Archives of disease in childhood
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Two children with severe septic shock are reported. One had meningococcal septicaemia and the other Escherichia coli septicaemia. They remained hypotensive despite high concentrations of conventional inotropes and vasopressors. ⋯ To restore blood pressure, in both cases, an infusion of angiotensin II was used; there was significant improvement in clinical status, resulting in a rapid reduction in the concentration of inotropes required. Both patients successfully survived their septic episodes. Angiotensin II in cases of severe refractory septic hypotension in the paediatric population offers an extra therapeutic manoeuvre.
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Late onset ornithine transcarbamylase deficiency (McKusick 311250) is reported in four Finnish patients, two boys and two heterozygous girls. The subtle onset and course of ornithine transcarbamylase deficiency emphasises the need for plasma ammonia and amino acid measurements in clinical situations suggesting a disorder of this nature.
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Randomized Controlled Trial Clinical Trial
A comparison of local anaesthetics for venepuncture.
To compare the effectiveness of EMLA cream and Ametop gel in providing analgesia for venous cannulation. ⋯ Both anaesthetic agents produced adequate analgesia. However, Ametop gel was more effective, with a statistically significant difference in the pain scores of the two groups (p < 0.05).
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Reported wheeze is the cornerstone of asthma diagnosis. ⋯ Conceptual understandings of "wheeze" for parents of children with reported wheeze are different from epidemiology definitions. Parents' reports of acute wheeze and clinicians' findings also differ.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Randomised placebo controlled trial of nebulised corticosteroids in acute respiratory syncytial viral bronchiolitis.
To evaluate short and long term effects of giving nebulised budesonide early in respiratory syncytial viral (RSV) bronchiolitis. ⋯ There are no short or long term clinical benefits from the administration of nebulised corticosteroids in the acute phase of RSV bronchiolitis.