Winter is Stretching Out

[Snowy Owl]

Parents are surprised of Course, kids are out not enough dressed,
colds are coming, lowering their immune switness if they encounter H1N1.

So lets get all these clothes out of the closet, no profen if needed just Tynelol.

Some Curcumin meals, mulvitamins, vitaD3, Zinc, these are not medical advice of course I am just a Medicine Man in Northern Quebec.

But all is corroborated in Alternatives Influenza Forums of Flu Trackers
Médecines traditionnelles et traitements alternatifs,
Tratamientos Naturales para La Enfermedades
Personal, Family, & Professional Pandemic Preparations
Medical Treatments - Clinical & Psychological Medicine
World's Indigenous Peoples - Health & Humanitarian Issues

Traditional & Alternative Influenza Interventions

Whether you are in the MidWest, nothern States, Canada and in few days Europa, Russia, Himmalaya Surroundings, China.

It is getting sharply almost chopping Cold.

Prepare for incoming Snow I hope, it would heat up.

Snowy Owl

[harpoon]

im curious as to why you would say that ibuprofen/advil etc is favored over acetaminophen/tylenol? They are both anti-pyretics, and fever is what makes it more difficult for viruses to reproduce, as well as causing more oxygen release into the tissues for the white blood cells enzymes to use in killing. so i wouldnt bother splitting hairs w/ advil vs tylenol, unless you have liver failure or something, in which case you got bigger problems

[AlaskaDenise]

...fever is what makes it more difficult for viruses to reproduce,

While that may generally be true, remember this virus currently has its replication-temperature set to high (PB2/627E), unlike every other human influenza virus starting with 1918.

.

[Snowy Owl]

Originally Posted by harpoon

im curious as to why you would say that ibuprofen/advil etc is favored over acetaminophen/tylenol? They are both anti-pyretics, and fever is what makes it more difficult for viruses to reproduce, as well as causing more oxygen release into the tissues for the white blood cells enzymes to use in killing. so i wouldnt bother splitting hairs w/ advil vs tylenol, unless you have liver failure or something, in which case you got bigger problems

Sorry Harpoon for the delay

The Japan Institute of Pharmaco-Vigilance have observed that two salts of NSAIDS fuel inflammation.

Tynenol is a must avoid ibuprofen (Avdil)

Snowy Owl

[harpoon]

hmm interesting stuff snowy, who'da thought nsaids stimulated inflammation? i cant find anything about that study on google, do you have a link somewhere?

Denise: so how does that change things? Should you put people on Oxygen and nsaids/steroids/tylenol to reduce the inflammation, if that (and the 'cytokine storm' associated with it) is whats actually killing people (although this wiki link says those drugs dont help people breathe any better...)

and what about outside a hospital setting, with no oxygen - might it be better to let the fever do its job (if the oxygen-release effects of fever i mentioned make any difference in virus killing), making sure to replenish fluids...?

[Snowy Owl]

Ibuprofen (and other NSAIDs) is commonly used for management of fever and other symptoms in influenza. Is there any reason for caution?
NB: NSAID = non-steroidal anti-inflammatory drugs

SusanC :: Use of NSAIDs in Influenza
2 things prompted me to write this diary:
1) the sudden death of a 6-year old after 1 day of illness. Media report suggests she was prescribed Advil.

2) A recent post in the BMJ from Rokuro Hama, chairperson, Japan Institute of Pharmacovigilance raises a potentially significant question, is the use of NSAIDs such as ibuprofen safe, in influenza.

Severe and fatal cases, including sudden death, are characterised by severe sepsis with multi-organ failure with findings such as fever, leucocytosis, leucopenia, acute respiratory distress syndrome (ARDS), liver impairment, renal failure, rhabdomyolysis, and hypotension.2 NSAIDs may aggravate these syndromes, leading to multi-organ failure.3

Since the flu pandemics of the 20th century salicylates have been linked to Reye's syndrome and their use restricted in children.

But NSAIDs such as diclofenac, mefenamic acid, and ibuprofen are still used as antipyretics in many countries, albeit less often than aspirin.

Since the use of diclofenac and mefenamic acid was restricted in children in Japan in 2000, the case fatality of so called flu associated encephalopathy has fallen dramatically.4

I don't know if the 2 are related, but ibuprofen is oftenly prescribed for children for fever and other symptoms. Indeed, it is in CDC's guidance for homecare, together with other NSAIDs

I did a search of literature. There isn't much research on this subject except from Japan, where they have paid a lot of attention to it.

There is some indication that diclofenac sodium especially, and mefenamic acid , may be dangerous. Note from the above that they had significant reduction of fatality after these 2 drugs were restricted in children. I don't know if ibuprofen also carries the same risks. Unfortunately, the author only mentioned ibuprofen once and didn't give further details

Here are 2 further papers, on NSAID and flu, especially diclofenac.

Acute encephalopathy associated with influenza and other viral infections

Acute encephalopathy is the most serious complication of pediatric viral infections, such as influenza and exanthem subitum. It occurs worldwide, but is most prevalent in East Asia, and every year several hundreds of Japanese children are affected by influenza-associated encephalopathy.

Mortality has recently declined, but is still high. Many survivors are left with motor and intellectual disabilities, and some with epilepsy. This article reviews various syndromes of acute encephalopathy by classifying them into three major categories.
The first group caused by metabolic derangement consists of various inherited metabolic disorders and the classical Reye syndrome. Salicylate is a risk factor of the latter condition.

The second group, characterized by a systemic cytokine storm and vasogenic brain edema, includes Reye-like syndrome, hemorrhagic shock and encephalopathy syndrome, and acute necrotizing encephalopathy.

Non-steroidal anti-inflammatory drugs, such as diclofenac sodium and mephenamic acid, may aggravate these syndromes. Severe cases are complicated by multiple organ failure and disseminated intravascular coagulation. Mortality is high, although methylprednisolone pulse therapy may be beneficial in some cases.

The third group, characterized by localized edema of the cerebral cortex, has recently been termed acute encephalopathy with febrile convulsive status epilepticus, and includes hemiconvulsion-hemiplegia syndrome and acute infantile encephalopathy predominantly affecting the frontal lobes.

Theophylline is a risk factor of these syndromes. The pathogenesis is yet to be clarified, but an increasing body of evidence points to excitotoxicity and delayed neuronal death.

Prognostic factors in influenza-associated encephalopathy

BACKGROUND: Recently, reports of influenza-associated encephalopathy have increased worldwide. Given the high mortality and morbidity rates attributable to this severe neurologic complication of influenza, we conducted a nationwide study in Japan to identify the prognostic factors.
METHODS: We retrospectively evaluated 442 cases of influenza-associated encephalopathy that were reported to the Collaborative Study Group on Influenza-Associated Encephalopathy, which was organized by the Japanese Ministry of Health, Labor, and Welfare in collaboration with hospitals, clinics, and local pediatric practices in Japan between 1998 and 2002. The outcome for each patient was classified as either survival or death. Predictors of death were identified using logistic regression analysis.

RESULTS: Four major prognostic factors for death were found to be significant by multivariate analysis (P < 0.05) in the 184 patients for whom we had complete data: elevation of aspartate aminotransferase, hyperglycemia, the presence of hematuria or proteinuria, and use of diclofenac sodium.

CONCLUSIONS: We identified patients who had factors associated with a poor prognosis, and these findings might be clinically useful for the management of this illness.

Now, there is no indication from media reports that any of the deaths so far had influenza-associated encephalopathy. OTOH, given this is a novel virus, the mechanism of disease may be different. There is some concern, from the age distribution of fatal cases, that this current H1N1 may be more similar to 1918 than 1957 or 68. We don't know that to be true, but if it is, the current generation of physicians have ZERO experience in treating primary influenza disease in patients totally immunologically naive to this virus. What may be safe in regular seasonal flu may or may not be safe in this context

We may need to be cautious. As some would say, more data would be useful. In the meantime, this is food for thought for parents.

Snowy

http://www.flutrackers.com/forum/sho...ight=Ibuprofen

[ming]

Scotland is also a cold country - and coming home at 11pm the other night, the temp was 1C - and we passed several crowds of teenagers wearing summer tops, t shirts, miniskirts, NO JACKETS, wandering about the streets !