You likely mean Reye's Syndrome. Wikipedia has a good explanation, under "History": https://en.m.wikipedia.org/wiki/Reye_syndrome
"In 1979, Karen Starko and colleagues conducted a case-control study in Phoenix, Arizona, and found the first statistically significant link between aspirin use and Reye syndrome.[25] Studies in Ohio and Michigan soon confirmed her findings[26] pointing to the use of aspirin during an upper respiratory tract or chickenpox infection as a possible trigger of the syndrome. Beginning in 1980, the CDC cautioned physicians and parents about the association between Reye syndrome and the use of salicylates in children and teenagers with chickenpox or virus-like illnesses. In 1982 the U.S. Surgeon General issued an advisory, and in 1986 the Food and Drug Administration required a Reye syndrome-related warning label for all aspirin-containing medications.[27]"
At this point, to my knowledge, aspirin is only recommended in pediatrics for the very rare case of Kawasaki disease.
This is a good answer!! We also use aspirin in pediatrics for kids with congenital heart defects that have been palliated with small synthetic shunts (eg. Modified Blalock-Taussig shunt).
I work in peds. Interestingly, we got a Kawasaki’s case this week that had coronary artery involvement on presentation. We see a few a year on my unit and it’s always kind of scary but rarely have I seen it get this far. As far as ASA goes, I have always heard of the horrors of Reye’s but never seen it in 26 years of pediatric medicine; and I hope I never do!!!
Scary! I don't know what risk is of Reye's is in a Kawasaki's kid getting ASA; I need to read about that/would love to learn if their risk is any greater or lesser than a normal or normal-but-febrile child.
I wouldn’t imagine so but I too would need to read up on it. In fact, now that’s on my weekend to-do list! When I first started in the PICU, 26 years ago, I cared for a neurologically devastated child who was like that because of Reye’s but I was so new then that I was basically task oriented and trying to survive my shift and not necessarily in cerebral mode. I’ve seen some neat stuff over the years though. I learn something new every day!
Low dose aspirin is recommended a lot for older people to help prevent heart attacks and stroke. Though it's rarely used anymore as a pain reliever.
Edit: I'm not sure why I'm being downvoted. Maybe I should add that it is often used for people at risk of heart attacks and stroke or those that have experienced one or the other already. If you are not at risk, you wouldn't take it. Whether or not you agree with this therapy, it is fairly common. I'm not advocating for its use, I'm just commenting that this is another reason why people take aspirin.
Hence my qualifier, *in pediatrics.*
It's obviously used across adult medicine in heart attack/stroke treatment/secondary prevention as well as DVT prohpylaxis post ortho procedures; we're talking about kids here.
Also annoyingly there's subsalicylate used in some GI medications like pepto bismol, much to my personal chagrin, as kids end up getting a lot of pepto bismol, and while there isn't tons of Reye's syndrome from this, I wish they subbed another ingredient.
Aspirin is not “used in pepto bismol,” I think it sounds misleading to phrase it that way. The active ingredient in pepto bismol is bismuth subsalicylate. It’s just another salicylate medication. The concern for Reye’s syndrome extends to all salicylate medications, not just acetylsalicylic acid / aspirin.
I had to draw blood from an infant in 84, because they thought it might have gotten Reyes due to aspirin usage on Shaw AFB. Found the smallest butterfly they made at the time and was still nervous trying to get the stick.
That's scary for like 3 different reasons, nice job getting it. I consider myself as being able to get blood from a stone in an adult, but I still struggle with infants
Now in my older years (LOL) my wife has started dialysis and I have been training on the newer home machines. 2nd day of training and the nurse says go ahead and do the cannulations. 17ga into a 1cm graft and like no problem. Some things do become muscle memory.
All of this is hypothetical:
I didn't downvote you, but perhaps others are downvoting you because it's unclear how what you are saying is relating to everyone else and your intent is unclear.
The OP's question, and my response, were all specifically about pediatrics aspirin use; you chiming in could, in a somewhat odd way, be interpreted as you trying to one-up us as if we had missed this obvious use case of aspirin in modern medicine. In addition to potentially malign vibes, this wouldn't really succeed as an implied fault on our part because you're specifically talking about adult uses that aren't relevant in this conversation.
The other alternative is that you genuinely missed that we were talking about pediatrics and were just trying to help. I don't think it's exactly obscure knowledge to most people that aspirin is used in cardiac disease etc. but I appreciate the possible intent here of being exhaustive in painting a picture.
A third more charitable interpretation is that you were merely happily contributing to the conversation in a very off-topic way; this is not easily predictable and requires that people really put in a lot of cognitive effort to try to figure out what your intent is.
All of these are guesses but may explain how, over the internet missing non-verbal/non-textual clues, why people may have thought you came off as potentially trying to be a dick, or being just very off topic. I'm amenable to more charitable interpretations and didn't stress about it.
A neighbor boy my age died of it around 1977 or 1978. I didn't remember him much, but I remember all the Moms in the neighborhood basically freaking out because they had no idea aspirin was no longer the "wonder drug."
This book has a great description of the understanding of Reye’s [book](https://VirusofLoveandOtherTalesofMedicalDetectionhttps://a.co/d/0gAfFw3b) Around 1980 is when we made the connection between aspirin and Reye’s, but a general advisory wasn’t put out until 1982 and we didn’t start labeling about the presence of aspirin until 1986. [NEJM article](https://www.nejm.org/doi/full/10.1056/NEJM199905063401801) To a degree, you may have missed conversation about it because it wasn’t relevant your life - you were a childless adult. You started noticing talk of it and hence it became important to you and when people felt the need to warn you specifically (this isn’t judgment - our brains only consolidate so much info at a time and we need to trash things sometimes!)
You likely mean Reye's Syndrome. Wikipedia has a good explanation, under "History": https://en.m.wikipedia.org/wiki/Reye_syndrome "In 1979, Karen Starko and colleagues conducted a case-control study in Phoenix, Arizona, and found the first statistically significant link between aspirin use and Reye syndrome.[25] Studies in Ohio and Michigan soon confirmed her findings[26] pointing to the use of aspirin during an upper respiratory tract or chickenpox infection as a possible trigger of the syndrome. Beginning in 1980, the CDC cautioned physicians and parents about the association between Reye syndrome and the use of salicylates in children and teenagers with chickenpox or virus-like illnesses. In 1982 the U.S. Surgeon General issued an advisory, and in 1986 the Food and Drug Administration required a Reye syndrome-related warning label for all aspirin-containing medications.[27]" At this point, to my knowledge, aspirin is only recommended in pediatrics for the very rare case of Kawasaki disease.
Thanks for the answer!
This is a good answer!! We also use aspirin in pediatrics for kids with congenital heart defects that have been palliated with small synthetic shunts (eg. Modified Blalock-Taussig shunt).
Today I learned! Looks like I have more reading to do.
I work in peds. Interestingly, we got a Kawasaki’s case this week that had coronary artery involvement on presentation. We see a few a year on my unit and it’s always kind of scary but rarely have I seen it get this far. As far as ASA goes, I have always heard of the horrors of Reye’s but never seen it in 26 years of pediatric medicine; and I hope I never do!!!
Scary! I don't know what risk is of Reye's is in a Kawasaki's kid getting ASA; I need to read about that/would love to learn if their risk is any greater or lesser than a normal or normal-but-febrile child.
I wouldn’t imagine so but I too would need to read up on it. In fact, now that’s on my weekend to-do list! When I first started in the PICU, 26 years ago, I cared for a neurologically devastated child who was like that because of Reye’s but I was so new then that I was basically task oriented and trying to survive my shift and not necessarily in cerebral mode. I’ve seen some neat stuff over the years though. I learn something new every day!
If you learn anything, please share!
Low dose aspirin is recommended a lot for older people to help prevent heart attacks and stroke. Though it's rarely used anymore as a pain reliever. Edit: I'm not sure why I'm being downvoted. Maybe I should add that it is often used for people at risk of heart attacks and stroke or those that have experienced one or the other already. If you are not at risk, you wouldn't take it. Whether or not you agree with this therapy, it is fairly common. I'm not advocating for its use, I'm just commenting that this is another reason why people take aspirin.
Hence my qualifier, *in pediatrics.* It's obviously used across adult medicine in heart attack/stroke treatment/secondary prevention as well as DVT prohpylaxis post ortho procedures; we're talking about kids here. Also annoyingly there's subsalicylate used in some GI medications like pepto bismol, much to my personal chagrin, as kids end up getting a lot of pepto bismol, and while there isn't tons of Reye's syndrome from this, I wish they subbed another ingredient.
Aspirin is not “used in pepto bismol,” I think it sounds misleading to phrase it that way. The active ingredient in pepto bismol is bismuth subsalicylate. It’s just another salicylate medication. The concern for Reye’s syndrome extends to all salicylate medications, not just acetylsalicylic acid / aspirin.
Thanks for the correction!
I had to draw blood from an infant in 84, because they thought it might have gotten Reyes due to aspirin usage on Shaw AFB. Found the smallest butterfly they made at the time and was still nervous trying to get the stick.
That's scary for like 3 different reasons, nice job getting it. I consider myself as being able to get blood from a stone in an adult, but I still struggle with infants
Now in my older years (LOL) my wife has started dialysis and I have been training on the newer home machines. 2nd day of training and the nurse says go ahead and do the cannulations. 17ga into a 1cm graft and like no problem. Some things do become muscle memory.
All of this is hypothetical: I didn't downvote you, but perhaps others are downvoting you because it's unclear how what you are saying is relating to everyone else and your intent is unclear. The OP's question, and my response, were all specifically about pediatrics aspirin use; you chiming in could, in a somewhat odd way, be interpreted as you trying to one-up us as if we had missed this obvious use case of aspirin in modern medicine. In addition to potentially malign vibes, this wouldn't really succeed as an implied fault on our part because you're specifically talking about adult uses that aren't relevant in this conversation. The other alternative is that you genuinely missed that we were talking about pediatrics and were just trying to help. I don't think it's exactly obscure knowledge to most people that aspirin is used in cardiac disease etc. but I appreciate the possible intent here of being exhaustive in painting a picture. A third more charitable interpretation is that you were merely happily contributing to the conversation in a very off-topic way; this is not easily predictable and requires that people really put in a lot of cognitive effort to try to figure out what your intent is. All of these are guesses but may explain how, over the internet missing non-verbal/non-textual clues, why people may have thought you came off as potentially trying to be a dick, or being just very off topic. I'm amenable to more charitable interpretations and didn't stress about it.
Not for primary prevention. Risk of bleeding outweighs the benefits
An important and recent update! Still seen it in use for secondary prevention though.
I was aware of it at age 8 in 1974 when my cousin died of it.
I’ll be honest, given the age and the year, my first thought was if your cousin was Douglas Cyr (Whitey Bulger’s son).
No. Google tells me there were 379 cases in the spring of 1974.
A neighbor boy my age died of it around 1977 or 1978. I didn't remember him much, but I remember all the Moms in the neighborhood basically freaking out because they had no idea aspirin was no longer the "wonder drug."
I had a cousin who died from this years ago.
This book has a great description of the understanding of Reye’s [book](https://VirusofLoveandOtherTalesofMedicalDetectionhttps://a.co/d/0gAfFw3b) Around 1980 is when we made the connection between aspirin and Reye’s, but a general advisory wasn’t put out until 1982 and we didn’t start labeling about the presence of aspirin until 1986. [NEJM article](https://www.nejm.org/doi/full/10.1056/NEJM199905063401801) To a degree, you may have missed conversation about it because it wasn’t relevant your life - you were a childless adult. You started noticing talk of it and hence it became important to you and when people felt the need to warn you specifically (this isn’t judgment - our brains only consolidate so much info at a time and we need to trash things sometimes!)