Initial treatment of an overdose involves resuscitation measures such as maintaining an adequate airway and adequate circulation followed by gastric decontamination by administering activated charcoal, which adsorbs the salicylate in the gastrointestinal tract. Stomach pumping is no longer routinely used in the treatment of poisonings, but is sometimes considered if the patient has ingested a potentially lethal amount less than one hour before presentation. Inducing vomiting with syrup of ipecac is not recommended. Repeated doses of activated charcoal have been proposed to be beneficial in cases of salicylate poisoning, especially in ingestion of enteric coated and extended release salicylic acid formulations which are able to remain in the gastrointestinal (GI) tract for longer periods of time. Repeated doses of activated charcoal are also useful to re-adsorb salicylates in the GI tract that may have desorbed from the previous administration of activated charcoal. The initial dose of activated charcoal is most useful if given within 2 hours of initial ingestion. Contraindications to the use of activated charcoal include altered mental status (due to the risk of aspiration), GI bleeding (often due to salicylates) or poor gastric motility. Whole bowel irrigation using the laxative polyethylene glycol can be useful to induce the gastrointestinal elimination of salicylates, particularly if there is partial or diminished response to activated charcoal.Alkalinization of the urine and plasma, by giving a bolus of sodium bicarbonate then adding sodium bicarbonate to maintenance fluids, is an effective method to increase the clearance of salicylates from the body.
Other truths being actively revealed include data suggesting that the pathogen itself (i.e., chlamydia) might play an equally important role, or perhaps even more important, than the host with disease susceptibility; asymptomatic chlamydial infections might be a common cause of reactive arthritis and the two variants of reactive arthritis might respond differently to treatment in spite of the congruent clinical presentation. However, much about this syndrome remains shrouded in mystery. Recent data has been suggesting that Chlamydia-induced reactive arthritis might be a common condition that clinicians are simply failing to recognise. Therefore, an emphasis is placed on disease awareness since viable treatment options are emerging. Treatment

Balanitis circinata is one out of multiple manifestations of the reactive arthritis.Right now, topical corticosteroid therapy is the most commonly used treatment, and topical calcineurin inhibitors have also been used successfully. Newer tests on patients showed that a less harmful off-label topical treatment with the immunomodulator pimecrolimus or the immunosuppressant tacrolimus can prevent all visible symptoms of this disease. Since reactive arthritis cannot be healed as such, affected people are forced to a continuous topical treatment – otherwise they will again note first symptoms after three to four days without it.However, strong debates and controversies continue regarding the exact indications of immunomodulators like pimecrolimus and their duration of use in the absence of active controlled trials. A study released in 2015 (tested were 7,457 children with a total of 26,792 person-years) did not find any evidence that pimecrolimus could cause cancer. == References ==