Arch Pediat Adol Med
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Arch Pediat Adol Med · Aug 1995
Pediatric asthma care in US emergency departments. Current practice in the context of the National Institutes of Health guidelines.
To determine whether US emergency department care for pediatric asthma conforms to the National Institutes of Health guidelines and whether the guidelines are likely to be adopted in clinical practice. ⋯ These data suggest that reported pediatric asthma care in US emergency departments differs substantially from the National Institutes of Health guidelines, with considerable variation by hospital type. The guidelines appear to provide an acceptable tool for emergency departments to use in assessing their pediatric asthma care. However, in light of the lack of evidence that the guidelines will improve outcomes, the impact of national guideline adoption remains unclear.
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Arch Pediat Adol Med · Aug 1995
Comparative StudyComparative neonatal morbidity of abdominal and vaginal deliveries after uncomplicated pregnancies.
To determine whether the risk of cesarean section following uncomplicated pregnancies has been reduced by current obstetric practices by comparing the neonatal risk of vaginal deliveries with the risk incurred following abdominal delivery in otherwise uncomplicated pregnancies. ⋯ Although reports have recently emerged suggesting otherwise, abdominal delivery following an uncomplicated pregnancy remains a risk factor for adverse neonatal outcome despite current obstetric practices.
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Arch Pediat Adol Med · Jul 1995
Mumps outbreak in a highly vaccinated school population. Evidence for large-scale vaccination failure.
To describe an outbreak and to identify risk factors for mumps occurring in a highly vaccinated high school population. (Note: Highly vaccinated means a population in which more than 95% have been vaccinated.) ⋯ The overall attack rate is the highest reported to date (and to our knowledge) for a population demonstrating virtually complete mumps vaccine coverage. Even verified documentation of vaccination may not be an accurate indicator of an individual's protection against mumps. Vaccination failure may play an important role in contemporary mumps outbreaks. We found no evidence to indicate that waning immunity (secondary vaccine failure) contributed significantly to this outbreak. A second dose of mumps vaccine, as recommended using measles-mumps-rubella vaccine, could potentially prevent similar outbreaks in secondary school populations in the future.
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Arch Pediat Adol Med · Jun 1995
Randomized Controlled Trial Comparative Study Clinical TrialThe clinical efficacy of nebulized racemic epinephrine and albuterol in acute bronchiolitis.
To investigate whether nebulized racemic epinephrine or albuterol improves respiratory distress in infants with acute bronchiolitis. ⋯ Elimination of hypoxia by supplemental oxygen and moistening of inspired air relieve the symptoms of acute bronchiolitis. Nebulized racemic epinephrine and albuterol are safe and useful in the treatment of acute bronchiolitis. Improvements in symptom scores at 15 minutes favor the use of racemic epinephrine. As the action of epinephrine is short, the effect can be increased by repeated inhalations.
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Arch Pediat Adol Med · Jun 1995
Randomized Controlled Trial Comparative Study Clinical TrialAntipyretic efficacy of ibuprofen and acetaminophen in children with febrile seizures.
To compare the antipyretic efficacy of ibuprofen syrup (5 mg/kg per dose) and acetaminophen syrup (10 mg/kg per dose) in children with a history of febrile seizures. ⋯ Ibuprofen and acetaminophen are effective antipyretic agents in children with a history of febrile seizures. Ibuprofen yielded significantly greater fever reduction than did acetaminophen 4 hours after the first dose. Research is needed on the value of antipyretic agents for the prevention of febrile seizure recurrence.