Archives of disease in childhood
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Randomized Controlled Trial
Analgesic effect of watching TV during venipuncture.
To assess the analgesic effect of passive or active distraction during venipuncture in children. ⋯ TV watching was more effective than active distraction. This was due either to the emotional participation of the mothers in the active procedure or to the distracting power of television.
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Comment Letter Comparative Study
Chest x ray and high-resolution computed tomography in cystic fibrosis.
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Multicenter Study
Derivation of the children's head injury algorithm for the prediction of important clinical events decision rule for head injury in children.
A quarter of all patients presenting to emergency departments are children. Although there are several large, well-conducted studies on adults enabling accurate selection of patients with head injury at high risk for computed tomography scanning, no such study has derived a rule for children. ⋯ A highly sensitive clinical decision rule is derived for the identification of children who should undergo computed tomography scanning after head injury. This rule has the potential to improve and standardise the care of children presenting with head injuries. Validation of this rule in new cohorts of patients should now be undertaken.
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Review Meta Analysis
Hypotonic versus isotonic saline in hospitalised children: a systematic review.
The traditional recommendations which suggest that hypotonic intravenous (i.v.) maintenance fluids are the solutions of choice in paediatric patients have not been rigorously tested in clinical trials, and may not be appropriate for all children. ⋯ The current practice of prescribing i.v. maintenance fluids in children is based on limited clinical experimental evidence from poorly and differently designed studies, where bias could possibly raise doubt about the results. They do not provide evidence for optimal fluid and electrolyte homoeostasis in hospitalised children. This systematic review indicates potential harm with hypotonic solutions in children, which can be anticipated and avoided with isotonic solutions. No single fluid rate or composition is ideal for all children. However, isotonic or near-isotonic solutions may be more physiological, and therefore a safer choice in the acute phase of illness and perioperative period.