[Feverphobia: Frecuency and related factors associated] / Fiebrefobia: Frecuencia y factores asociados

Introduction: Fever is common in childhood and there is a high level of concern on behalf of caregivers to manage it, this is called "feverphobia". Objective: The objective was to evaluate the presence of feverphobia and associated factors in the study population. Methods: observational, cross-sectional, prospective, and analytical study during 2021 to 2022 through an ad hoc survey self-administered to parents and/or caregivers of patients under 6 years of age who consulted the emergency room of the Dr. Roberto del Río Children's Hospital in Santiago, Chile. The association between sociodemographic variables, knowledge, attitudes, and fears regarding febrile children was analyzed by Chi square and Fisher's test in addition to univariate logistic regression analysis. Results: A total of 381 surveys were carried out. 98% presented some degree of feverphobia. A fever below 38°C was defined by 40.6%. Physical measures were used by 56% of caregivers. The main sequelae feared were convulsions in 82% and 42.7% reported that it could be lethal. A total of 92.1% used unreliable sources of information and 66% had never received education from health personnel on this subject. Logistic regression showed that being a parent, basic or high school level and a thermal threshold below 38°C were the most associated variables. Conclusions: Feverphobia is a current phenomenon in our population and health education to the parents and caregivers could prevent it.

Introducción: La fiebre es común en la niñez y existe un alto nivel de preocupación por parte de los cuidadores para manejarla, a esto se le denomina "fiebrefobia". Objetivo: El objetivo fue evaluar la presencia de fiebrefobia y factores asociados en la población de estudio. Materiales y método: estudio observacional, transversal, con recolección prospectiva y analítico durante el 2021 a 2022, a través de una encuesta ad hoc auto administrada a los padres y/o cuidadores de pacientes menores de 6 años que consultaron a la emergencia del Hospital de Niños Dr. Roberto del Río en Santiago de Chile. Se analizó la asociación entre las variables sociodemográficas, conocimientos, actitudes y temores frente al niño febril mediante Chi cuadrado, Fisher además de análisis de regresión logística univariante. Resultados: Se realizaron 381 encuestas. El 98% presentó algún grado de fiebrefobia. El 40,6% definió fiebre bajo los 38°C. El 56 % de los cuidadores utilizaba medidas físicas. La principal secuela temida por los tutores fueron las convulsiones (82 %) y un 42,7% refirió que podía ser letal. La mayoría (92%) utilizó fuentes de información no confiables y dos tercios (66%) nunca recibieron información sobre el tema por parte del personal de salud.  La regresión logística evidenció que el hecho de ser progenitor, el nivel de escolaridad básica o media y un umbral térmico menor a 38°C fueron las variables mayormente asociadas a la fiebrefobia. Conclusiones: La fiebrefobia es un fenómeno vigente en nuestra población y la entrega de información adecuada y oportuna pudiese prevenirlo.

Antitussive, Expectorant and Antipyretic Effect of the Ethanolic Extract of the Leaves of Momordica charantia L.

The traditional use of the M. charantia L. plant to treat coughs, fever and expectoration is widely practiced in different cultures, but its effectiveness and safety still require scientific investigation. This study sought to perform a chemical analysis and evaluate the antitussive, expectorant and antipyretic effects of the ethanolic extract of M. charantia leaves (EEMc) in rats and mice. The EEMc was subjected to chemical analysis by HPLC-DAD, revealing the presence of the flavonoids astragalin and isoquercetin. Acute oral toxicity in mice did not result in deaths, although changes in liver weight and stool consistency were observed. EEMc demonstrated an antitussive effect at doses of 100 and 300 mg/kg in mice subjected to cough induction by citric acid nebulization. Furthermore, it showed expectorant activity at a dose of 300 mg/kg, assessed based on the elimination of the phenol red marker in bronchoalveolar lavage. In the evaluation of antipyretic activity in rats, fever induced by Saccharomyces cerevisiae was reduced at all doses tested during the first hour after treatment. This innovative study identified the presence of astragalin and isoquercetin in EEMc and indicated that the extract has antitussive, expectorant and antipyretic properties. Therefore, EEMc presents itself as a promising option in herbal medicine for the treatment of respiratory symptoms and fever.

Prospecting for candidate molecules from Conus virgo toxins to develop new biopharmaceuticals.

Background: A combination of pharmacological and biomedical assays was applied in this study to examine the bioactivity of Conus virgo crude venom in order to determine the potential pharmacological benefit of this venom, and its in vivo mechanism of action. Methods: Two doses (1/5 and 1/10 of LC50, 9.14 and 4.57 mg/kg) of the venom were used in pharmacological assays (central and peripheral analgesic, anti-inflammatory and antipyretic), while 1/2 of LC50 (22.85 mg/kg) was used in cytotoxic assays on experimental animals at different time intervals, and then compared with control and reference drug groups. Results: The tail immersion time was significantly increased in venom-treated mice compared with the control group. Also, a significant reduction in writhing movement was recorded after injection of both venom doses compared with the control group. In addition, only the high venom concentration has a mild anti-inflammatory effect at the late inflammation stage. The induced pyrexia was also decreased significantly after treatment with both venom doses. On the other hand, significant increases were observed in lipid peroxidation (after 4 hours) and reduced glutathione contents and glutathione peroxidase activity, while contents of lipid peroxidation and nitric oxide (after 24 hours) and catalase activity were depleted significantly after venom administration. Conclusion: These results indicated that the crude venom of Conus virgo probably contain bioactive components that have pharmacological activities with low cytotoxic effects. Therefore, it may comprise a potential lead compound for the development of drugs that would control pain and pyrexia.

Prospecting for candidate molecules from Conus virgo toxins to develop new biopharmaceuticals

Background: A combination of pharmacological and biomedical assays was applied in this study to examine the bioactivity of Conus virgo crude venom in order to determine the potential pharmacological benefit of this venom, and its in vivo mechanism of action. Methods: Two doses (1/5 and 1/10 of LC50, 9.14 and 4.57 mg/kg) of the venom were used in pharmacological assays (central and peripheral analgesic, anti-inflammatory and antipyretic), while 1/2 of LC50 (22.85 mg/kg) was used in cytotoxic assays on experimental animals at different time intervals, and then compared with control and reference drug groups. Results: The tail immersion time was significantly increased in venom-treated mice compared with the control group. Also, a significant reduction in writhing movement was recorded after injection of both venom doses compared with the control group. In addition, only the high venom concentration has a mild anti-inflammatory effect at the late inflammation stage. The induced pyrexia was also decreased significantly after treatment with both venom doses. On the other hand, significant increases were observed in lipid peroxidation (after 4 hours) and reduced glutathione contents and glutathione peroxidase activity, while contents of lipid peroxidation and nitric oxide (after 24 hours) and catalase activity were depleted significantly after venom administration. Conclusion: These results indicated that the crude venom of Conus virgo probably contain bioactive components that have pharmacological activities with low cytotoxic effects. Therefore, it may comprise a potential lead compound for the development of drugs that would control pain and pyrexia.(AU)

Analgesic, antipyretic, anti-inflammatory, and hepatoprotective activities of Pulicaria crispa (Forssk. ) Oliv. (Asteraceae)

Abstract Some plants of the genus Pulicaria have been used in traditional medicines for treating back pain and inflammation. They possess various bioactivities such as antipyretic, analgesic, and hepatoprotective. This study aimed to investigate the potential analgesic, antipyretic, anti- inflammatory, and hepatoprotective activities of Pulicaria crispa (P. crispa) extract (PCE). Analgesic activity was evaluated using the hot plate and acetic acid-induced writhing tests. Antipyretic and anti-inflammatory activities were evaluated using rectal temperature and carrageenan-induced hind paw edema methods, respectively. CCl4-intoxication was used for hepatoprotective activity. Also, liver histopathology was assessed. PCE, at 500 mg/kg, exhibited significant analgesic, antipyretic, and anti-inflammatory effects. The increased serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and bilirubin of CCl4-exposed rats reflects their liver injury. PCE significantly decreased the elevated liver markers. The hepatoprotective effect of PCE was confirmed, as it successfully reversed the altered levels of total protein, malondialdehyde (MDA), and non-protein sulfhydryls (NP-SH) in the liver tissues of CCl4-exposed rats. Histopathological studies confirmed the hepatoprotective nature of PCE. Pretreatment of rats with PCE reduced the severity of CCl4-induced liver damage. These findings concluded that PCE possesses analgesic, antipyretic, anti-inflammatory, and hepatoprotective activities.

Association of fever and antipyretic treatment with progressive organ dysfunction in sepsis: Prospective cohort.

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.

INTRODUCCIÓN: No se conoce si la fiebre y el tratamiento antipirético se relacionan con progresión de la disfunción orgánica (PDO) en sepsis. OBJETIVO: Evaluar la asociación de la fiebre y el tratamiento antipirético con la PDO en sepsis. MÉTODOS: Estudio de cohorte prospectiva de pacientes con sepsis. Se registró temperatura axilar máxima (T° máx.), dosis total de fármacos antipiréticos y puntuación diaria de la escala SOFA. La PDO se definió como el incremento de SOFA ≥ 1 punto. Se utilizó un modelo de regresión logística multivariado para evaluar la asociación estudiada. RESULTADOS: Se incluyeron 305 pacientes: 163 mujeres (53.4 %) con puntuación SOFA de ocho puntos (6-11); 130 participantes (42.62 %) presentaron T° máx. ≥ 38 °C y 76 (24.9 %), PDO. La mortalidad en los pacientes con fiebre fue de 26.2 % versus 20 % sin fiebre (p = 0.21) y con PDO, de 73.7 % versus 5.7 % (p = 0.01). La T° máx. ≥ 39°C tuvo RM = 4.96 (IC 95 % = 1.97-12.47, p = 0.01) y el uso de antipiréticos, RM = 1.04 (IC 95 % = 0.58-1.86, p = 0.88). CONCLUSIONES: La T° máx. axilar ≥ 39°C es un factor de riesgo para PDO en sepsis. El uso de antipiréticos no se asoció a PDO.

Triazol-phenyl Antipyretic Derivatives Inhibit mPGES-1 mRNA Levels in LPS-Induced RAW 264.7 Macrophage Cells.

BACKGROUND: Microsomal prostaglandin E synthase-1 (mPGES-1) catalyzes the terminal step of prostaglandin E2 (PGE2) production, which plays an important role in the regulation of febrile response. In our previous work, ligand-based pharmacophore models, built with mPGES-1 inhibitors, were employed to identify a novel series of compounds that reduce the febrile response in rats. OBJECTIVES: The study aimed to evaluate the mechanism of action of the most active compound (1). METHODS: For in vivo assays, rats were pretreated with the antipyretic compounds 1-8, 30 min before LPS injection. For in vitro assays, RAW 264.7 macrophage cells were incubated with the antipyretic compounds 1-8 for 1 hour before LPS stimulus. After 16 h, quantitative real-time PCR was carried out. Additionally, the PGE2 concentration in the hypothalamus was quantified by ELISA and the inhibitory effect of N-cyclopentyl-N'-[3-(3-cyclopropyl-1H-1,2,4-triazol- 5-yl)phenyl]ethanediamide (1) over human COX-2 enzymatic activity was determined with a COX Colorimetric Inhibitor Screening Assay Kit. RESULTS: Compound 1 and CAY10526 showed comparable efficacy to reduce the febrile response when injected i.v. (compound 1: 63.10%, CAY10526: 70.20%). Moreover, compound 1 significantly reduced the mPGES-1 mRNA levels, in RAW264.7 cells, under inflammatory conditions. A chemically-similar compound (8-) also significantly reduced the mRNA levels of the gene target. On the other hand, compounds 6 and 7, which are also somewhat similar to compound 1, did not significantly impact mPGES-1 mRNA levels. CONCLUSIONS: PGE2 concentration reduction in the hypothalamus, due to compound 1 central injection, is related to decreased mPGES-1 mRNA levels but not to COX-2 inhibition (IC50> 50 µM). Therefore, compound 1 is a promising lead for innovative antipyretic drug development.

Meta-analysis of the therapeutic use of dipyrone in dogs: pharmacological effects and clinical safety / Meta-análise do uso terapêutico da dipirona em cães: efeitos farmacológicos e segurança clínica

Dipyrone (metamizole) is well-known for its powerful effect with central and peripheral activity. This meta-analysis involved articles published between 1973 and 2021, revealing that Brazil is the country which most published scientific articles relating the use of dipyrone in dogs, and this drug is widely recommended as an analgesic to control pain in cases of postoperative and cancer. Dipyrone is one of the favorite drugs used in small animal clinic in Brazil, and 12 commercial brands are available to use in dogs at doses among 25 to 50mg/kg for oral, intravenous and intramuscular administration. The effects of dipyrone may be potentiated when used in combination with other analgesic agents such as tramadol. In several studies, the occurrence of vomiting has been observed as an adverse effect, especially when the drug is used during surgical procedures, but metamizole has presented a low potential to cause gastric ulceration. The meta-analysis study of the use of dipyrone in dogs shows the clinical importance of this drug in Brazil, being an effective and safe medication, as long as it is used in the indicated dose of 25 mg/kg.

A dipirona (metamizol) é bem conhecida por seu poderoso efeito com atividade central e periférica. Esta meta-nálise envolveu estudos publicados entre os anos de 1973 a 2021, revelando que o Brasil é o país que mais publicou artigos científicos envolvendo o uso de dipirona em cães, sendo este fármaco amplamente recomendado como analgésico para controlar a dor em casos de câncer e dor pós-operatória. É um dos medicamentos preferidos da clínica médica de pequenos animais no Brasil. 12 marcas comerciais estão disponíveis para uso em cães em doses que variam de 25 a 50g para administração oral, intravenosa e intramuscular. Os efeitos da dipirona podem ser potencializados quando usada em combinação com outros analgésicos, como o tramadol. Em vários estudos, a ocorrência de vômito tem sido observada como efeito adverso, principalmente quando o medicamento é usado durante procedimentos cirúrgicos, mas tem baixo potencial para causar ulceração gástrica. O estudo de meta-análise do uso de dipirona em cães evidencia a importância do uso clínico deste fármaco no Brasil, sendo um medicamento eficaz e seguro para cães, desde que utilizada na dose indicada de 25 mg / kg.

Meta-analysis of the therapeutic use of dipyrone in dogs: pharmacological effects and clinical safety / Meta-análise do uso terapêutico da dipirona em cães: efeitos farmacológicos e segurança clínica

Dipyrone (metamizole) is well-known for its powerful effect with central and peripheral activity. This meta-analysis involved articles published between 1973 and 2021, revealing that Brazil is the country which most published scientific articles relating the use of dipyrone in dogs, and this drug is widely recommended as an analgesic to control pain in cases of postoperative and cancer. Dipyrone is one of the favorite drugs used in small animal clinic in Brazil, and 12 commercial brands are available to use in dogs at doses among 25 to 50mg/kg for oral, intravenous and intramuscular administration. The effects of dipyrone may be potentiated when used in combination with other analgesic agents such as tramadol. In several studies, the occurrence of vomiting has been observed as an adverse effect, especially when the drug is used during surgical procedures, but metamizole has presented a low potential to cause gastric ulceration. The meta-analysis study of the use of dipyrone in dogs shows the clinical importance of this drug in Brazil, being an effective and safe medication, as long as it is used in the indicated dose of 25 mg/kg.(AU)

A dipirona (metamizol) é bem conhecida por seu poderoso efeito com atividade central e periférica. Esta meta-nálise envolveu estudos publicados entre os anos de 1973 a 2021, revelando que o Brasil é o país que mais publicou artigos científicos envolvendo o uso de dipirona em cães, sendo este fármaco amplamente recomendado como analgésico para controlar a dor em casos de câncer e dor pós-operatória. É um dos medicamentos preferidos da clínica médica de pequenos animais no Brasil. 12 marcas comerciais estão disponíveis para uso em cães em doses que variam de 25 a 50g para administração oral, intravenosa e intramuscular. Os efeitos da dipirona podem ser potencializados quando usada em combinação com outros analgésicos, como o tramadol. Em vários estudos, a ocorrência de vômito tem sido observada como efeito adverso, principalmente quando o medicamento é usado durante procedimentos cirúrgicos, mas tem baixo potencial para causar ulceração gástrica. O estudo de meta-análise do uso de dipirona em cães evidencia a importância do uso clínico deste fármaco no Brasil, sendo um medicamento eficaz e seguro para cães, desde que utilizada na dose indicada de 25 mg / kg.(AU)

RMD86, a thiophene derivative, promotes antinociceptive and antipyretic activities in mice.

Treatment of pain and fever remains an important challenge for modern medicine. Non-steroidal anti-inflammatory drugs (NSAIDs) are the pharmacological options most often used, but their frequent use exposes the patient to serious side effects and dangerous drug interactions. In this context, thiophene derivatives are promising therapeutic alternatives. In this study, we evaluated the in vivo and in silico antinociceptive and antipyretic properties of RMD86, a thiophene derivative. At 100 mg/kg, RMD86 induced no significant changes in the motor coordination of mice in the Rotarod test. At 25, 50, and 100 mg/kg RMD86 significantly reduced the number of abdominal contortions induced by acetic acid (antinociceptive activity) in mice when compared to the control. In the formalin test, for the first phase, there was a reduction in licking times at doses of 50 and 100 mg/kg. In the second phase, reduction occurred at all doses. In the hot plate test, RMD86 (at 100 mg/kg) increased latency time in the first 30 min. For antipyretic activity, RMD86, when compared to the reference drug acetaminophen (250 mg/kg), significantly reduced pyrexia at 30, 60, and 120 min, at dosages of 25, 50 and 100 mg/kg. Molecular docking studies revealed that RMD86 presents a greater number of interactions and lower energy values than both the co-crystallized ligand and the reference drug (meloxicam) against COX-1 and COX-2 isoenzymes. The results give evidence of the analgesic and antipyretic properties like NSAIDs suggesting its potential for pain therapy.

Encuesta sobre conocimiento, hábitos de prescripción y manejo de la fiebre en pediatras de un hospital pediátrico / Survey on knowledge, prescription habits, and management of fever among pediatricians at a children's hospital

Introducción. Existen discrepancias en el abordaje de la fiebre por parte de los pediatras. El objetivo fue describir conocimientos, hábitos de prescripción e indicaciones de tratamiento farmacológico y no farmacológico de la fiebre por parte de los médicos de un hospital pediátrico de la Ciudad de Buenos Aires.Material y métodos. Estudio observacional, descriptivo, analítico, de corte transversal, realizado en el Hospital de Niños Ricardo Gutiérrez durante 2018.Resultados. Se realizaron 100 encuestas. El 37 % de los pediatras siempre indicaba medios físicos, mientras que el 54 %, ocasionalmente. El 68 % alternaba antitérmicos, aunque el 72 % consideraba que esta práctica aumentaba el riesgo de toxicidad. El 32 % respondió que el tratamiento precoz disminuía el riesgo de convulsiones.Conclusiones. Existen hábitos de prescripción e indicaciones de tratamiento farmacológico y no farmacológico de la fiebre por parte de los pediatras con escasa evidencia de su eficacia.

Introduction. There are discrepancies in relation to pediatricians' approach to fever. Our objective was to describe the knowledge, prescription habits, and drug and non-drug treatment indications for fever among physicians at a children's hospital in the Autonomous City of Buenos Aires.Material and methods. Observational, descriptive, analytical, cross-sectional study conducted at Hospital de Niños Ricardo Gutiérrez in 2018.Results. A total of 100 surveys were completed: 37 % of pediatricians always indicated physical methods, whereas 54 % did so occasionally; 68 % alternated antipyretic agents, while 72 % considered this practice increased the risk for toxicity; and 32 % stated that early management reduced the risk for seizures.Conclusions. Pediatricians have prescription habits and indicate drug and non-drug treatments for fever that have demonstrated little effectivenes

Survey on knowledge, prescription habits, and management of fever among pediatricians at a children's hospital. / Encuesta sobre conocimiento, hábitos de prescripción y manejo de la fiebre en pediatras de un hospital pediátrico.

INTRODUCTION: There are discrepancies in relation to pediatricians' approach to fever. Our objective was to describe the knowledge, prescription habits, and drug and non-drug treatment indications for fever among physicians at a children's hospital in the Autonomous City of Buenos Aires. Material and methods. Observational, descriptive, analytical, cross-sectional study conducted at Hospital de Niños Ricardo Gutiérrez in 2018. RESULTS: A total of 100 surveys were completed: 37 % of pediatricians always indicated physical methods, whereas 54 % did so occasionally; 68 % alternated antipyretic agents, while 72 % considered this practice increased the risk for toxicity; and 32 % stated that early management reduced the risk for seizures. CONCLUSIONS: Pediatricians have prescription habits and indicate drug and non-drug treatments for fever that have demonstrated little effectiveness.

Introducción. Existen discrepancias en el abordaje de la fiebre por parte de los pediatras. El objetivo fue describir conocimientos, hábitos de prescripción e indicaciones de tratamiento farmacológico y no farmacológico de la fiebre por parte de los médicos de un hospital pediátrico de la Ciudad de Buenos Aires. Material y métodos. Estudio observacional, descriptivo, analítico, de corte transversal, realizado en el Hospital de Niños Ricardo Gutiérrez durante 2018. Resultados. Se realizaron 100 encuestas. El 37 % de los pediatras siempre indicaba medios físicos, mientras que el 54 %, ocasionalmente. El 68 % alternaba antitérmicos, aunque el 72 % consideraba que esta práctica aumentaba el riesgo de toxicidad. El 32 % respondió que el tratamiento precoz disminuía el riesgo de convulsiones. Conclusiones. Existen hábitos de prescripción e indicaciones de tratamiento farmacológico y no farmacológico de la fiebre por parte de los pediatras con escasa evidencia de su eficacia.

Conocimientos y manejo de la fiebre en padres de niños menores de 5 años en un hospital pediátrico / Knowledge and management of fever in parents of children under 5 years of age at a children's hospital

Introducción. La fiebre en pediatría es motivo de consulta frecuente. El objetivo fue evaluar los conocimientos, actitudes y temores de los padres ante la fiebre de sus hijos.Material y métodos. Estudio observacional, analítico, transversal. En 2018, se realizó una encuesta a padres de niños de entre 6 meses y 5 años que asistieron al Hospital de Niños Ricardo Gutiérrez de la Ciudad de Buenos Aires.Se analizó la asociación entre las variables sociodemográficas y los conocimientos, actitudes y temores frente al cuadro febril.Resultados. Se realizaron 201 encuestas. El 56,7 % de los padres consideró que la fiebre era mala para la salud. El 37 % definió fiebre entre 37 °C y 37,5 °C, y el 59 %, 38-38,5 ºC. La media de temperatura considerada grave fue 39,2 °C (desvío estándar 0,69). El 93 % de los cuidadores utilizaba medidas físicas; el 97 % administraba antitérmicos y el 14,5 % los alternaba. Los temores a las consecuencias fueron, en el 82 %, convulsiones; en el 41 %, deshidratación; en el 18 %, daño cerebral y, en el 12 %, muerte. El 86,5 % despertaba a sus hijos para administrarles antitérmico. En el estrato de mayor instrucción materna, fue menor el temor a la fiebre (odds ratio0,5; intervalo de confianza del 95 %: 0,28-0,91).Conclusiones. Un tercio de los encuestados consideró fiebre valores bajos de temperatura. El temor a la fiebre fue elevado y el nivel de instrucción materna podría mitigarlo.

Introduction. In pediatrics, fever is a common reason for consultation. The objective was to assess parental knowledge, behaviors, and fears in the management of fever in their children.Materials and methods. Observational, analytical, cross-sectional study. In 2018, a survey was administered to the parents of children aged 6 months to 5 years who attended Hospital de Niños Ricardo Gutiérrez, in the Autonomous City of Buenos Aires. The association between sociodemographic outcome measures and knowledge, behaviors, and fears in cases of fever was analyzed.Results. A total of 201 surveys were completed: 56.7 % of parents considered that fever was bad for health; 37 % defined fever between 37 °C and 37.5 °C, and 59 %, between 38 °C and 38.5 °C. The mean temperature considered severe was 39.2 °C (standard deviation: 0.69). Physical methods were used by 93 % of caregivers; 97 % administered antipyretic agents, and 14.5 % used alternating agents. Fears of consequences included seizures in 82 %, dehydration in 41 %, brain damage in 18 %, and death in 12 %. Also, 86.5 % woke up their children to give them an antipyretic agent. Among the higher maternal education level, fear of fever was lower (odds ratio: 0.5; 95 % confidence interval: 0.28-0.91).Conclusions. One-third of survey respondents considered low body temperature values as fever. Fear of fever was high, and the level of maternal education may mitigate it.

Knowledge and management of fever in parents of children under 5 years of age at a children's hospital. / Conocimientos y manejo de la fiebre en padres de niños menores de 5 años en un hospital pediátrico.

INTRODUCTION: In pediatrics, fever is a common reason for consultation. The objective was to assess parental knowledge, behaviors, and fears in the management of fever in their children. MATERIALS AND METHODS: Observational, analytical, cross-sectional study. In 2018, a survey was administered to the parents of children aged 6 months to 5 years who attended Hospital de Niños Ricardo Gutiérrez, in the Autonomous City of Buenos Aires. The association between sociodemographic outcome measures and knowledge, behaviors, and fears in cases of fever was analyzed. RESULTS: A total of 201 surveys were completed: 56.7 % of parents considered that fever was bad for health; 37 % defined fever between 37 °C and 37.5 °C, and 59 %, between 38 °C and 38.5 °C. The mean temperature considered severe was 39.2 °C (standard deviation: 0.69). Physical methods were used by 93 % of caregivers; 97 % administered antipyretic agents, and 14.5 % used alternating agents. Fears of consequences included seizures in 82 %, dehydration in 41 %, brain damage in 18 %, and death in 12 %. Also, 86.5 % woke up their children to give them an antipyretic agent. Among the higher maternal education level, fear of fever was lower (odds ratio: 0.5; 95 % confidence interval: 0.28-0.91). CONCLUSIONS: One-third of survey respondents considered low body temperature values as fever. Fear of fever was high, and the level of maternal education may mitigate it.

Introducción. La fiebre en pediatría es motivo de consulta frecuente. El objetivo fue evaluar los conocimientos, actitudes y temores de los padres ante la fiebre de sus hijos. Material y métodos. Estudio observacional, analítico, transversal. En 2018, se realizó una encuesta a padres de niños de entre 6 meses y 5 años que asistieron al Hospital de Niños Ricardo Gutiérrez de la Ciudad de Buenos Aires. Se analizó la asociación entre las variables sociodemográficas y los conocimientos, actitudes y temores frente al cuadro febril. Resultados. Se realizaron 201 encuestas. El 56,7 % de los padres consideró que la fiebre era mala para la salud. El 37 % definió fiebre entre 37 °C y 37,5 °C, y el 59 %, 38-38,5 ºC. La media de temperatura considerada grave fue 39,2 °C (desvío estándar 0,69). El 93 % de los cuidadores utilizaba medidas físicas; el 97 % administraba antitérmicos y el 14,5 % los alternaba. Los temores a las consecuencias fueron, en el 82 %, convulsiones; en el 41 %, deshidratación; en el 18 %, daño cerebral y, en el 12 %, muerte. El 86,5 % despertaba a sus hijos para administrarles antitérmico. En el estrato de mayor instrucción materna, fue menor el temor a la fiebre (odds ratio 0,5; intervalo de confianza del 95 %: 0,28-0,91). Conclusiones. Un tercio de los encuestados consideró fiebre valores bajos de temperatura. El temor a la fiebre fue elevado y el nivel de instrucción materna podría mitigarlo.

Efficacy of a phenol derivative, isopropyl vanillate, as an anti-inflammatory agent: A new small molecule inhibitor of COX and neutrophil migration.

Inflammation is the response of the body to noxious stimuli such as infections, trauma, or injury. Experimental studies have shown that vanillic acid has anti-inflammatory effects. The objective of this study was to investigate the anti-inflammatory and antipyretic properties of the derivative of vanillic acid, isopropyl vanillate (ISP-VT), in mice. The results of this study indicated that ISP-VT reduced paw edema induced by carrageenan, dextran sulfate (DEX), compound 48/80, serotonin, bradykinin (BK), histamine (HIST), and prostaglandin E2 (PGE2). Furthermore, ISP-VT reduced recruitment of leukocytes and neutrophils and reduced its adhesion and rolling, and decreased myeloperoxidase enzyme activity (MPO), cytokine levels (tumor necrosis factor-α and interleukin-6), and vascular permeability. ISP-VT also significantly reduced the expression of cyclooxygenase-2 (COX-2) in subplantar tissue of mice. ISP-VT inhibited COX-2 selectively compared to the standard drug. Our results showed that although ISP-VT binds to COX-1, it is less toxic than indomethacin, as evidenced by MPO analysis of gastric tissue. Treatment with the ISP-VT significantly reduced rectal temperature in yeast-induced hyperthermia in mice. Our results showed that the main mechanism ISP-VT-induced anti-inflammatory activity is by inhibition of COX-2. In conclusion, our results indicate that ISP-VT has potential as an anti-inflammatory and antipyretic therapeutic compound.

Synthesis of some novel pyrimidine, thiophene, coumarin, pyridine and pyrrole derivatives and their biological evaluation as analgesic, antipyretic and anti-inflammatory agents

Pyrimidine derivative 3 was afforded through the reaction of compound (1) with 5-ureidohydantion (2). Product 3 underwent a cyclization to produce fused pyrimidine derivative 7, although the latter product 7 was synthesized through one step via the reaction of compound (1) with 5-ureidohydantion (2) using another catalyst. Compound 3 was oriented to react with cyclic ketones 8a,b in the presence of elemental sulfur, salicylaldehyde (10), aryldiazonium chlorides 12a,b and ω-bromo-4-methoxy- acetophenone (14), which afforded, fused thiophene derivatives 9a,b, coumarin derivative 11, arylhdrazono derivatives 13a,b and 4-methoxyphenyl butenyl derivative 15, respectively. The latter product 15 was reacted with either potassium cyanide (16a) or potassium thiocyanide (16b) to form cyano and thiocyano derivatives 17a,b, respectively. Compound 17a underwent further cyclization to afford pyridopyrimidine derivative 19. Compound 15 was reacted with either hydrazine (20a) or phenylhydrazine (20b) to produce hydrazo derivatives 21a,b and these products were cyclize to produce pyrrole derivatives 23a,b. Finally, 5-ureidohydantion (2) was reacted with compounds 24a,b,c to afford pyrimidine derivatives 25a,b,c. The structures of the synthesized compounds were confirmed using IR, 1H NMR, 13C NMR and mass spectrometry techniques. Compounds 11 and 19 have promising as analgesic and antipyretic activities

Evaluation of antipyretic, sedative and hypnotic activities of methanol extract of Tabebuia hypoleuca (C. Wright ex Sauvalle) Urb. stems / [Evaluación de la actividad antipirética, sedante e hipnótica del extracto metanólico de los tallos de Tabebuia hypoleuca (C. Wright ex Sauvalle) Urb

Species of the genus Tabebuia are used in traditional medicine and are reported in the literature for their properties against various diseases. The objective of this study was to evaluate the antipyretic, sedative and hypnotic activities of methanol extract of Tabebuia hypoleuca stems (THME) using the Brewer's yeast induced pyrexia, Open field and Sodium thiopental-induced sleeping time tests, respectively. In the Brewer's yeast induced pyrexia test, THME at 500 mg/kg produced a significant (p<0.001) decrease of the fever as from the first hour after administration and was sustained for 4 h. In the Open-field test, THME did not cause any significant change in the number of crossings, rearing, preening and defecation, and either in the time of immobility. Moreover, THME did not produce changes in neither the sleeping latency nor the sleeping time induced by sodium thiopental. These results showed that THME administered orally at 500 mg/kg exerts antipyretic activity, probably mediated by the inhibition of the enzyme cyclooxygenase-2. This study also showed that THME does not exert sedative and hypnotic effects at the doses tested.

Especies del género Tabebuia se utilizan en la medicina tradicional y se reportan en la literatura por sus propiedades contra diversas enfermedades. El objetivo de este estudio fue evaluar la actividad antipirética, sedante e hipnótica del extracto metanólico de los tallos de Tabebuia hypoleuca (THME) utilizando las pruebas de pirexia inducida por levadura de cerveza, campo abierto y tiempo de sueño inducido por tiopental sódico respectivamente. En el ensayo de pirexia inducida por levadura de cerveza, THME a 500 mg/kg produjo una reducción significativa (p<0.001) de la fiebre a partir de la primera hora después de la administración y se mantuvo durante cuatro horas. En el ensayo de campo abierto, THME no causó ningún cambio significativo en el número de cruces, levantamientos, acicalamientos y defecación, ni en el tiempo de inmovilidad. Además, THME no produjo cambios ni en la latencia de sueño, ni en el tiempo de sueño inducido por tiopental sódico. Estos resultados mostraron que THME administrado oralmente en dosis de 500 mg/kg posee actividad antipirética, mediado probablemente a la inhibición de la enzima ciclooxigenasa-2. Este estudio también demostró que THME no posee actividad sedante e hipnótica en las dosis ensayadas.

2016 Update of the Italian Pediatric Society Guidelines for Management of Fever in Children.

OBJECTIVE: To review new scientific evidence to update the Italian guidelines for managing fever in children as drafted by the panel of the Italian Pediatric Society. STUDY DESIGN: Relevant publications in English and Italian were identified through search of MEDLINE and the Cochrane Database of Systematic Reviews from May 2012 to November 2015. RESULTS: Previous recommendations are substantially reaffirmed. Antipyretics should be administered with the purpose to control the child's discomfort. Antipyretics should be administered orally; rectal administration is discouraged except in the setting of vomiting. Combined use of paracetamol and ibuprofen is discouraged, considering risk and benefit. Antipyretics are not recommended preemptively to reduce the incidence of fever and local reactions in children undergoing vaccination, or in attempt to prevent febrile convulsions in children. Ibuprofen and paracetamol are not contraindicated in children who are febrile with asthma, with the exception of known cases of paracetamol- or nonsteroidal anti-inflammatory drug-induced asthma. CONCLUSIONS: Recent medical literature leads to reaffirmation of previous recommendations for use of antipyretics in children who are febrile.

Anti-inflammatory effects of royal poinciana through inhibition of toll-like receptor 4 signaling pathway.

Inflammation is part of the non-specific immune response that occurs in reaction to any type of bodily injury. In some disorders the inflammatory process, which under normal conditions is self-limiting, becomes continuous and chronic inflammatory diseases develop subsequently including cardiovascular diseases, diabetes, cancer etc. Barks of Delonix regia is used traditionally in the treatment of inflammatory diseases. Therefore, in this study we evaluated the therapeutic potential of D. regia ethanol extract and its active constituent ß-Elemene with special interest in inflammation model using standard in vivo anti-inflammatory models: Carrageenan-induced paw edema, Cotton pellet granuloma, and Acetic acid-induced vascular permeability. To explicate the mechanism of action for the possible anti-inflammatory activity, we determined the level of major inflammatory mediators (NO, iNOS, COX-2-dependent prostaglandin E2 or PGE2), and pro-inflammatory cytokines (TNF-a, IL-1b, IL-6, and IL-12). Additionally, we determined the toll-like receptor 4 (TLR4), Myeloid differentiation primary response gene 88 (MyD88), by mRNA expression in drug treated LPS-induced murine macrophage model. To explore the mechanism of anti-inflammatory activity, we evaluated expression of c-Jun N-terminal kinases (JNK), nuclear factor kappa-B cells (NF-kB), and NF-kB inhibitor alpha (IK-Ba). Furthermore, we determined the acute and sub-acute toxicity of D. regia extract in BALB/c mice. This study established a significant anti-inflammatory activity of D. regia extract and ß-Elemene along with the inhibition of TNF-a, IL-1b, IL-6 and IL-12 expressions. Further, the expression of TLR4, NF-kBp65, MyD88, iNOS and COX-2 molecules were reduced in drug-treated groups, but not in the LPS-stimulated untreated or control groups, Thus, our results collectively indicated that the D. regia extract and ß-Elemene can efficiently inhibit inflammation.

Preclinical validation of antinociceptive, antiinflammatory, and antipyretic activities of Cordia martinicensis leave decoction / Validación preclínica de las actividades antinociceptiva, antiinflamatoria y antipirética de decocción de hojas de Cordia martinicensis

INTRODUCTION: leave decoction of Cordia martinicensis (Jacq.) Roem. & Schult. is commonly used in Dominica, Martinique and St. Lucia to relieve thoracic pain and fever. OBJECTIVES: to validate the antiinflammatory, antinociceptive (analgesic), and antipyretic ethnobotanical uses of Cordia martinicensis in experimental animal models. METHODS: 30 % aqueous extract of Cordia martinicensis dry leaves was prepared just before use. Analgesic activity was assayed by writhing and tail flick, and antiinflammatory activity by the ear oedema test, both in mice. Finally, antipyretic activity was tested by inducing pyrexia with brewer's yeast in rats. RESULTS: decoction of Cordia martinicensis significantly decreased the number of abdominal stretchings by 44.4 %, but it didn't produce a significant antinociceptive response to thermal stimuli. It also displayed strong antiinflammatory activity, the percentage of inhibition was near 60 %, and a dose of 5 mg/kg showed significant antipyretic activity. Cordia martinicensis reacted positively to alkaloids, flavonoids, tannins, and anthocyanidines, and did not show any signs of toxicity. CONCLUSIONS: this is the first report on the activity of Cordia martinicensis directly related to its popular use, and it provides pharmacological validation for the relief of fever, inflammation and pain. Further studies should be done to identify the active principles responsible for the biological activity of the plant.

INTRODUCCIÓN: la decocción de hojas de Cordia martinicensis (Jacq.) Roem. & Schult. muestra un uso tradicional significativo para el alivio del dolor torácico y la fiebre, por parte de la población de Dominica, Martinica y Santa Lucía. OBJETIVOS: validar el uso etnobotánico de Cordia martinicensis en esta región, como antiinflamatorio, antinociceptivo (analgésico) y antipirético, en modelos experimentales en animales. MÉTODOS: el extracto acuoso al 30 % de hojas secas de Cordia martinicensis se preparó justo antes de ser usado. La actividad analgésica fue estudiada mediante el modelo de contorciones abdominales y retirada de la cola en ratones. El efecto antiinflamatorio se evaluó sobre el edema en la oreja del ratón inducido por aceite de Croton.Finalmente, la actividad antipirética del extracto se evaluó mediante la inducción de fiebre en ratas por levadura de cerveza. RESULTADOS: la decocción de Cordia martinicensis disminuyó significativamente el número de contorciones abdominales en 44.4 %, pero no la respuesta al estímulo térmico; en edema en la oreja inhibió la inflamación 60 %, tanto tópico como oral. Resultó capaz de disminuir la fiebre a dosis de 5 mg/kg. Cordia martinicensis contiene alcaloides, flavonoides, taninos, y antocyanidinas y no mostró señales de toxicidad. CONCLUSIONES: constituye el primer estudio de validación del uso tradicional de Cordia martinicensis, avalando el uso farmacológico en procesos de fiebre, dolor e inflamación. Es necesario continuar los estudios fitoquímicos para determinar los principios activos responsables de su actividad biológica.