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Archive 1 | Archive 2 | Archive 3 | Archive 4 | Archive 5 |
Please stop your
disruptive editing. If you continue to
vandalize Wikipedia, as you did at
Paracetamol, you may be
blocked from editing. --
CFCF
🍌 (
email)
04:10, 27 July 2015 (UTC)
There certainly seems to be an epidemiological association here, but I don't think consensus view is favors causation to the extent of the language that was added.
Here are the papers I found:
1) http://www.ncbi.nlm.nih.gov/pubmed/20933592: " At present, the evidence is inconclusive that any such association is causal."
2) http://www.ncbi.nlm.nih.gov/pubmed/23547988 " Is acetaminophen a real asthma promoter or an innocent bystander?"
3) http://www.ncbi.nlm.nih.gov/pubmed/23347656 "However, the epidemiological evidence is now compelling and there is a clear need to establish causation so that appropriate advice and interventions can be developed for children at risk of asthma. This requires randomised trials"
4) http://www.ncbi.nlm.nih.gov/pubmed/23292157 "Truly indicated antibiotics should not be withheld from infants or young children for fears they might develop asthma. Likewise, there is no sound reason to replace paracetamol as the preferred pain relief and fever medication in this age group."
5) http://www.ncbi.nlm.nih.gov/pubmed/23253685: "Causality cannot be established from observational studies because of the arguable presence of many confounding factors and biases. Randomised trials are needed to disclose the nature of the association"
6) http://www.ncbi.nlm.nih.gov/pubmed/21505328 "Several studies have shown an association between acetaminophen use during pregnancy and allergic diseases in the offspring. Furthermore, this association has also been found between early exposure and recent exposure to the drug and several allergic conditions. However, other studies did not confirm those associations."
Extensively quoting from what appears to be the single review of this area that unambiguously concludes a causative relationship is undue weight. Furhtermore, offering treatment guidance to avoid the use of acetominophen goes well outside published treatment guidelines and regulatory actions. NPOV requires that space alloted to different opinions should reflect their acceptance among experts. The modified language of this section does not do that. Formerly 98 ( talk) 05:03, 20 February 2014 (UTC)
Nowhere in my edit was it claimed epidemiological associations prove causation. Indicated epidemiological association between paracetamol use and asthma well established. Detailed factors which firmly establish epidemiological association. Cited multiple references to peer reviewed medical journals supporting strong epidemiological association between paracetamol use and asthma. Epidemiological evidence invaluable and used to establish link between cigarette smoking and lung cancer. Added link to Epidemiology wiki page. Additionally, I left in your edit regarding possible debate word for word. Please stop deleting my accurate and properly referenced content. — Preceding
unsigned comment added by
BoboMeowCat (
talk •
contribs)
11:01, 20 February 2014 (UTC)
I have compromised and cooperated fully. Edits regarding possible debate and possible confounding by indication were left in place word for word. Additionally, I’ve added a statement which explicitly indicates epidemiological associations do not prove causation. I had already linked to Epidemiology Wiki page for clarity. Despite this, my accurate and properly sourced information regarding strong epidemiological link to asthma has been repeatedly deleted. Because of this repeated occurrence, I’ve become concerned that “compromise” is being misused to mean censorship of accurate and properly referenced information regarding paracetamol’s well established epidemiological link to asthma.
My text was never copied and pasted, as words were changed. Wording has now been extensively changed to remove any remote hint of copyright violation. I’m going to ask again that this accurate and properly referenced information not be deleted, as repeatedly doing so suggests censorship of accurate information regarding epidemiological link to asthma and possible conflict of interest editing. –BoboMeowCat
I'd like to ask that you please stop pretending I'm asserting causality rather than sharing accurate information regarding a very well established epidemiological association between paracetamol and asthma (which I followed with a detailed explanation of what makes this association so well established). I cited many sources to support. Also, please note explicit statement in my edit which indicates epidemiological associations do not prove causation. At this point, I'm fully expecting JMH649 will support you, as you summoned him in the first place, and his edits were extremely similar to your edits. I'm concerned that there appears to be an effort to censor accurate and properly referenced information, suggesting conflict of interest editing. If it is felt that information from any of your above mentioned sources is relevant, I'd like to ask you to please add that information as a separate edit, and refrain from again deleting accurate and properly referenced content. -- BoboMeowCat ( talk) 23:04, 21 February 2014 (UTC)
Formelly 98 and Doc James, I’d like you to ask yourselves why you (or anyone for that matter) would want to censor accurate information regarding paracetamol’s very strong, repeatedly demonstrated, epidemiological link to asthma? If accurate and properly referenced information (from 5 credible sources, 2 of which were reviews of many studies) makes people think, “wow, this very well may be a concern”, then it seems that accurate information should not be censored by Wikipedia. I have browsed multiple medication pages on Wikipedia and browsed multiple edits. It appears that conflict of interest edits, on medication pages in particular, are common on Wikipedia. Such edits repeatedly downplay potential health concerns of medications. These edits appear to be made, in large part, by individuals with known or likely ties to the pharmaceutical industry.
Please add any properly referenced additional information and/or properly referenced rebuttals, as a separate edit. Again, please refrain from deleting accurate and properly referenced content, because censorship of this accurate information regarding paracetamol's well established epidemiological link to asthma seems to undermine the credibility and utility of Wikipedia. -- BoboMeowCat ( talk) 02:56, 22 February 2014 (UTC)
Bob we are to write in easy to understandable text. What you have added is much less understandable than what was there before. We all agree that there is an association. Is there proven causation? No and we should all be able to agree on that. That requires an RCT. One has not yet been done. Thus the association is tentative as it could be due to confounders. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 04:25, 22 February 2014 (UTC)
Jmh649, only including information which suggests link not valid, while disallowing information which strongly suggests link valid, does not reflect neutrality. It is not balanced. The references to 11 primary and secondary sources included to illustrate that my edit does not represent "undue weight" material and my edit not based on "isolated studies". Regardless, accurate and extensively well referenced content again deleted, and I've been threatened with banning, if I were to restore this content. Please note, I've left in place your edits regarding possible doubt word for word. I have never deleted any of your or Formely 98's content. It is becoming clear that only information regarding doubt of association well be maintained, while all evidence suggesting link valid will be deleted. -- BoboMeowCat ( talk) 18:18, 23 February 2014 (UTC)
Hey User:BoboMeowCat. It appears that this is how you wish the section to appear. One of things we pay mind to is WP:WEIGHT. Can you please justify giving this section, which concerns an association and not an actual risk, equal weight with the liver toxicity section, which is an actual risk? The kind of argument that would be compelling, would be bringing a recent review article on overall acetaminophen toxicity that gives this association as much or more weight as liver toxicity. Thanks. Jytdog ( talk) 00:30, 24 February 2014 (UTC)
This sentence is a little long "As of 2014, because there is insufficient data to determine if paracetamol use by pregnant women and young children causes asthma, [1] and there are different approaches to risk management, expert opinion is divided as to whether paracetamol should continue to be administered to pregnant women and children as it has in the past, [2] [3] whether paracetamol administration should be limited to cases where there is no good substitute, such as in infants younger than 3 months, [4] or if its use should be avoided until its safety is proven. [5]" Could use some simplification. The AAP deems acetaminophen to be appropriate to use to help with confort in children. [3]. The community is not exactly divided. Those recommending acetaminophen not be used are definitely the smaller group. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 02:03, 24 February 2014 (UTC)
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- dug up the most recent EMA statement, which I got off the UK NHS press release reacting to recent data, which I also linked to. Jytdog ( talk) 07:18, 24 February 2014 (UTC)
Expert commentary
Too liberal use of acetaminophen in childhood should no longer be recommended. There is a good deal of evidence suggesting that acetaminophen exposure is associated to the development of wheezing disorders and may increase its clinical manifestations in those children who already suffer them. Although the possibility still exists that acetaminophen is actually an innocent bystander, limiting its use to clinical situations in which no other alternatives remain offers practicing pediatricians a great opportunity to decrease wheezing incidence and morbidity in childhood with this simple and low-cost measure. Meanwhile, regulatory agencies should do their part and seriously reconsider the safety profile of acetaminophen and promote new and more definitive clinical trials evaluating this limiting intervention.
Five-year view
Most probably, the use of acetaminophen is going to decrease in the next few years from today's liberal use to a more limited one, but only when no other alternatives exist. Absolute banning does not seem possible or even adequate in the near future due to the lack of alternatives in some situations (newborns and infants below three months of age, intravenous use and ibuprofen contraindications such as ibuprofen intolerance and ibuprofen-associated serious gastrointestinal adverse events). This sharp decrease in population exposure to acetaminophen is likely to produce a measurable decrease in wheezing disorders prevalence and morbidity in childhood. "
Nice work. Not to make light of a serious issue, but a very humorous take on correlation and causation here. Perhaps this image could be incorporated on the Monsanto page. http://www.pd.infn.it/~dorigo/autism_organic_foods.jpg Formerly 98 ( talk) 13:22, 24 February 2014 (UTC)
To test the hypothesis that acetaminophen exposure increases wheezing disorders severity or morbidity in asthmatic children, and its corollary, that avoiding acetaminophen exposure in asthmatic children would improve asthma control and morbidity, a more attainable clinical trial design would be needed, recruiting asthmatic children (several substudies with different age limits) to be randomized to one of two arms: intervention versus no intervention (open-labeled) or acetaminophen versus ibuprofen (double-blind design). Again, a placebo arm, contrary to common claims, would be impractical and unethical. Primary outcome could be one of the many already used: days free of symptoms, symptoms scores, drug consumption scores, asthma exacerbations or asthma-related quality of life, and the duration necessary to obtain enough statistical power would be in the range of months, not years.
In fact, such a clinical trial already exists [15] . It was performed in the early 1990s but published in the early 2000s, when the hypothesis of the detrimental effect of acetaminophen in asthma had already been launched. Being the only clinical trial ever performed on the subject, it deserves careful reading and a detailed description. From 2 February 1991 to 12 June 1993, 84,192 children between 6 months and 12 years of age with a febrile illness were recruited and randomly assigned to receive suspensions of either acetaminophen (12 mg/kg) or ibuprofen (5 or 10 mg/kg) to test the safety profile of ibuprofen. A subgroup analysis of those children being treated for asthma, defined as those who had received a [beta]-agonist, theophylline (remember, we were in the early 1990) or an inhaled steroid on the day before enrollment, identified an outstanding number of 1879 children, 632 randomized to acetaminophen, 636 to ibuprofen low-dose and 611 to ibuprofen high-dose. Primary outcomes were a report of hospitalization or outpatient visit for asthma in the month after enrollment. The number of hospitalizations was too low to reach significance (eight, four and six in the acetaminophen, low-dose ibuprofen and high-dose ibuprofen groups, respectively), but the number of outpatient visits for asthma was higher in the acetaminophen group compared with both ibuprofen groups (5.0 vs 2.9%). The authors reported this difference computing an adjusted relative risk estimate using the Mantel-Haenszel procedure; adjusting for age, gender and race and considering the acetaminophen group as the reference category: this estimate was 0.56 (0.34-0.95) for ibuprofen. This estimate did not vary when multiple stratifications where performed and did not differ between both ibuprofen doses. It should be taken into account that this clinical trial was originally designed to test the hypothesis that among children with asthma and without a history of aspirin sensitivity, ibuprofen suspension for fever-control increased the risk of acute bronchospasm and other morbidities from asthma. However, they found exactly the contrary. In their paper, the authors did not mention the reason for the 11 years elapsed between the end of the clinical trial and its publication. The possibility exists that their results were so unexpected and so contrary to common beliefs at the time that they only decided to publish them when the whole acetaminophen detrimental effect of wheezing disorders hypothesis begun to arise. Even to date, this large and well-designed clinical trial is not receiving due attention and some authors continue to explain their results as a beneficial effect of ibuprofen instead of a detrimental effect of acetaminophen. As practicing pediatricians, this discussion is absolutely irrelevant: avoiding acetaminophen is absolutely equivalent to using ibuprofen, because no other alternative exists.
One of our key roles here on Wikipedia is to take complicated verbiage and get to the point.
This "A 1998 paper hypothesized that giving young children paracetamol may cause asthma later in life and while subsequent epidemiological studies have found a correlation between paracetamol use by young children and pregnant women and asthma, as of February 2014 it remained unclear if paracetamol actually has a role in causing asthma."
really means
"There is an association between paracetamol use and asthma but it is unclear if it has a role in causing asthma."
with the latter being much more clear and to the point. Thus restored. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 18:10, 24 February 2014 (UTC)
User:BoboMeowCat. The causal link is not proven; not a single source that you bring above says that it is. It is also a fact, as the article states, that the mainstream view has not yet shifted to changing acetaminophen administration to kids based on a concern about this. This is how wikipedia works; we give the WP:WEIGHT to the mainstream, consensus view, which we identify through the statements of major medical bodies, as we have done here. We represent, but give less weight to, minority views, which we have also done here. Wikipedia is not here to WP:RIGHTGREATWRONGS - we give the weight to the mainstream, consensus views. If you want to advocate for changing the mainstream view, Wikipedia is not the place to do it. Please read WP:ADVOCACY. When a mainstream medical body changes its recommendation based on a concern about asthma, we can revisit this. If you know of any that have done so, please bring a source for that. Until you do, the article is going as far as it can. I am giving you a heads up here now - I and others have explained, based on Wikipedia guidelines and policies, ( WP:MEDRS and WP:WEIGHT) how the content you are interested in is handled at Wikipedia. Further, no one is supporting your position that the mainstream says that acetaminophen causes asthma nor a position that the minority view deserves more weight. Please read WP:IDHT - you are getting pretty close to falling squarely within that. I for one am going to stop responding to you pretty soon, until you bring the kind of sources we need to go further. You are new here, so I am trying to warn you very clearly. If you continue to try to actually edit the article to increase the weight given to this issue, without bringing the kind of source needed to give it more weight, I'll bring you to the WP:NPOVN board, and you will get blocked again or perhaps even topic banned. I hope you do not go in that direction, but based on your behavior thus far (blocked for editing warring, then bringing a groundless COIN case, and coming back here and repeating yourself) my guess is that you are are not going to listen. I hope you do listen. best regards Jytdog ( talk) 18:06, 25 February 2014 (UTC)
I can live with the wording of the most recent revision by BoboMeowCat. If he is satisfied, we may be close to consensus. Formerly 98 ( talk) 20:37, 25 February 2014 (UTC)
Have added that "The majority of the evidence does not; however, support a causal role." for acetaminophen based on "The weight of evidence of the collected studies in our review strongly suggests that the association of antibiotics with childhood asthma reflects various forms of bias, the most prominent of which is confounding by indication. Recent studies and meta-analyses support the same conclusion for paracetamol. " [4] Doc James ( talk · contribs · email) (if I write on your page reply on mine) 14:32, 18 May 2014 (UTC)
Well, I added a brief entry under "Adverse Effects" with a reference. I'm not convinced it's a necessarily adverse effect, but certainly interesting :-) I used the new in-place editor to add the reference; not sure how to add multiple authors; shall amend presently with the markup editor. Jon ( talk) 10:33, 14 April 2015 (UTC)
Two recent studies indicate problems in hyperactivity [1] and neural development [2] of children.
References
This looks like a good source:
Should you take Tylenol, Advil, or aspirin for pain? Here's what the evidence says. (vox.com)
-- Distelfinck ( talk) 22:17, 18 August 2015 (UTC)
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I am not a big fan of this bland statement as this is true for half the stuff in Wikipedia. Therefore have removed "however, further studies are needed to evaluate the validity of concerns regarding the neurological development of the offspring" Doc James ( talk · contribs · email) 09:32, 12 July 2016 (UTC)
User:Abductive your changes here and here and here are adding WP:UNDUE weight to the risks of this drug, and the content you added about "physicians have not internalized these results and continue to recommend" is unsupported editorializing. If you add this back one more time you will violate 3RR and can be blocked. Jytdog ( talk) 18:16, 16 August 2016 (UTC)
Paracetamol is generally accepted as safe during pregnancy as supported by the references provided. One of the articles does not appear to be pubmed indexed [7]? Doc James ( talk · contribs · email) 19:17, 16 August 2016 (UTC)
FYI this has appeared in the uk press today. - Roxy the dog™ bark 21:29, 16 August 2016 (UTC)
A very large study suggesting that Acetaminophen or Paracetamol use doing pregnancy may be responsible for ADHD and other disorders in childrem
http://www.ncbi.nlm.nih.gov/pubmed/24566677Cite error: There are <ref>
tags on this page without content in them (see the
help page).
This should be part of the discussion on this drug. 2602:306:BCED:1070:6809:6C22:4C3:FD07 ( talk) 17:41, 22 August 2016 (UTC)
The result of the move request was: Not moved per WP:SNOW. ( non-admin closure) Zarcadia ( talk) 20:50, 16 November 2016 (UTC)
Paracetamol →
Para-acetylaminophenol –
WP:COMMONALITY ; this should not favour either British English (paracetamol) or North American English (acetaminophen), instead it should use the origin term that paracetamol (para-acetylaminophenol) and acetaminophen (para-acetylaminophenol) and Tylenol (para-acetylaminophenol) are abbreviations of, namely "
para-acetylaminophenol" --
65.94.171.217 (
talk)
04:30, 16 November 2016 (UTC)
*'''Support'''
or *'''Oppose'''
, then sign your comment with ~~~~
. Since
polling is not a substitute for discussion, please explain your reasons, taking into account
Wikipedia's policy on article titles.What is the INN of paracetamol? - DePiep ( talk) 21:57, 25 November 2016 (UTC)
User:Jtamad why are you adding a blog source to a medical section? Jytdog ( talk) 03:57, 19 August 2017 (UTC)
References
There is a blanket statement at the start of this article which seems to be entirely out of place and largely false.
"There is poor evidence for fever relief in children."
This links to a meta-study that is 15 years old, that contains a very small sample size.
Even as somebody who is not medical, this statement seems absurd, given that many people have success with paracetamol for fever relief in children. Even my local world renowned children's hospital (Royal Children's Hospital in Melbourne, Australia) have guidelines written in 2013 that recommend the use of paracetamol for fever relief.
http://www.rch.org.au/kidsinfo/fact_sheets/Pain_relief_for_children_-_Paracetamol_and_Ibuprofen/
I would think it prudent to just remove this sentence altogether, as it is totally out of place and at odds with common sense. — Preceding unsigned comment added by Jessejackson100 ( talk • contribs) 02:49, 27 May 2017 (UTC)
Jessejackson100 ( talk) 02:56, 27 May 2017 (UTC) JJ
The article seems very weak on evidence that paracetamol really has any pain-relieving effect at all. Largely the article just seems to take it for granted that it does actually work, with the exception of a couple of special applications where efficacy is questioned. For me the effect of paracetamol on any type of pain (that I have tested) is zero to undetectable. I know that I am not unique in this respect. 86.191.44.105 ( talk) 04:31, 2 February 2017 (UTC)
![]() | This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 | Archive 3 | Archive 4 | Archive 5 |
Please stop your
disruptive editing. If you continue to
vandalize Wikipedia, as you did at
Paracetamol, you may be
blocked from editing. --
CFCF
🍌 (
email)
04:10, 27 July 2015 (UTC)
There certainly seems to be an epidemiological association here, but I don't think consensus view is favors causation to the extent of the language that was added.
Here are the papers I found:
1) http://www.ncbi.nlm.nih.gov/pubmed/20933592: " At present, the evidence is inconclusive that any such association is causal."
2) http://www.ncbi.nlm.nih.gov/pubmed/23547988 " Is acetaminophen a real asthma promoter or an innocent bystander?"
3) http://www.ncbi.nlm.nih.gov/pubmed/23347656 "However, the epidemiological evidence is now compelling and there is a clear need to establish causation so that appropriate advice and interventions can be developed for children at risk of asthma. This requires randomised trials"
4) http://www.ncbi.nlm.nih.gov/pubmed/23292157 "Truly indicated antibiotics should not be withheld from infants or young children for fears they might develop asthma. Likewise, there is no sound reason to replace paracetamol as the preferred pain relief and fever medication in this age group."
5) http://www.ncbi.nlm.nih.gov/pubmed/23253685: "Causality cannot be established from observational studies because of the arguable presence of many confounding factors and biases. Randomised trials are needed to disclose the nature of the association"
6) http://www.ncbi.nlm.nih.gov/pubmed/21505328 "Several studies have shown an association between acetaminophen use during pregnancy and allergic diseases in the offspring. Furthermore, this association has also been found between early exposure and recent exposure to the drug and several allergic conditions. However, other studies did not confirm those associations."
Extensively quoting from what appears to be the single review of this area that unambiguously concludes a causative relationship is undue weight. Furhtermore, offering treatment guidance to avoid the use of acetominophen goes well outside published treatment guidelines and regulatory actions. NPOV requires that space alloted to different opinions should reflect their acceptance among experts. The modified language of this section does not do that. Formerly 98 ( talk) 05:03, 20 February 2014 (UTC)
Nowhere in my edit was it claimed epidemiological associations prove causation. Indicated epidemiological association between paracetamol use and asthma well established. Detailed factors which firmly establish epidemiological association. Cited multiple references to peer reviewed medical journals supporting strong epidemiological association between paracetamol use and asthma. Epidemiological evidence invaluable and used to establish link between cigarette smoking and lung cancer. Added link to Epidemiology wiki page. Additionally, I left in your edit regarding possible debate word for word. Please stop deleting my accurate and properly referenced content. — Preceding
unsigned comment added by
BoboMeowCat (
talk •
contribs)
11:01, 20 February 2014 (UTC)
I have compromised and cooperated fully. Edits regarding possible debate and possible confounding by indication were left in place word for word. Additionally, I’ve added a statement which explicitly indicates epidemiological associations do not prove causation. I had already linked to Epidemiology Wiki page for clarity. Despite this, my accurate and properly sourced information regarding strong epidemiological link to asthma has been repeatedly deleted. Because of this repeated occurrence, I’ve become concerned that “compromise” is being misused to mean censorship of accurate and properly referenced information regarding paracetamol’s well established epidemiological link to asthma.
My text was never copied and pasted, as words were changed. Wording has now been extensively changed to remove any remote hint of copyright violation. I’m going to ask again that this accurate and properly referenced information not be deleted, as repeatedly doing so suggests censorship of accurate information regarding epidemiological link to asthma and possible conflict of interest editing. –BoboMeowCat
I'd like to ask that you please stop pretending I'm asserting causality rather than sharing accurate information regarding a very well established epidemiological association between paracetamol and asthma (which I followed with a detailed explanation of what makes this association so well established). I cited many sources to support. Also, please note explicit statement in my edit which indicates epidemiological associations do not prove causation. At this point, I'm fully expecting JMH649 will support you, as you summoned him in the first place, and his edits were extremely similar to your edits. I'm concerned that there appears to be an effort to censor accurate and properly referenced information, suggesting conflict of interest editing. If it is felt that information from any of your above mentioned sources is relevant, I'd like to ask you to please add that information as a separate edit, and refrain from again deleting accurate and properly referenced content. -- BoboMeowCat ( talk) 23:04, 21 February 2014 (UTC)
Formelly 98 and Doc James, I’d like you to ask yourselves why you (or anyone for that matter) would want to censor accurate information regarding paracetamol’s very strong, repeatedly demonstrated, epidemiological link to asthma? If accurate and properly referenced information (from 5 credible sources, 2 of which were reviews of many studies) makes people think, “wow, this very well may be a concern”, then it seems that accurate information should not be censored by Wikipedia. I have browsed multiple medication pages on Wikipedia and browsed multiple edits. It appears that conflict of interest edits, on medication pages in particular, are common on Wikipedia. Such edits repeatedly downplay potential health concerns of medications. These edits appear to be made, in large part, by individuals with known or likely ties to the pharmaceutical industry.
Please add any properly referenced additional information and/or properly referenced rebuttals, as a separate edit. Again, please refrain from deleting accurate and properly referenced content, because censorship of this accurate information regarding paracetamol's well established epidemiological link to asthma seems to undermine the credibility and utility of Wikipedia. -- BoboMeowCat ( talk) 02:56, 22 February 2014 (UTC)
Bob we are to write in easy to understandable text. What you have added is much less understandable than what was there before. We all agree that there is an association. Is there proven causation? No and we should all be able to agree on that. That requires an RCT. One has not yet been done. Thus the association is tentative as it could be due to confounders. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 04:25, 22 February 2014 (UTC)
Jmh649, only including information which suggests link not valid, while disallowing information which strongly suggests link valid, does not reflect neutrality. It is not balanced. The references to 11 primary and secondary sources included to illustrate that my edit does not represent "undue weight" material and my edit not based on "isolated studies". Regardless, accurate and extensively well referenced content again deleted, and I've been threatened with banning, if I were to restore this content. Please note, I've left in place your edits regarding possible doubt word for word. I have never deleted any of your or Formely 98's content. It is becoming clear that only information regarding doubt of association well be maintained, while all evidence suggesting link valid will be deleted. -- BoboMeowCat ( talk) 18:18, 23 February 2014 (UTC)
Hey User:BoboMeowCat. It appears that this is how you wish the section to appear. One of things we pay mind to is WP:WEIGHT. Can you please justify giving this section, which concerns an association and not an actual risk, equal weight with the liver toxicity section, which is an actual risk? The kind of argument that would be compelling, would be bringing a recent review article on overall acetaminophen toxicity that gives this association as much or more weight as liver toxicity. Thanks. Jytdog ( talk) 00:30, 24 February 2014 (UTC)
This sentence is a little long "As of 2014, because there is insufficient data to determine if paracetamol use by pregnant women and young children causes asthma, [1] and there are different approaches to risk management, expert opinion is divided as to whether paracetamol should continue to be administered to pregnant women and children as it has in the past, [2] [3] whether paracetamol administration should be limited to cases where there is no good substitute, such as in infants younger than 3 months, [4] or if its use should be avoided until its safety is proven. [5]" Could use some simplification. The AAP deems acetaminophen to be appropriate to use to help with confort in children. [3]. The community is not exactly divided. Those recommending acetaminophen not be used are definitely the smaller group. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 02:03, 24 February 2014 (UTC)
Henderson
was invoked but never defined (see the
help page).{{
cite journal}}
: Check date values in: |date=
(
help); Unknown parameter |coauthors=
ignored (|author=
suggested) (
help)
{{
cite journal}}
: Check date values in: |date=
(
help)
{{
cite journal}}
: Check date values in: |date=
(
help)
- dug up the most recent EMA statement, which I got off the UK NHS press release reacting to recent data, which I also linked to. Jytdog ( talk) 07:18, 24 February 2014 (UTC)
Expert commentary
Too liberal use of acetaminophen in childhood should no longer be recommended. There is a good deal of evidence suggesting that acetaminophen exposure is associated to the development of wheezing disorders and may increase its clinical manifestations in those children who already suffer them. Although the possibility still exists that acetaminophen is actually an innocent bystander, limiting its use to clinical situations in which no other alternatives remain offers practicing pediatricians a great opportunity to decrease wheezing incidence and morbidity in childhood with this simple and low-cost measure. Meanwhile, regulatory agencies should do their part and seriously reconsider the safety profile of acetaminophen and promote new and more definitive clinical trials evaluating this limiting intervention.
Five-year view
Most probably, the use of acetaminophen is going to decrease in the next few years from today's liberal use to a more limited one, but only when no other alternatives exist. Absolute banning does not seem possible or even adequate in the near future due to the lack of alternatives in some situations (newborns and infants below three months of age, intravenous use and ibuprofen contraindications such as ibuprofen intolerance and ibuprofen-associated serious gastrointestinal adverse events). This sharp decrease in population exposure to acetaminophen is likely to produce a measurable decrease in wheezing disorders prevalence and morbidity in childhood. "
Nice work. Not to make light of a serious issue, but a very humorous take on correlation and causation here. Perhaps this image could be incorporated on the Monsanto page. http://www.pd.infn.it/~dorigo/autism_organic_foods.jpg Formerly 98 ( talk) 13:22, 24 February 2014 (UTC)
To test the hypothesis that acetaminophen exposure increases wheezing disorders severity or morbidity in asthmatic children, and its corollary, that avoiding acetaminophen exposure in asthmatic children would improve asthma control and morbidity, a more attainable clinical trial design would be needed, recruiting asthmatic children (several substudies with different age limits) to be randomized to one of two arms: intervention versus no intervention (open-labeled) or acetaminophen versus ibuprofen (double-blind design). Again, a placebo arm, contrary to common claims, would be impractical and unethical. Primary outcome could be one of the many already used: days free of symptoms, symptoms scores, drug consumption scores, asthma exacerbations or asthma-related quality of life, and the duration necessary to obtain enough statistical power would be in the range of months, not years.
In fact, such a clinical trial already exists [15] . It was performed in the early 1990s but published in the early 2000s, when the hypothesis of the detrimental effect of acetaminophen in asthma had already been launched. Being the only clinical trial ever performed on the subject, it deserves careful reading and a detailed description. From 2 February 1991 to 12 June 1993, 84,192 children between 6 months and 12 years of age with a febrile illness were recruited and randomly assigned to receive suspensions of either acetaminophen (12 mg/kg) or ibuprofen (5 or 10 mg/kg) to test the safety profile of ibuprofen. A subgroup analysis of those children being treated for asthma, defined as those who had received a [beta]-agonist, theophylline (remember, we were in the early 1990) or an inhaled steroid on the day before enrollment, identified an outstanding number of 1879 children, 632 randomized to acetaminophen, 636 to ibuprofen low-dose and 611 to ibuprofen high-dose. Primary outcomes were a report of hospitalization or outpatient visit for asthma in the month after enrollment. The number of hospitalizations was too low to reach significance (eight, four and six in the acetaminophen, low-dose ibuprofen and high-dose ibuprofen groups, respectively), but the number of outpatient visits for asthma was higher in the acetaminophen group compared with both ibuprofen groups (5.0 vs 2.9%). The authors reported this difference computing an adjusted relative risk estimate using the Mantel-Haenszel procedure; adjusting for age, gender and race and considering the acetaminophen group as the reference category: this estimate was 0.56 (0.34-0.95) for ibuprofen. This estimate did not vary when multiple stratifications where performed and did not differ between both ibuprofen doses. It should be taken into account that this clinical trial was originally designed to test the hypothesis that among children with asthma and without a history of aspirin sensitivity, ibuprofen suspension for fever-control increased the risk of acute bronchospasm and other morbidities from asthma. However, they found exactly the contrary. In their paper, the authors did not mention the reason for the 11 years elapsed between the end of the clinical trial and its publication. The possibility exists that their results were so unexpected and so contrary to common beliefs at the time that they only decided to publish them when the whole acetaminophen detrimental effect of wheezing disorders hypothesis begun to arise. Even to date, this large and well-designed clinical trial is not receiving due attention and some authors continue to explain their results as a beneficial effect of ibuprofen instead of a detrimental effect of acetaminophen. As practicing pediatricians, this discussion is absolutely irrelevant: avoiding acetaminophen is absolutely equivalent to using ibuprofen, because no other alternative exists.
One of our key roles here on Wikipedia is to take complicated verbiage and get to the point.
This "A 1998 paper hypothesized that giving young children paracetamol may cause asthma later in life and while subsequent epidemiological studies have found a correlation between paracetamol use by young children and pregnant women and asthma, as of February 2014 it remained unclear if paracetamol actually has a role in causing asthma."
really means
"There is an association between paracetamol use and asthma but it is unclear if it has a role in causing asthma."
with the latter being much more clear and to the point. Thus restored. Doc James ( talk · contribs · email) (if I write on your page reply on mine) 18:10, 24 February 2014 (UTC)
User:BoboMeowCat. The causal link is not proven; not a single source that you bring above says that it is. It is also a fact, as the article states, that the mainstream view has not yet shifted to changing acetaminophen administration to kids based on a concern about this. This is how wikipedia works; we give the WP:WEIGHT to the mainstream, consensus view, which we identify through the statements of major medical bodies, as we have done here. We represent, but give less weight to, minority views, which we have also done here. Wikipedia is not here to WP:RIGHTGREATWRONGS - we give the weight to the mainstream, consensus views. If you want to advocate for changing the mainstream view, Wikipedia is not the place to do it. Please read WP:ADVOCACY. When a mainstream medical body changes its recommendation based on a concern about asthma, we can revisit this. If you know of any that have done so, please bring a source for that. Until you do, the article is going as far as it can. I am giving you a heads up here now - I and others have explained, based on Wikipedia guidelines and policies, ( WP:MEDRS and WP:WEIGHT) how the content you are interested in is handled at Wikipedia. Further, no one is supporting your position that the mainstream says that acetaminophen causes asthma nor a position that the minority view deserves more weight. Please read WP:IDHT - you are getting pretty close to falling squarely within that. I for one am going to stop responding to you pretty soon, until you bring the kind of sources we need to go further. You are new here, so I am trying to warn you very clearly. If you continue to try to actually edit the article to increase the weight given to this issue, without bringing the kind of source needed to give it more weight, I'll bring you to the WP:NPOVN board, and you will get blocked again or perhaps even topic banned. I hope you do not go in that direction, but based on your behavior thus far (blocked for editing warring, then bringing a groundless COIN case, and coming back here and repeating yourself) my guess is that you are are not going to listen. I hope you do listen. best regards Jytdog ( talk) 18:06, 25 February 2014 (UTC)
I can live with the wording of the most recent revision by BoboMeowCat. If he is satisfied, we may be close to consensus. Formerly 98 ( talk) 20:37, 25 February 2014 (UTC)
Have added that "The majority of the evidence does not; however, support a causal role." for acetaminophen based on "The weight of evidence of the collected studies in our review strongly suggests that the association of antibiotics with childhood asthma reflects various forms of bias, the most prominent of which is confounding by indication. Recent studies and meta-analyses support the same conclusion for paracetamol. " [4] Doc James ( talk · contribs · email) (if I write on your page reply on mine) 14:32, 18 May 2014 (UTC)
Well, I added a brief entry under "Adverse Effects" with a reference. I'm not convinced it's a necessarily adverse effect, but certainly interesting :-) I used the new in-place editor to add the reference; not sure how to add multiple authors; shall amend presently with the markup editor. Jon ( talk) 10:33, 14 April 2015 (UTC)
Two recent studies indicate problems in hyperactivity [1] and neural development [2] of children.
References
This looks like a good source:
Should you take Tylenol, Advil, or aspirin for pain? Here's what the evidence says. (vox.com)
-- Distelfinck ( talk) 22:17, 18 August 2015 (UTC)
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I am not a big fan of this bland statement as this is true for half the stuff in Wikipedia. Therefore have removed "however, further studies are needed to evaluate the validity of concerns regarding the neurological development of the offspring" Doc James ( talk · contribs · email) 09:32, 12 July 2016 (UTC)
User:Abductive your changes here and here and here are adding WP:UNDUE weight to the risks of this drug, and the content you added about "physicians have not internalized these results and continue to recommend" is unsupported editorializing. If you add this back one more time you will violate 3RR and can be blocked. Jytdog ( talk) 18:16, 16 August 2016 (UTC)
Paracetamol is generally accepted as safe during pregnancy as supported by the references provided. One of the articles does not appear to be pubmed indexed [7]? Doc James ( talk · contribs · email) 19:17, 16 August 2016 (UTC)
FYI this has appeared in the uk press today. - Roxy the dog™ bark 21:29, 16 August 2016 (UTC)
A very large study suggesting that Acetaminophen or Paracetamol use doing pregnancy may be responsible for ADHD and other disorders in childrem
http://www.ncbi.nlm.nih.gov/pubmed/24566677Cite error: There are <ref>
tags on this page without content in them (see the
help page).
This should be part of the discussion on this drug. 2602:306:BCED:1070:6809:6C22:4C3:FD07 ( talk) 17:41, 22 August 2016 (UTC)
The result of the move request was: Not moved per WP:SNOW. ( non-admin closure) Zarcadia ( talk) 20:50, 16 November 2016 (UTC)
Paracetamol →
Para-acetylaminophenol –
WP:COMMONALITY ; this should not favour either British English (paracetamol) or North American English (acetaminophen), instead it should use the origin term that paracetamol (para-acetylaminophenol) and acetaminophen (para-acetylaminophenol) and Tylenol (para-acetylaminophenol) are abbreviations of, namely "
para-acetylaminophenol" --
65.94.171.217 (
talk)
04:30, 16 November 2016 (UTC)
*'''Support'''
or *'''Oppose'''
, then sign your comment with ~~~~
. Since
polling is not a substitute for discussion, please explain your reasons, taking into account
Wikipedia's policy on article titles.What is the INN of paracetamol? - DePiep ( talk) 21:57, 25 November 2016 (UTC)
User:Jtamad why are you adding a blog source to a medical section? Jytdog ( talk) 03:57, 19 August 2017 (UTC)
References
There is a blanket statement at the start of this article which seems to be entirely out of place and largely false.
"There is poor evidence for fever relief in children."
This links to a meta-study that is 15 years old, that contains a very small sample size.
Even as somebody who is not medical, this statement seems absurd, given that many people have success with paracetamol for fever relief in children. Even my local world renowned children's hospital (Royal Children's Hospital in Melbourne, Australia) have guidelines written in 2013 that recommend the use of paracetamol for fever relief.
http://www.rch.org.au/kidsinfo/fact_sheets/Pain_relief_for_children_-_Paracetamol_and_Ibuprofen/
I would think it prudent to just remove this sentence altogether, as it is totally out of place and at odds with common sense. — Preceding unsigned comment added by Jessejackson100 ( talk • contribs) 02:49, 27 May 2017 (UTC)
Jessejackson100 ( talk) 02:56, 27 May 2017 (UTC) JJ
The article seems very weak on evidence that paracetamol really has any pain-relieving effect at all. Largely the article just seems to take it for granted that it does actually work, with the exception of a couple of special applications where efficacy is questioned. For me the effect of paracetamol on any type of pain (that I have tested) is zero to undetectable. I know that I am not unique in this respect. 86.191.44.105 ( talk) 04:31, 2 February 2017 (UTC)