Pediatrics
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Randomized Controlled Trial Multicenter Study
Intranasal triamcinolone and growth velocity.
Inadequate designs and conflicting results from previous studies prompted the US Food and Drug Administration to publish guidelines for the design of clinical trials evaluating the effects of orally inhaled and intranasal corticosteroids on the growth of children. This study conformed to these guidelines to evaluate the effect of triamcinolone acetonide aqueous nasal spray (TAA-AQ) on the growth of children with perennial allergic rhinitis (PAR). ⋯ By using rigorous Food and Drug Administration-recommended design elements, this study detected a small, statistically significant effect of TAA-AQ on the GV of children with PAR.
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Randomized Controlled Trial Comparative Study
Benefits of strict rest after acute concussion: a randomized controlled trial.
To determine if recommending strict rest improved concussion recovery and outcome after discharge from the pediatric emergency department (ED). ⋯ Recommending strict rest for adolescents immediately after concussion offered no added benefit over the usual care. Adolescents' symptom reporting was influenced by recommending strict rest.
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Randomized Controlled Trial
Morphine or Ibuprofen for post-tonsillectomy analgesia: a randomized trial.
Pediatric sleep disordered breathing is often caused by hypertrophy of the tonsils and is commonly managed by tonsillectomy. There is controversy regarding which postsurgical analgesic agents are safe and efficacious. ⋯ Ibuprofen in combination with acetaminophen provides safe and effective analgesia in children undergoing tonsillectomy. Post-tonsillectomy morphine use should be limited, as it may be unsafe in certain children.
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Retrospective studies show that most parents prefer to share in decisions to forgo life-sustaining treatment (LST) from their children. We do not yet know how physicians and parents communicate about these decisions and to what extent parents share in the decision-making process. ⋯ We conclude that parents are able to handle a more active role than they are currently being given. Parents' greatest concern is that their child might suffer.