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Acute Disease Cochrane Pediatric Emergency Medicine Reviews

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Cochrane Systematic Review: Aloe vera for treating acute and chronic wounds

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Dat AD, Poon F, Pham KB, Doust J

OBJECTIVES: To determine the effects of Aloe vera-derived products (for example dressings and topical gels) on the healing of acute wounds (for example lacerations, surgical incisions and burns) and chronic wounds (for example infected wounds, arterial and venous ulcers).

Cochrane Systematic Review: Antibiotics for the common cold and acute purulent rhinitis

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Kenealy T, Arroll B

OBJECTIVES: To determine the efficacy of antibiotics compared with placebo for reducing general and specific nasopharyngeal symptoms of acute upper respiratory tract infections (URTIs) (common colds). To determine if antibiotics have any influence on the tcomes for acute purulent rhinitis and acute clear rhinitis lasting less than 10 days before the intervention. To determine whether there are significant adverse outcomes associated with antibiotic therapy for participants with a clinical diagnosis of acute URTI or acute purulent rhinitis.

Cochrane Systematic Review: Antibiotics for the prevention of acute and chronic suppurative otitis media in children

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Leach AJ, Morris PS

OBJECTIVES: To determine the effectiveness of long-term antibiotics (for longer than six weeks) in preventing any AOM, AOM with perforation and C

Cochrane Systematic Review: Azithromycin for respiratory tract infections

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Panpanich R, Lerttrakarnnon P, Laopaiboon M

OBJECTIVES: To compare the effectiveness of azithromycin to amoxycillin or amoxycillin/clavulanic acid (amoxyclav) in the treatment of LRTI, in terms of clinical failure, incidence of adverse events and microbial eradication.

Cochrane Systematic Review: Beta2-agonists for bronchitis

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Becker LA, Hom J, Villasis-Keever M, van der Wouden JC

OBJECTIVES: To determine whether beta2-agonists improve bronchitis symptoms in patients with no underlying pulmonary disease.

Cochrane Systematic Review: Bronchodilators for bronchiolitis

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Gadomski AM, Scribani MB

OBJECTIVES: To assess the effects of bronchodilators on clinical outcomes in infants (0 to 12 months) with acute bronchiolitis.

Cochrane Systematic Review: Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old

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Roqu i Figuls M, Gin-Garriga M, Granados Rugeles C, Perrotta C

OBJECTIVES: The main objective was to determine the efficacy of chest physiotherapy in infants aged less than 24 months old with acute bronchiolitis. A condary objective was to determine the efficacy of different techniques of chest physiotherapy (for ample, vibration and percussion and passive forced exhalation).

Cochrane Systematic Review: Chinese medicinal herbs for bronchitis

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Jiang L, Li K, Wu T

OBJECTIVES: This review aimed to summarise the existing evidence on the comparative effectiveness and safety of Chinese medicinal herbs for treating uncomplicated bronchitis.

Cochrane Systematic Review: Chinese medicinal herbs for sore throat

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Huang Y, Wu T, Zeng L, Li S

OBJECTIVES: To assess the efficacy and safety of Chinese herbal medicines for patients with sore throat.

Cochrane Systematic Review: Corticosteroids for bacterial meningitis

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Brouwer MC, McIntyre P, Prasad K, van de Beek D.

Objectives: To examine the effect of adjuvant corticosteroid therapy versus placebo on mortality, hearing loss and neurological sequelae in people of all ages with bacterial meningitis.

Cochrane Systematic Review: Decongestants and antihistamines for acute otitis media in children

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Coleman C, Moore M.

Objectives: To determine the efficacy of decongestant and antihistamine therapy in children with AOM on outcomes of AOM resolution, symptom resolution, medication side effects, and complications of AOM.

Cochrane Systematic Review: Decongestants, antihistamines and nasal irrigation for acute sinusitis in children

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Shaikh N, Wald ER, Pi M.

Objectives: To systematically review the efficacy of decongestants, antihistamines and nasal irrigation in children with clinically diagnosed acute sinusitis. We considered the following four interventions: 1) decongestants versus placebo or no medication, 2) antihistamines versus placebo or no medication, 3) decongestant and antihistamine combination versus placebo or no medication, 4) nasal irrigation versus no irrigation. The primary outcomes of the review were symptom resolution (improvement in symptom score from enrolment to day five and overall symptom burden (as measured by average symptom scores while on therapy).

Cochrane Systematic Review: Delayed antibiotics for respiratory infections

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Spurling GK, Del Mar CB, Dooley L, Foxlee R, Farley R.

Objectives: To evaluate the use of delayed antibiotics compared to immediate or no antibiotics as a prescribing strategy for ARTIs. We evaluated clinical outcomes including duration and severity measures for pain, malaise, fever, cough and rhinorrhoea in sore throat, otitis media, bronchitis (cough) and the common cold. We also evaluated the outcomes of antibiotic use, patient satisfaction, antibiotic resistance and re-consultation rates and use of alternative therapies.

Cochrane Systematic Review: Epinephrine for bronchiolitis

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Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, Klassen...

Objectives: To examine the efficacy and safety of epinephrine in children less than two with viral bronchiolitis.

Cochrane Systematic Review: Fluid therapy for bacterial meningitis

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Maconochie IK, Bhaumik S.

Objectives: To evaluate treatment of bacterial meningitis with differing volumes of initial fluid administration (up to 72 hours after first presentation) and the effects on death and neurological sequelae.

Cochrane Systematic Review: Glucocorticoids for viral bronchiolitis in infants and young children

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Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson ...

Objectives: To review the efficacy and safety of systemic and inhaled glucocorticoids in children with viral bronchiolitis.

Cochrane Systematic Review: Heliox inhalation therapy for bronchiolitis in infants

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Liet JM, Ducruet T, Gupta V, Cambonie G.

Objectives: To assess heliox in addition to standard medical care for acute bronchiolitis in infants.

Cochrane Systematic Review: Honey for acute cough in children

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Oduwole O, Meremikwu MM, Oyo-Ita A, Udoh EE.

Objectives: To evaluate the effectiveness of honey for acute cough in children in ambulatory settings.

Cochrane Systematic Review: Inhaled corticosteroids during acute bronchiolitis in the prevention of post-bronchiolitic wheezing

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Blom DJ, Ermers M, Bont L, van Woensel JB, Van Aalderen WM.

Objectives: The objective of this review was to evaluate the effect of inhaled corticosteroids, started during the acute phase of bronchiolitis, on the prevention of post-bronchiolitic wheezing.

Cochrane Systematic Review: Intranasal steroids for acute sinusitis

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Zalmanovici Trestioreanu A, Yaphe J.

Objectives: We examined whether intranasal corticosteroids (INCS) are effective in relieving symptoms of acute sinusitis in adults and children.

Cochrane Systematic Review: Nebulised hypertonic saline solution for acute bronchiolitis in infants

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Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP.

Objectives: To assess the effects of nebulised hypertonic ( 3%) saline solution in infants with viral bronchiolitis.

Cochrane Systematic Review: Once or twice daily versus three times daily amoxicillin with or without clavulanate for the treatment of acute otitis media

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Thanaviratananich S, Laopaiboon M, Vatanasapt P.

Objectives: To compare the effectiveness of one or two daily doses with three or four daily doses of amoxicillin, with or without clavulanate, for the treatment of AOM in children; and to compare complication rates and adverse reactions.

Cochrane Systematic Review: Osmotic therapies added to antibiotics for bacterial meningitis

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Wall EC, Ajdukiewicz KM, Heyderman RS, Garner P.

Objectives: To evaluate the effects on mortality, deafness and neurological disability of osmotic therapies added to antibiotics for bacterial meningitis in children and adults.

Cochrane Systematic Review: Over-the-counter (OTC) medications for acute cough in children and adults in ambulatory settings

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Smith SM, Schroeder K, Fahey T.

Objectives: To assess the effects of oral OTC cough preparations for acute cough in children and adults.

Cochrane Systematic Review: Over-the-counter (OTC) medications to reduce cough as an adjunct to antibiotics for acute pneumonia in children and adults

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Chang CC, Cheng AC, Chang AB.

Objectives: To evaluate the efficacy of OTC cough medications as an adjunct to antibiotics in children and adults with pneumonia.

Cochrane Systematic Review: Oxygen therapy for lower respiratory tract infections in children between 3 months and 15 years of age

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Rojas MX, Granados Rugeles C, Charry-Anzola LP.

Objectives: To determine in the treatment of LRTIs: the effectiveness of oxygen therapy and oxygen delivery methods; the safety of these methods; and indications for oxygen therapy.

Cochrane Systematic Review: Pelargonium sidoides extract for treating acute respiratory tract infections

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Timmer A, Gnther J, Motschall E, Rcker G, Antes G, Kern WV.

Objectives: To assess the efficacy and safety of P. sidoides for the treatment of ARIs in children and adults.

Cochrane Systematic Review: Probiotics for preventing acute upper respiratory tract infections

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Hao Q, Lu Z, Dong BR, Huang CQ, Wu T.

Objectives: To assess the effectiveness and safety of probiotics for preventing acute URTIs.

Cochrane Systematic Review: Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections

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Schuetz P, Mller B, Christ-Crain M, Stolz D, Tamm M, Bouadma L, Luyt CE, Wolf...

Objectives: The aim of this systematic review based on individual patient data was to assess the safety and efficacy of using procalcitonin for starting or stopping antibiotics over a large range of patients with varying severity of ARIs and from different clinical settings.

Cochrane Systematic Review: Saline nasal irrigation for acute upper respiratory tract infections

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Kassel JC, King D, Spurling GK.

Objectives: To evaluate the efficacy of saline nasal irrigation in treating the symptoms of acute URTIs.

Cochrane Systematic Review: Short-course antibiotics for acute otitis media

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Kozyrskyj A, Klassen TP, Moffatt M, Harvey K.

Objectives: To determine the effectiveness of a short course of antibiotics (less than seven days) in comparison to a long course of antibiotics (seven days or greater) for the treatment of AOM in children.

Cochrane Systematic Review: Short-term late-generation antibiotics versus longer term penicillin for acute streptococcal pharyngitis in children

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Altamimi S, Khalil A, Khalaiwi KA, Milner RA, Pusic MV, Al Othman MA.

Objectives: To summarize the evidence regarding the efficacy of two to six days of newer oral antibiotics (short duration) compared to 10 days of oral penicillin (standard duration) in treating children with acute GABHS pharyngitis.

Cochrane Systematic Review: Steam inhalation or humidified oxygen for acute bronchiolitis in children up to three years of age

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Umoren R, Odey F, Meremikwu MM.

Objectives: To evaluate the effect of steam inhalation or humidified oxygen to relieve respiratory distress and to evaluate adverse events in children up to three years old with acute bronchiolitis.

Cochrane Systematic Review: Systemic corticosteroids for acute sinusitis

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Venekamp RP, Thompson MJ, Hayward G, Heneghan CJ, Del Mar CB, Perera R, Glasz...

Objectives: To assess the effects of systemic corticosteroids on clinical response rates and to determine adverse effects and relapse rates of systemic corticosteroids compared to placebo or standard clinical care in children and adults with acute sinusitis.

Cochrane Systematic Review: Third generation cephalosporins versus conventional antibiotics for treating bacterial meningitis

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Prasad K, Kumar A, Gupta PK, Singhal T.

Objectives: The objective of this review was to compare the effectiveness and safety of third generation cephalosporins and conventional treatment with penicillin or ampicillin-chloramphenicol in patients with community-acquired ABM.

Cochrane Systematic Review: Topical analgesia for acute otitis media

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Foxlee R, Johansson A, Wejfalk J, Dawkins J, Dooley L, Del Mar C.

Objectives: To assess the effectiveness of topical analgesia for AOM.

Cochrane Systematic Review: Addition of intravenous beta2-agonists to inhaled beta2-agonists for acute asthma

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Travers AH, Milan SJ, Jones AP, Camargo CA Jr, Rowe BH.

Objectives: To determine the benefit of adding intravenous (IV) beta(2)-agonists to inhaled beta(2)-agonist therapy for acute asthma treated in the emergency department.

Cochrane Systematic Review: Antibiotics for acute asthma

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Graham V, Lasserson T, Rowe BH.

Objectives: To determine the efficacy of antibiotics prescribed in the treatment of acute asthma

Cochrane Systematic Review: Antibiotics for persistent cough or wheeze following acute bronchiolitis in children

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McCallum GB, Morris PS, Chang AB.

Objectives: To determine the effectiveness of antibiotics compared to a control (no treatment or placebo) for persistent respiratory symptoms (within six months), following acute bronchiolitis.

Cochrane Systematic Review: Anticholinergic therapy for acute asthma in children

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Teoh L, Cates CJ, Hurwitz M, Acworth JP, van Asperen P, Chang AB.

Objectives: To determine the effectiveness of only inhaled anticholinergic drugs (i.e. administered alone), compared to a control in children over the age of two years with acute asthma.

Cochrane Systematic Review: Anticholinergic therapy for bronchiectasis

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Lasserson T, Holt K, Evans D, Greenstone M.

Objectives: To determine the effect of anticholinergic therapy in acute exacerbations and stable bronchiectasis.

Cochrane Systematic Review: Combined inhaled anticholinergics and beta2-agonists for initial treatment of acute asthma in children

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Griffiths B, Ducharme FM.

Objectives: To determine whether the addition of inhaled anticholinergics to SABAs provides clinical improvement and affects the incidence of adverse effects in children with acute asthma exacerbations.

Cochrane Systematic Review: Corticosteroids for hospitalised children with acute asthma

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Smith M, Iqbal S, Elliott TM, Everard M, Rowe BH.

Objectives: To determine the benefit of systemic corticosteroids (oral, intravenous, or intramuscular) compared to placebo and inhaled steroids in acute paediatric asthma.

Cochrane Systematic Review: Corticosteroids for preventing relapse following acute exacerbations of asthma

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Rowe BH, Spooner CH, Ducharme FM, Bretzlaff JA, Bota GW.

Objectives: To determine the benefit of corticosteroids (oral, intramuscular, or intravenous) for the treatment of asthmatic patients discharged from an acute care setting (i.e. usually the emergency department) after assessment and treatment of an acute asthmatic exacerbation.

Cochrane Systematic Review: Early emergency department treatment of acute asthma with systemic corticosteroids

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Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW.

Objectives: To determine the benefit of treating patients with acute asthma with systemic corticosteroids within an hour of presenting to the emergency department (ED).

Cochrane Systematic Review: Early use of inhaled corticosteroids in the emergency department treatment of acute asthma

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Edmonds ML, Milan SJ, Camargo CA Jr, Pollack CV, Rowe BH.

Objectives: To determine the benefit of ICS for the treatment of patients with acute asthma managed in the emergency department (ED).

Cochrane Systematic Review: Heliox for non-intubated acute asthma patients

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Rodrigo G, Pollack C, Rodrigo C, Rowe BH.

Objectives: To determine the effect of the addition of heliox to standard medical care on the course of acute asthma, as measured by pulmonary function testing and clinical endpoints.

Cochrane Systematic Review: Holding chambers (spacers) versus nebulisers for beta-agonist treatment of acute asthma

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Cates CJ, Welsh EJ, Rowe BH.

Objectives: To assess the effects of holding chambers (spacers) compared to nebulisers for the delivery of beta(2)-agonists for acute asthma.

Cochrane Systematic Review: Inhaled corticosteroids for subacute cough in children

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Anderson-James S, Marchant JM, Acworth JP, Turner C, Chang AB.

Objectives: To evaluate the efficacy of ICS in reducing the severity of cough in children with subacute cough.

Cochrane Systematic Review: Inhaled magnesium sulfate in the treatment of acute asthma

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Powell C, Dwan K, Milan SJ, Beasley R, Hughes R, Knopp-Sihota JA, Rowe BH.

Objectives: To determine the efficacy of inhaled MgSO(4) administered in acute asthma on pulmonary functions and admission rates.Specific aims: To quantify the effects of inhaled MgSO(4) i) in addition to inhaled (2)-agonist, ii) in comparison to inhaled (2)-agonist alone or iii) in addition to combination treatment with inhaled (2) -agonist and ipratropium bromide.

Cochrane Systematic Review: Inhaled steroids for acute asthma following emergency department discharge

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Edmonds ML, Milan SJ, Brenner BE, Camargo CA Jr, Rowe BH.

Objectives: To determine the effectiveness of ICS on outcomes in the treatment of acute asthma following discharge from the ED. To quantify the effectiveness of ICS therapy on acute asthma following ED discharge, when used in addition to, or as a substitute for, systemic corticosteroids.

Cochrane Systematic Review: Intravenous aminophylline for acute severe asthma in children over two years receiving inhaled bronchodilators

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Mitra A, Bassler D, Goodman K, Lasserson TJ, Ducharme FM.

Objectives: To determine if the addition of intravenous aminophylline produces a beneficial effect in children with acute severe asthma receiving conventional therapy.

Cochrane Systematic Review: Intravenous beta2-agonists for acute asthma in the emergency department

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Travers A, Jones AP, Kelly K, Barker SJ, Camargo CA, Rowe BH.

Objectives: To determine the benefit of intravenous (IV) beta2-agonists for severe acute asthma treated in the emergency department.

Cochrane Systematic Review: Intravenous beta2-agonists versus intravenous aminophylline for acute asthma

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Travers AH, Jones AP, Camargo CA Jr, Milan SJ, Rowe BH.

Objectives: To compare the benefit of IV beta(2)-agonists versus IV aminophylline for acute asthma treated in the emergency department and in patients admitted to hospital with acute severe asthma.

Cochrane Systematic Review: Ketamine for management of acute exacerbations of asthma in children

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Jat KR, Chawla D.

Objectives: To evaluate the efficacy of ketamine compared to placebo, no intervention or standard care for management of severe acute asthma in children who had not responded to standard therapy.

Cochrane Systematic Review: Leukotriene receptor antagonists in addition to usual care for acute asthma in adults and children

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Watts K, Chavasse RJ.

Objectives: To determine if the addition of a leukotriene receptor antagonist (LTRA) produces a beneficial effect in children and adults with acute asthma who are currently receiving inhaled bronchodilators and systemic corticosteroids.

Cochrane Systematic Review: Magnesium sulfate for treating exacerbations of acute asthma in the emergency department

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Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo CA Jr.

Objectives: To examine the effect of additional intravenous magnesium sulfate in patients with acute asthma managed in the emergency department.

Cochrane Systematic Review: Primary closure versus delayed closure for non bite traumatic wounds within 24 hours post injury

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Eliya-Masamba MC, Banda GW

OBJECTIVES: To determine the effect on time to healing of primary closure versus delayed closure for non bite traumatic wounds presenting within 24 hours post injury. To explore the adverse effects of primary closure compared with delayed closure for non bite traumatic wounds presenting within 24 hours post injury.

Cochrane Systematic Review: Emergency intubation for acutely ill and injured patients

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Lecky F, Bryden D, Little R, Tong N, Moulton C

OBJECTIVES: To determine in acutely ill and injured patients who have real or anticipated problems in maintaining an adequate airway whether emergency endotracheal intubation, as opposed to other airway management techniques, improves the outcome in terms of survival, degree of disability at discharge or length of stay and complications occurring in hospital.

Cochrane Systematic Review: Antibiotic treatment for travellers' diarrhoea

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De Bruyn G, Hahn S, Borwick A. Antibiotic treatment for travellers' diarrhoe...

OBJECTIVES: The aims of this review were to assess the effects of antibiotics on traveller's diarrhoea in relation to duration of illness, severity of illness, and adverse effects of medications.

Cochrane Systematic Review: Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) and acute lung injury in children and adults

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Afshari A, Brok J, Mller AM, Wetterslev J. Inhaled nitric oxide for acute re...

OBJECTIVES: To systematically assess the benefits and harms of INO in critically ill patients with AHRF.

Cochrane Systematic Review: Probiotics for treating acute infectious diarrhoea

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Allen SJ, Martinez EG, Gregorio GV, Dans LF

OBJECTIVES: To assess the effects of probiotics in proven or presumed acute infectious diarrhoea.

Cochrane Systematic Review: Anticholinergics for neuroleptic-induced acute akathisia

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Rathbone J, Soares-Weiser K

OBJECTIVES: To review anticholinergic drugs for neuroleptic-induced acute akathisia.

Cochrane Systematic Review: Antibiotics for acute pyelonephritis in children

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Hodson EM, Willis NS, Craig JC

OBJECTIVES: To determine the benefits and harms of different antibiotic regimens for the treatment of acute pyelonephritis in children.

Cochrane Systematic Review: Short versus standard duration oral antibiotic therapy for acute urinary tract infection in children

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Michael M, Hodson EM, Craig JC, Martin S, Moyer VA

OBJECTIVES: The objective of this review was to assess the benefits and harms of short-course (2-4 days) compared to standard duration (7-14 days) oral antibiotic treatment for acute UTI in children.

Cochrane Systematic Review: High-frequency ventilation versus conventional ventilation for treatment of acute lung injury and acute respiratory distress syndrome

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Sud S, Sud M, Friedrich JO, Wunsch H, Meade MO, Ferguson ND, Adhikari NK

OBJECTIVES: To determine clinical and physiological effects of high frequency oscillation (HFO) in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) compared to conventional ventilation.

Cochrane Systematic Review: Intravenous immunoglobulin for presumed viral myocarditis in children and adults

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Robinson J, Hartling L, Vandermeer B, Crumley E, Klassen TP

OBJECTIVES: To compare the outcome of patients with presumed viral myocarditis treated with IVIG to patients who did not receive IVIG.

Cochrane Systematic Review: Dipyrone for acute primary headaches

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Ramacciotti AS, Soares BG, Atallah AN

OBJECTIVES: To determine the effectiveness and safety of dipyrone for acute primary headaches in adults and children.

Cochrane Systematic Review: Oral zinc for treating diarrhoea in children

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Lazzerini M, Ronfani L

OBJECTIVES: To evaluate oral zinc supplementation for treating children with acute or persistent diarrhoea.

Cochrane Systematic Review: Antiemetics for reducing vomiting related to acute gastroenteritis in children and adolescents

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Fedorowicz Z, Jagannath VA, Carter B

OBJECTIVES: To assess the safety and effectiveness of antiemetics on gastroenteritis induced vomiting in children and adolescents.

Cochrane Systematic Review: Antibiotics for treating community acquired pneumonia in people with sickle cell disease

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Mart-Carvajal AJ, Conterno LO

OBJECTIVES: To determine the efficacy and safety of the antibiotic treatment approaches (monotherapy or combined) for people with sickle cell disease suffering from community-acquired pneumonia.

Cochrane Systematic Review: Non-pharmacological management of infant and young child procedural pain

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Pillai Riddell RR, Racine NM, Turcotte K, Uman LS, Horton RE, Din Osmun L, A...

OBJECTIVES: To assess the efficacy of non-pharmacological interventions for infant and child (up to three years) acute pain, excluding breastmilk, sucrose, and music. Analyses accounted for infant age (preterm, neonate, older) and pain response (pain reactivity, pain-related regulation).

Cochrane Systematic Review: Polymer-based oral rehydration solution for treating acute watery diarrhoea

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Gregorio GV, Gonzales ML, Dans LF, Martinez EG

OBJECTIVES: To compare polymer-based ORS with glucose-based ORS for treating acute watery diarrhoea.

Cochrane Systematic Review: Bradykinin beta-2 receptor antagonists for acute traumatic brain injury

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Ker K, Blackhall K

OBJECTIVES: The objective was to assess the safety and effectiveness of beta-2 receptor antagonists for TBI.

Cochrane Systematic Review: Early versus Delayed Refeeding for Children with Acute Diarrhoea

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Gregorio GV, Dans LF, Silvestre MA

OBJECTIVES: To compare the efficacy and safety of early and late reintroduction of feeding in children with acute diarrhoea.

Cochrane Systematic Review: Oral corticosteroids for bronchiectasis (stable and acute exacerbations)

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Lasserson T, Holt K, Greenstone M.

Objectives: To determine the efficacy of oral corticosteroids in acute and stable bronchiectasis

Cochrane Systematic Review: Diclofenac for acute pain in children

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Standing JF, Savage I, Pritchard D, Waddington M

OBJECTIVES: 1) Assess the efficacy of diclofenac for acute pain in children. 2) Assess the safety of diclofenac for short-term use in children. 3) Identify gaps in the evidence to direct future research.