Study
This study aimed to investigate the chemical composition, and evaluate the antioxidant, anti-inflammatory, anti-pyretic, and the analgesic properties of methanol extracts from the leaves of (Lamiaceae). Thirty-five secondary metabolites were characterized in both extracts using HPLC-PDA-ESI-MS/MS. Phenolic acids, mainly rosmarinic acid and its derivatives, dominated the extract, while the phenolic diterpene carnosol and the methylated flavonoid salvigenin, prevailed in extract. Molecular docking study was carried out to estimate the anti-inflammatory potential and the binding affinities of some individual secondary metabolites from both extracts to the main enzymes involved in the inflammation pathway. In vitro enzyme inhibitory assays and in vivo assays were used to investigate the antioxidant and anti-inflammatory activities of the extracts. Results revealed that both studied species exhibited antioxidant, anti-inflammatory, analgesic, and antipyretic effects. They showed to be a more potent antioxidant than ascorbic acid and more selective against cyclooxygenase (COX-2) than diclofenac and indomethacin. Relatively, the extract was more potent as COX-2 inhibitor than . In conclusion, and may be interesting candidates for the treatment of inflammation and oxidative stress-related disorders.
Topics: Analgesics; Animals; Anti-Inflammatory Agents; Antipyretics; Carrageenan; Cell Movement; Edema; Leukocytes; Male; Mice; Molecular Docking Simulation; Plant Extracts; Plant Leaves; Rats, Wistar; Secondary Metabolism; Tandem Mass Spectrometry; Thymus Plant
PubMed: 32294957
DOI: 10.3390/biom10040599 -
Critical Care (London, England) 2011In recent years, fever control in critically ill patients by medications and/or external cooling has gained widespread use, notably in patients suffering from... (Review)
Review
In recent years, fever control in critically ill patients by medications and/or external cooling has gained widespread use, notably in patients suffering from neurological injuries. Nevertheless, such a strategy in septic patients is not supported by relevant data. Indeed, in response to sepsis, experimental and clinical studies argue that fever plays a key role in increasing the clearance of microorganisms, the immune response and the heat shock response. Moreover, fever is a cornerstone diagnostic sign in clinical practice, which aids in early and appropriate therapy, and allows physicians to follow the infection course. After discussing the physiological aspects of fever production, the present review aims to delineate the advantages and drawbacks of fever in septic patients. Finally, the treatment of fever by pharmacological and/or physical means is discussed with regards to their drawbacks, which argues for their careful use in septic patients in the absence of clinical relevance.
Topics: Animals; Antipyretics; Critical Illness; Fever; Humans; Intensive Care Units; Sepsis
PubMed: 21672276
DOI: 10.1186/cc10097 -
The Journal of Clinical Psychiatry 2018To date, no study has specifically compared antipsychotic-free patients with schizophrenia living in the community between rural and urban areas. This study examined the... (Comparative Study)
Comparative Study
OBJECTIVE
To date, no study has specifically compared antipsychotic-free patients with schizophrenia living in the community between rural and urban areas. This study examined the rural-urban differences among antipsychotic-free community-dwelling individuals with schizophrenia in China.
METHODS
Data on 1,365 community-dwelling patients with schizophrenia (n = 742 in a rural area and n = 623 in an urban area) with diagnoses according to DSM-IV or ICD-10 were collected by interviews during 2013-2014 and 2015-2016. Data on patients' sociodemographic and clinical characteristics, prescriptions of psychotropic drugs, and antipsychotic treatment status were recorded using a standardized protocol and data collection procedure.
RESULTS
The prevalence of antipsychotic-free status in the total sample (N = 1,365) was 27.3%; the proportion of antipsychotic-free patients was significantly lower (17.5%) in the urban area (17.5%) than in the rural area (35.4%; χ² = 55.03, P < .001). Binary logistic regression analysis revealed that antipsychotic-free patients, whether from the urban area or the rural area, were older (P = .001, odds ratio [OR] = 0.95 in urban; P = .006, OR = 0.97 in rural) and had poorer attitude toward medication treatment (P < .001, OR = 1.21 in urban; P < .001, OR = 1.31 in rural). Antipsychotic-free patients from the urban area also had fewer admissions, lower education level, and greater likelihood of living by themselves. Antipsychotic-free patients from the rural area also had worse insight into the disease, fewer anxiety symptoms, more prominent positive symptoms, and lower body mass index and were more likely to be women.
CONCLUSIONS
Antipsychotic-free status was more common in community-dwelling patients with schizophrenia in the rural area than in the urban area. Older age and poorer attitude toward medication treatment were common features of antipsychotic-free patients. There were correspondingly different risk factors for antipsychotic-free status between rural and urban areas. Building a positive medication treatment attitude is an important strategy for establishing medication adherence in older, community-dwelling patients with schizophrenia.
Topics: Adult; Age Factors; Aged; Antipyretics; China; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Independent Living; Male; Medication Adherence; Middle Aged; Patient Acceptance of Health Care; Prevalence; Rural Population; Schizophrenia; Urban Population
PubMed: 29702756
DOI: 10.4088/JCP.17m11599 -
American Family Physician Nov 2010Influenza is a contagious airborne viral illness characterized by abrupt onset of symptoms. Fever, myalgia, headache, rhinitis, sore throat, and cough are commonly...
Influenza is a contagious airborne viral illness characterized by abrupt onset of symptoms. Fever, myalgia, headache, rhinitis, sore throat, and cough are commonly reported symptoms. The diagnosis should be made clinically, and the decision to begin antiviral therapy should not be delayed for laboratory confirmation of influenza. The 2009 pandemic influenza A (H1N1) virus is expected to continue to circulate during the 2010-2011 season, but it is not certain whether it will replace or cocirculate with seasonal influenza A subtypes that have been circulating since 1977. The 2009 H1N1 virus is largely resistant to adamantanes, but it is sensitive to neuraminidase inhibitors such as oseltamivir. Neuraminidase inhibitors have modest effectiveness in reducing influenza-related symptoms in patients at low risk of complications. Patients at high risk of complications, including pregnant women, should be treated with antiviral agents, preferably within 48 hours of symptom onset. Family physicians should follow guidelines from the World Health Organization and the Centers for Disease Control and Prevention when treating patients with influenza or influenza-like symptoms.
Topics: Anti-Inflammatory Agents; Antipyretics; Antiviral Agents; Drug Administration Schedule; Drug Dosage Calculations; Drug Resistance, Viral; Female; Humans; Influenza, Human; Male; Neuraminidase; Post-Exposure Prophylaxis; Practice Guidelines as Topic; Pregnancy
PubMed: 21121554
DOI: No ID Found -
Acta Biochimica Polonica Nov 2023Aloe barbadensis is a stemless plant with a length of 60-100 cm with juicy leaves which is used for its remedial and healing properties in different suburbs of various...
Isolation, preparation and investigation of leaf extracts of Aloe barbadensis for its remedial effects on tumor necrosis factor alpha (TNF-α) and interleukin (IL-6) by in vivo and in silico approaches in experimental rats.
Aloe barbadensis is a stemless plant with a length of 60-100 cm with juicy leaves which is used for its remedial and healing properties in different suburbs of various countries. The present study was conducted to investigate the effect of A. barbadensis leaf extract (aqueous and ethanolic) in yeast induced pyrexia and acetic acid induced writhing in rat model to evaluate the antipyretic biomarkers and its phytochemical screening with computational analysis. For analgesic activity model 60 Albino rats (160-200 kg) were divided into four groups. Of the 4 groups, control consisted of 6 rats (Group I) treated with normal saline, standard comprised of 6 rats treated with drug diclofenac (Group I). Experimental groups consisted of 48 rats, treated with A. barbadensis ethanolic and aqueous leaf extracts at doses of 50 mg/kg, 100 mg/kg, 200 mg/kg, and 400 mg/kg (Group III. IV). For antipyretic activity group division was same as in analgesic activity. All groups were treated the same as in the analgesic activity except for the second group which was treated with paracetamol. In both antipyretic and analgesic activity at the dose of 400 mg/kg, group III showed significant inhibition. TNF-α and IL-6 showed significant antipyretic activity at a dose of 400 mg/kg. For molecular docking aloe emodin and cholestanol were used as ligand molecules to target proteins Tnf-α and IL-6. Acute oral toxicity study was performed. There was no mortality even at the dose of 2000 mg/kg. Quantitative and qualitative phytochemical screening was performed for the detection of various phytochemicals. Hence, A. barbadensis leaf extracts can be used in the form of medicine for the treatment of pain and fever.
Topics: Rats; Animals; Antipyretics; Tumor Necrosis Factor-alpha; Plant Extracts; Aloe; Interleukin-6; Molecular Docking Simulation; Analgesics; Saccharomyces cerevisiae; Ethanol; Phytochemicals; Plant Leaves
PubMed: 37938932
DOI: 10.18388/abp.2020_6827