The Journal of pediatrics
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The Journal of pediatrics · May 2003
Initiation of home mechanical ventilation in children with neuromuscular diseases.
To determine how often home mechanical ventilation (HMV) is instituted electively in children with respiratory failure from neuromuscular diseases and whether there were opportunities to discuss therapeutic options with patients/families before respiratory failure. ⋯ Most patients with neuromuscular disease had HMV initiated nonelectively after acute respiratory failure caused by pneumonia. Opportunities for discussing the therapeutic options with patients and families before respiratory failure were missed or ineffective.
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The Journal of pediatrics · May 2003
Clinical TrialRelations between exhaled nitric oxide and measures of disease activity among children with mild-to-moderate asthma.
Exhaled nitric oxide (FE(NO)) was evaluated in children with asthma after 4 to 6 years of treatment with budesonide, nedocromil, or albuterol as needed. ⋯ Budesonide therapy was more effective than nedocromil in reducing FE(NO). Unfortunately, the effects of long-term budesonide were not sustained after its discontinuation. FE(NO) may be a complementary tool to current practice guidelines in assessing asthma control and medication response.
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The Journal of pediatrics · Apr 2003
Randomized Controlled Trial Clinical TrialMidazolam syrup as a premedication to reduce the discomfort associated with pediatric intravenous catheter insertion.
This randomized, double-blind, placebo-controlled study evaluated midazolam syrup for reducing discomfort from intravenous placement in children 9 months to 6 years. Parents and observers rated the child's discomfort by using visual analogue scales. Median parents' pain scores were significantly lower in the midazolam than the placebo group (P =.002). Midazolam effectively reduces discomfort associated with intravenous insertion.
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The Journal of pediatrics · Apr 2003
Comparative StudyRapid increase of morphine and benzodiazepine usage in the last three days of life in children with cancer is related to neuropathic pain.
To test the hypothesis that children with terminal cancer and neuropathic pain require rapid increases of opioids and benzodiazepines immediately before death, we compared drug usage in the last 72 hours of life in children with and without neuropathic pain. ⋯ Dying children with cancer and neuropathic pain have higher baseline requirements of morphine and benzodiazepines and require rapid increases of both drugs in the last 72 hours of life than dying children without neuropathic pain.