Pediatrics
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Randomized Controlled Trial Comparative Study
Estimating blood loss: comparative study of the accuracy of parents and health care professionals.
Hematemesis and hematochezia are not uncommon presenting complaints in children. The amount of blood loss reported by the parent is likely to influence the pediatrician's decision regarding investigations and management. Currently, there are only very limited data regarding the ability of laypersons to estimate blood losses visually. This study investigated the accuracy of parents, in comparison to pediatric health care professionals, in estimating blood loss volumes. ⋯ Visual estimation of blood losses is highly inaccurate, both by laypersons and by health care professionals. Physicians should, therefore, base management decisions primarily on clinical findings and not overly rely on the history provided, or their own estimates.
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Randomized Controlled Trial
Improvement of short- and long-term outcomes for very low birth weight infants: Edmonton NIDCAP trial.
Our objective was to determine the impact of Newborn Individualized Developmental Care and Assessment Program (NIDCAP)-based care on length of stay of very low birth weight (VLBW) infants. Secondary outcome measures were days of ventilation, incidence of chronic lung disease, and 18-month neurodevelopmental outcomes. ⋯ NIDCAP-based care for VLBW infants improved short- and long-term outcomes significantly.
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Randomized Controlled Trial
Preterm resuscitation with low oxygen causes less oxidative stress, inflammation, and chronic lung disease.
The goal was to reduce adverse pulmonary adverse outcomes, oxidative stress, and inflammation in neonates of 24 to 28 weeks of gestation initially resuscitated with fractions of inspired oxygen of 30% or 90%. ⋯ Resuscitation of preterm neonates with 30% oxygen causes less oxidative stress, inflammation, need for oxygen, and risk of bronchopulmonary dysplasia.
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Multicenter Study
Decision-making by adolescents and parents of children with cancer regarding health research participation.
Low rates of participation of adolescents and young adults (AYAs) in clinical oncology trials may contribute to poorer outcomes. Factors that influence the decision of AYAs to participate in health research and whether these factors are different from those that affect the participation of parents of children with cancer. ⋯ AYAs identified time commitment and having too much to think about as significant impediments to research participation. Addressing these barriers by minimizing time requirements and further supporting decision-making may improve informed consent and impact on enrollment in trials.
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Athletic field risks associated with blunt, nonpenetrating chest blows (commotio cordis) are receiving increasing attention, but the epidemiology of these events is incomplete. ⋯ Sudden deaths in competitive lacrosse participants are rare and no more common than in most other sports. These catastrophic events were caused disproportionately by commotio cordis and included athletes wearing chest barriers, thereby underscoring the importance of developing effective chest protection to create a safer athletic environment for our youth.