PURPOSE: Fever is the single most common problem in children visiting the emergency department. Fever is treated with a variety of methods, including the recommended combination of tepid massage, and antipyretics. We compared the effects of antipyretics and tepid massage for the management of febrile children. METHODS: We conducted a prospective, randomized, controlled study to assess 49 children who visited to the ED, Kyung Hee Medical Center, with complaints of fever. Ages ranged from 3 to 60 months. Patients were grouped into one of the following three treatment groups: 1) acetaminophen only, 2) tepid massage only, and 3) acetaminophen and tepid massage. We measured body temperature at 0 and 30 minutes after management. RESULTS: The mean temperature at 30 minutes had decreased by initial temperature 0.58degrees C, 0.48degrees C, and 0.90degrees C for groups 1), 2), and 3), respectively. Although body temperature for group 3) decreased to a greater degree than it did in the other groups, the differences were not statistically significant. CONCLUSION: Although tepid massage have been recommended for managing fever, their effect is still uncertain, so they are not recommended, especially in the cases of crowded emergency rooms.
Acetaminophen ; Antipyretics* ; Body Temperature ; Child ; Emergencies* ; Emergency Service, Hospital* ; Fever* ; Humans ; Massage* ; Prospective Studies

PURPOSE: To assess the reliability of percutaneous nephrolithotomy (PNL) in pediatric patients by comparing complications between pediatric patients and adults by use of the modified Clavien grading system. MATERIALS AND METHODS: The data of 74 pediatric (0 to 16 years) and 535 adult (17 years and older) patients who underwent PNL owing to kidney stone disease between January 2005 and December 2011 were analyzed retrospectively. The complications in the pediatric and adult patients were classified in five grades according to the modified Clavien system. RESULTS: The most frequent cause of grade I complications was fever requiring antipyretics, which was seen in 4 pediatric patients (5.4%) and 30 adult patients (5.6%). Grade II complications (blood transfusions, <12 hours urinary leakage) were observed in 11 pediatric patients (14.8%) and 80 adult patients (14.9%). Grade III complications were also seen in 6 pediatric patients (8.1%) (grade IIIb; D-J catheter implantation under general anesthesia) and 78 adult patients (14.5%) (grade IIIa; D-J catheter implantation and angio-embolization under local anesthesia). There was no statistically significant difference between the two groups in terms of grade I, II, or III complications (p>0.05). Colonic injury occured in one patient (1.3%) in the pediatric group (grade IVa). In the adult group, one patient (0.2%) died as the result of myocardial infarction (grade V). CONCLUSIONS: Thanks to technological developments and minimalization of the equipment used, when indicated, pediatric patients can be safely treated with PNL with low complication rates similar to those in adult patients.
Adult ; Antipyretics ; Catheters ; Colon ; Fever ; Humans ; Kidney Calculi ; Myocardial Infarction ; Nephrolithiasis ; Nephrostomy, Percutaneous ; Retrospective Studies

Aspirin and NSAIDs idiosyncracy is rare in childhood and usually occurs in adults with intrinsic asthma. We have experienced three adolescences, 14, 15 and 16 year-old boys who complained of urticaria and angioedema after having antipyretics and/or analgesics. We confirmed them as aspirin idiosyncracy with oral challenge test. Urticaria and angioedema were developed after ingestion of aspirin.
Adolescent* ; Adult ; Analgesics ; Angioedema ; Anti-Inflammatory Agents, Non-Steroidal ; Antipyretics ; Aspirin* ; Asthma ; Eating ; Humans ; Urticaria

PURPOSE: To investigate caregivers' preference regarding fever management in the emergency department. METHODS: Between July 2011 and June 2014, we surveyed the preference in fever management by caregivers of febrile children aged 7 years or younger who visited the emergency department. The questionnaire consisted of the characteristics of the children and their caregivers, usefulness of tepid massage, and the caregivers' preference in fever management, in particular the combination of methods and the doses of antipyretics. RESULTS: Among a total of 161 children, 161 were enrolled in the study, with the mean age of 5.0 years. Of the caregivers, 64.6% were in their 30s and 50.9% were parents, and 70.2% and 24.2% reported that tepid massage was "very useful" and "a little useful," respectively. The most preferred combination of methods was "tepid massage, acetaminophen, and ibuprofen (50.9%; P < 0.001)." "Tepid massage and ibuprofen" was preferred to "tepid massage and acetaminophen (24.2% vs 7.5%)." The most preferred dose of antipyretics was 1 mL/kg/day (divided into 3 doses; 60.2%; P = 0.012), followed by 1 mL/kg/day (divided into 3 doses) plus 2 mL/dose (29.1%). CONCLUSION: Caregivers may recognize tepid massage as a useful fever management. The most preferred fever management was the combination of tepid massage, acetaminophen, and ibuprofen with a dose of 1 mL/kg/day.
Acetaminophen ; Antipyretics ; Caregivers ; Child ; Emergencies ; Emergency Medicine ; Emergency Service, Hospital ; Fever ; Humans ; Ibuprofen ; Massage ; Parents

As an effective antipyretic medicine,Indigo Naturalis has a long history of application in the field of Chinese medicine.The content of organics,mainly indigo and indirubin,is about 10%. However,the active ingredients and mechanism of its antipyretic effect have not yet been fully elucidated. In view of this,they were investigated in this study with the rectal temperature change as an indicator and 2,4-dinitrophenol-induced fever rats as subjects. The content of PGE2 and c AMP in the hypothalamus and the serum levels of TNF-α,IL-1β and IL-6 were determined by ELISA. Moreover,the plasma samples of fever rats were analyzed by metabonomics in combination with UPLC-Q-TOF-MS for the exploration of potential biomarkers and the discussion on the antipyretic mechanism of Indigo Naturalis and its active ingredients. The results showed that the rising trend of rectal temperature in rats was suppressed 0. 5 h after the treatment with Indigo Naturalis,organic matter,indigo or indirubin as compared with the rats of model group( P < 0. 05),among which Indigo Naturalis and organic matter had better antipyretic effect. ELISA results showed that organic matter and indigo can inhibit the expression of PGE2 and c AMP( P<0. 01),while Indigo Naturalis and organic matter were effective in curbing the increase in TNF-α( P<0. 05). A total of 21 endogenous metabolites were identified from the plasma samples of the Indigo Naturalis,organic matter,indigo and indirubin groups,which were mainly involved in glycerophospholipid metabolism.
2,4-Dinitrophenol ; Animals ; Antipyretics ; Drugs, Chinese Herbal ; Indigo Carmine ; Indigofera ; Rats

The antipyretic effects of Qingkailing soft capsules and hard capsules were compared based on metabonomics technology,so as to provide basis for clinical rational use and quality control evaluation of its preparations. By using ultra high performance liquid chromatography-linear ion trap/orbitrap high resolution mass spectrometry( UPLC-LTQ/Orbitrap),and multivariate tatistical methods such as principal component analysis( PCA),partial least squares-discriminate analysis( PLS-DA) and orthogonal signal correction partial least square discriminant analysis( OPLS-DA),the changes of plasma endogenous metabolites in rat fever model induced by dry yeast were studied,so as to look for biomarkers related to fever. Based on these results,the antipyretic effects of two types of Qingkailing preparations were compared. The results indicated that metabolic profiles of the experimental groups could be distinguished distinctly,and 8 endogenous metabolites showed differences as compared with the normal control group( P<0. 05),including nicotinic acid,choline,hippuric acid,phosphocholine,Lyso PC( 14 ∶ 0),Lyso PC [16 ∶ 1( 9 Z) ],Lyso PC( 18 ∶ 0) and Lyso PC [20 ∶ 3( 5 Z,8 Z,11 Z) ]. They could be regarded as biomarkers related to fever. Qingkailing soft capsule and hard capsule had different effects on the regulation of plasma metabolites in yeast-induced fever model rats. Qingkailing soft capsule had different degrees of callbacks on eight biomarkers,including significant callbacks on nicotinic acid( P<0. 05),hippuric acid( P< 0. 01),phosphocholine( P< 0. 05),and Lyso PC [20 ∶3( 5 Z,8 Z,11 Z) ]( P<0. 05),while hard capsule only had significant callbacks on nicotinic acid( P<0. 05),hippuric acid( P<0. 01),and phosphocholine( P< 0. 05),with no callbacks on choline,Lyso PC( 14 ∶ 0),Lyso PC [16 ∶ 1( 9 Z) ],Lyso PC( 18 ∶0),and Lyso PC [20 ∶3( 5 Z,8 Z,11 Z) ]. This indicated that Qingkailing soft capsule had better callback effect than hard capsule. In this study,Qingkailing soft capsules and hard capsules were used to intervene the changes of related biomarkers in yeast-induced fever rat models,and then the antipyretic effect and mechanism between these two kinds of capsules were compared. The two dosage forms played an antipyretic role mainly by regulating lipid metabolism and controlling inflammation. The callback effect of soft capsule on the potential biomarkers of lysophosphatidylcholine was significantly higher than that of hard capsule. The differences in antipyretic effect of Qingkailing soft capsule and hard capsule were expounded from the point of metabonomics,providing experimental data and theoretical basis for the selection of clinical dosage forms.
Animals ; Antipyretics/pharmacology* ; Biomarkers/blood* ; Capsules ; Drugs, Chinese Herbal/pharmacology* ; Metabolomics ; Rats

PURPOSE: The purposes of this review were to address misconceptions of childhood fever and fever management practice among parents and health care providers, and to identify the scientific evidences against such misconceptions and practices. METHODS: Journal databases and clinical guidelines from 2000 to 2015 were searched. The search terms were fever, fever management, misconception, myth, fiction, fact, fever phobia, child, antipyretics, tepid bath, alternating use/combined use of antipyretics, and physical cooling method. RESULTS: There are significant gaps between current concepts and practices, and the scientific evidence. Misconceptions and unrealistic concerns about childhood fever still exist among parents and even health care providers, worldwide. The evidences suggest that antipyretics should be given carefully with the aim of relieving discomfort or pain rather than decreasing the temperature itself. Alternating use of antipyretics should be discouraged due to the risk of confusion and error. Antipyretics do not prevent febrile convulsions. Moreover, the scientific evidence does not support tepid sponge massage. CONCLUSION: Evidence-based childhood fever management interventions should be targeted toward parents and health care providers. By adopting an evidence-based approach to nursing interventions, pediatric nurses can ensure children receive appropriate and safe fever management.
Antipyretics ; Baths ; Child ; Evidence-Based Practice ; Fever* ; Health Personnel ; Humans ; Massage ; Nursing ; Parents ; Phobic Disorders ; Porifera ; Seizures, Febrile

PURPOSE: This study was conducted to compare demographic and characteristic differences in self-poisoned patients by age groups using a comprehensive trauma database. METHODS: This study included 1,823 patients who were admitted to the emergency room following self-poisoning. Three age groups were defined: young patients (less than 19 years), adult patients (19 to 64 years) and elderly patients (65 years and old). From January 2011 to December 2015, data were obtained from in a single emergency medical center. We investigated the materials of poisoning, ingestion time, GCS, systolic blood pressure, heart rate, and outcomes of patients. RESULTS: A total of 1,823 self-poisoned patients visited the hospital during 5 years. Among these, 130 (7.1%) were categorized as young, 1,460 (80.1%) were adults and 233 (12.8%) were elderly. The most common drug of self-poisoning substances was antipyretics (50.0%) for those in the young group, sedative drugs (45.0%) for adults, and pesticides (41.2%) for the elderly. Mortality was 2.7% in the adult group and 14.6% in the elderly group. After adjusting for all factors related to mortality, the odds ratio (OR) of mortality was 2.63 in the elderly group (95% confidence interval [CI]: 1.44-4.81). CONCLUSION: There were definite differences in the characteristics of three groups. The younger patients used drugs that could be easily obtained while older patients used more lethal drugs.
Adult ; Aged ; Antipyretics ; Blood Pressure ; Eating ; Emergencies ; Emergency Service, Hospital ; Epidemiology* ; Heart Rate ; Humans ; Intention ; Mortality ; Odds Ratio ; Pesticides ; Poisoning*

Anesthetic management of pediatric liver transplantation in a patient with osteogenesis imperfecta (OI) requires tough decisions and comprehensive considerations of the cascade of effects that may arise and the required monitoring. Total intravenous anesthesia (TIVA) with propofol and remifentanil was chosen as the main anesthetic strategy. Malignant hyperthermia (MH), skeletal fragility, anhepatic phase during liver transplantation, uncertainties of TIVA in children, and propofol infusion syndrome were considered and monitored. There were no adverse events during the operation. Despite meticulous precautions with regard to the risk of MH, there was an episode of high fever (40degrees C) in the ICU a few hours after the operation, which was initially feared as MH. Fortunately, MH was ruled out as the fever subsided soon after hydration and antipyretics were given. Although the delivery of supportive care and the administration of dantrolene are the core principles in the management of MH, perioperative fever does not always mean a MH in patients at risk for MH, and other common causes of fever should also be considered.
Anesthesia, Intravenous ; Antipyretics ; Child ; Dantrolene ; Fever ; Humans ; Infant* ; Liver Transplantation* ; Malignant Hyperthermia ; Osteogenesis Imperfecta* ; Pediatrics ; Pharmacokinetics ; Propofol

A Case of acute Ginko poisoning in a Year and 1 month old girl was presented. The patient was admitted, with chief complainsof abrupt vomiting, general clonic convulson and unconsciouseness, which was developed 2 hours after ingestion of Ginko biloba L.. There was revealed leukocytosis, increased C.S.F. pressure with positive Babinski sign. This patient was treated with anticonvulsants, antipyretics, steroid hormone, mannitol and maintained fluid and electrolyte balance. The patient was discharged in good condition, 8th hospital day.
Anticonvulsants ; Antipyretics ; Eating ; Female ; Ginkgo biloba* ; Humans ; Infant, Newborn ; Leukocytosis ; Mannitol ; Poisoning ; Reflex, Babinski ; Vomiting ; Water-Electrolyte Balance