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Evidence Repository: Pain Treatment (2022)  (2022)

Evidence Repository: Pain Treatment (2022)

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For a list of references that were used in the creation of this resource, see Evidence Repository: Pain Treatment (2022)

For a list of references that were used in the creation of this resource, see Evidence Repository: Pain Treatment (2022)

Bottom Line Recommendations: Pain Treatment (2022)

Bottom Line Recommendations: Pain Treatment (2022)

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Dr. Samina Ali, Dr. Corrie Chumpitazi, Dr. Amy Drendel, & Dr. Naveen Poonai

Dr. Samina Ali, Dr. Corrie Chumpitazi, Dr. Amy Drendel, & Dr. Naveen Poonai

Bottom Line Recommendations: Procedural Pain (2022)

Bottom Line Recommendations: Procedural Pain (2022)

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Drs. Samina Ali, Amy Drendel, Corrie Chumpitazi, Naveen Poonai

Drs. Samina Ali, Amy Drendel, Corrie Chumpitazi, Naveen Poonai

Evidence Repository: Procedural pain

Evidence Repository: Procedural pain

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Drs. Samina Ali, Amy Drendel, Corrie Chumpitazi, Naveen Poonai

Drs. Samina Ali, Amy Drendel, Corrie Chumpitazi, Naveen Poonai

Evidence repositories are collections of best available resources and evidence (clinical guidelines, peer reviewed literature, systematic reviews, etc.), collated by our knowledge synthesis team and content advisors. This evidence repository is not intended to be an exhaustive list of resources for a topic, but rather a curated list of current, evidence-based resources, based on expert consensus of relevance and usability for a general emergency department setting. We search databases (Cochrane Library, PubMed, TRIP Database) and web search engines (Google, Google Scholar) to locate evidence. Additionally, hospital websites are browsed for guidance documents, such as clinical practice guidelines (CPG) for healthcare professionals.
Every effort is made to identify resources that are open access (i.e. publicly available, free of charge, not requiring a subscription).
More information about the creation of our evidence repositories can be found at https://pubmed.ncbi.nlm.nih.gov/28537762/ 

Evidence repositories are collections of best available resources and evidence (clinical guidelines, peer reviewed literature, systematic reviews, etc.), collated by our knowledge synthesis team and content advisors. This evidence repository is not intended to be an exhaustive list of resources for a topic, but rather a curated list of current, evidence-based resources, based on expert consensus of relevance and usability for a general emergency department setting. We search databases (Cochrane Library, PubMed, TRIP Database) and web search engines (Google, Google Scholar) to locate evidence. Additionally, hospital websites are browsed for guidance documents, such as clinical practice guidelines (CPG) for healthcare professionals.
Every effort is made to identify resources that are open access (i.e. publicly available, free of charge, not requiring a subscription).
More information about the creation of our evidence repositories can be found at https://pubmed.ncbi.nlm.nih.gov/28537762/ 

Clinical Pathway: ED Pathway for Evaluation/Treatment of Febrile Young Infant (0-56 Days Old)  (2017)

Clinical Pathway: ED Pathway for Evaluation/Treatment of Febrile Young Infant (0-56 Days Old)

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Scarfone R, Gala R, Murray A, Funari MK, Lavelle J, Bell L

Scarfone R, Gala R, Murray A, Funari MK, Lavelle J, Bell L

The clinical pathway for treating and evaluating febrile infants is built upon publicly available medical evidence and/or a consensus of medical practitioners at The Childrens Hospital of Philadelphia.

The clinical pathway for treating and evaluating febrile infants is built upon publicly available medical evidence and/or a consensus of medical practitioners at The Childrens Hospital of Philadelphia.

Infographic: Opioids- Information for Clinicians  (2021)

Infographic: Opioids- Information for Clinicians

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Recommandations de base: Prise en charge de la douleur (2022)

Recommandations de base: Prise en charge de la douleur (2022)

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Dr. Samina Ali, Dr. Corrie Chumpitazi, Dr. Amy Drendel, & Dr. Naveen Poonai

Dr. Samina Ali, Dr. Corrie Chumpitazi, Dr. Amy Drendel, & Dr. Naveen Poonai

Clinical guidelines

Clinical Practice Guideline: AAOS clinical practice guideline: the treatment of pediatric diaphyseal femur fractures  (2009)

Clinical Practice Guideline: AAOS clinical practice guideline: the treatment of pediatric diaphyseal femur fractures

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Kocher, MS, Sink, EL, Blasier, RD, Luhmann, SJ, Mehlman, CT, Scher, DM, Matheney, T & Sanders, JO

Kocher, MS, Sink, EL, Blasier, RD, Luhmann, SJ, Mehlman, CT, Scher, DM, Mathe...

This is a summary of the recommendations in the AAOS clinical practice guideline, The Treatment of Pediatric Diaphyseal Femur Fractures.

This is a summary of the recommendations in the AAOS clinical practice guideline, The Treatment of Pediatric Diaphyseal Femur Fractures.

Clinical Practice Guideline: Treatment of Pediatric Diaphyseal Femur Fractures  (2015)

Clinical Practice Guideline: Treatment of Pediatric Diaphyseal Femur Fractures

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Jevsevar DS & Shea K

Jevsevar DS & Shea K

This is an AAOS clinical guideline on the treatment of pediatric diaphyseal femur fractures (PDFF).

This is an AAOS clinical guideline on the treatment of pediatric diaphyseal femur fractures (PDFF).

Clinical Practice Guidelines: The treatment of pediatric supracondylar humerus fractures  (2012)

Clinical Practice Guidelines: The treatment of pediatric supracondylar humerus fractures

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Howard A, Mulpuri K, Abel MF, Braun S, Bueche M, Epps H, Hosalkar H, Mehlman CT, Scherl S, Goldberg M, Turkelson CM, Wies JL, Boyer K, American Academy of Or...

Howard A, Mulpuri K, Abel MF, Braun S, Bueche M, Epps H, Hosalkar H, Mehlman ...

Based on the best current evidence and a systematic review of published studies, 14 recommendations have been created to guide clinical practice and management of supracondylar fractures of the humerus in children.

Based on the best current evidence and a systematic review of published studies, 14 recommendations have been created to guide clinical practice and management of supracondylar fractures of the humerus in children.

Clinical Practice Guidelines: The treatment of pediatric supracondylar humerus fractures: Evidence-Based Guideline and Evidence Report  (2011)

Clinical Practice Guidelines: The treatment of pediatric supracondylar humerus fractures: Evidence-Based Guideline and Evidence Report

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Howard A, Mulpuri K, Abel MF, Braun S, Bueche M, Epps H, Hosalkar H, Mehlman CT, Scherl S, Goldberg M, Turkelson CM, Wies JL, Boyer K; American Academy of Or...

Howard A, Mulpuri K, Abel MF, Braun S, Bueche M, Epps H, Hosalkar H, Mehlman ...

This clinical practice guideline is based on a systematic review of published studies on the treatment of supracondylar fractures of the humerus in children. In addition to providing practice recommendations, this guideline highlights gaps in the literature and areas that require future research.

This clinical practice guideline is based on a systematic review of published studies on the treatment of supracondylar fractures of the humerus in children. In addition to providing practice recommendations, this guideline highlights gaps in the literature and areas that require future research.

Clinical Practice Guidelines: Treatment of Distal Radius Fractures: Guideline and Evidence Report  (2009)

Clinical Practice Guidelines: Treatment of Distal Radius Fractures: Guideline and Evidence Report

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Lichtman DM, Randipsingh RR, Boyer MI, Putnam MD, Ring D, Slutsky DJ, Taras JS

Lichtman DM, Randipsingh RR, Boyer MI, Putnam MD, Ring D, Slutsky DJ, Taras JS

This an an AAOS clinical guideline for pediatric distal radial fractures.

This an an AAOS clinical guideline for pediatric distal radial fractures.

Overviews of systematic reviews

Cochrane Summary: Surgical treatment for forearm fractures in children (fractures involving the shafts of the radius and ulna)  (2011)

Cochrane Summary: Surgical treatment for forearm fractures in children (fractures involving the shafts of the radius and ulna)

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Abraham A, Kumar S, Chaudhry S, Ibrahim T

Abraham A, Kumar S, Chaudhry S, Ibrahim T

Fractures of the shafts of the forearm bones in children are common injuries and occur after a fall on an outstretched hand. There are two bones in the forearm: the radius and the ulna. After a fall either one or both bones may fracture. The shape of forearm bones are important for the twisting motion of the hand, such as in receiving change from a shop keeper with an open palm (supination) or turning a key in a door (turning the palm facing down - pronation). Treatment of the forearm fracture aims to restore the shape of the bones such that supination and pronation ability is restored. The first stage of treatment involves manipulating (setting) the bones to the correct shape. This is usually done under anaesthesia. The second stage involves stabilising the fractured bones either with a plaster cast (conservative treatment) or metal implants (surgical treatment). This review aimed to examine the evidence from randomised controlled trials comparing conservative versus surgical methods and trials comparing different surgical methods for treatment of these fractures. We hoped to find which are the best methods in terms of function and complications. In spite of a thorough search we found no evidence from properly conducted studies to help inform decisions on treatment of these fractures.

Fractures of the shafts of the forearm bones in children are common injuries and occur after a fall on an outstretched hand. There are two bones in the forearm: the radius and the ulna. After a fall either one or both bones may fracture. The shape of forearm bones are important for the twisting motion of the hand, such as in receiving change from a shop keeper with an open palm (supination) or turning a key in a door (turning the palm facing down - pronation). Treatment of the forearm fracture aims to restore the shape of the bones such that supination and pronation ability is restored. The first stage of treatment involves manipulating (setting) the bones to the correct shape. This is usually done under anaesthesia. The second stage involves stabilising the fractured bones either with a plaster cast (conservative treatment) or metal implants (surgical treatment). This review aimed to examine the evidence from randomised controlled trials comparing conservative versus surgical methods and trials comparing different surgical methods for treatment of these fractures. We hoped to find which are the best methods in terms of function and complications. In spite of a thorough search we found no evidence from properly conducted studies to help inform decisions on treatment of these fractures.

Systematic reviews

Cochrane Systematic Review: Antidepressants for the treatment of abdominal pain-related functional gastrointestinal disorders in children and adolescents

Cochrane Systematic Review: Antidepressants for the treatment of abdominal pain-related functional gastrointestinal disorders in children and adolescents

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Kaminski A, Kamper A, Thaler K, Chapman A, Gartlehner G

Kaminski A, Kamper A, Thaler K, Chapman A, Gartlehner G

OBJECTIVES: The primary objectives were to conduct a systematic review to evaluate the efficacy and safety of antidepressants for the treatment of abdominal pain-related FGIDs in children and adolescents.

OBJECTIVES: The primary objectives were to conduct a systematic review to evaluate the efficacy and safety of antidepressants for the treatment of abdominal pain-related FGIDs in children and adolescents.

Cochrane Systematic Review: Adjusting the pH of lidocaine for reducing pain on injection

Cochrane Systematic Review: Adjusting the pH of lidocaine for reducing pain on injection

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Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora Gandhi P, Schumann R

Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora Gandhi P, Schumann R

OBJECTIVES: The objective of this review was to determine if adjusting the pH of lidocaine had any effect on pain resulting from non-intravascular injections in adults and children. We tested the hypothesis that adjusting the pH of lidocaine solution to a level closer to the physiologic pH reduces this pain.

OBJECTIVES: The objective of this review was to determine if adjusting the pH of lidocaine had any effect on pain resulting from non-intravascular injections in adults and children. We tested the hypothesis that adjusting the pH of lidocaine solution to a level closer to the physiologic pH reduces this pain.

Cochrane Systematic Review: Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery

Cochrane Systematic Review: Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery

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Andreae MH, Andreae DA

Andreae MH, Andreae DA

OBJECTIVES: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of persistent pain six or 12 months after surgery.

OBJECTIVES: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of persistent pain six or 12 months after surgery.

Cochrane Systematic Review: Conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain

Cochrane Systematic Review: Conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain

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Almeida MO, Silva BN, Andriolo RB, Atallah AN, Peccin MS

Almeida MO, Silva BN, Andriolo RB, Atallah AN, Peccin MS

OBJECTIVES: To assess the effects (benefits and harms) of conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain.

OBJECTIVES: To assess the effects (benefits and harms) of conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain.

Cochrane Systematic Review: Pharmacotherapy for patellofemoral pain syndrome

Cochrane Systematic Review: Pharmacotherapy for patellofemoral pain syndrome

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Heintjes E, Berger MY, Bierma-Zeinstra SM, Bernsen RM, Verhaar JA, Koes BW

Heintjes E, Berger MY, Bierma-Zeinstra SM, Bernsen RM, Verhaar JA, Koes BW

OBJECTIVES: This review aims to summarise the evidence of effectiveness of pharmacotherapy in reducing anterior knee pain and improving knee function in people with PFPS.

OBJECTIVES: This review aims to summarise the evidence of effectiveness of pharmacotherapy in reducing anterior knee pain and improving knee function in people with PFPS.

Cochrane Systematic Review: Pharmacological interventions for recurrent abdominal pain (RAP) and irritable bowel syndrome (IBS) in childhood

Cochrane Systematic Review: Pharmacological interventions for recurrent abdominal pain (RAP) and irritable bowel syndrome (IBS) in childhood

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Huertas-Ceballos AA, Logan S, Bennett C, Macarthur C, Martin AE

Huertas-Ceballos AA, Logan S, Bennett C, Macarthur C, Martin AE

OBJECTIVES: To determine the effectiveness of medication for recurrent abdominal pain in school-age children.

OBJECTIVES: To determine the effectiveness of medication for recurrent abdominal pain in school-age children.

Cochrane Systematic Review: Oxcarbazepine for neuropathic pain

Cochrane Systematic Review: Oxcarbazepine for neuropathic pain

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Zhou M, Chen N, He L, Yang M, Zhu C, Wu F

Zhou M, Chen N, He L, Yang M, Zhu C, Wu F

OBJECTIVES: To determine the benefits and harms of oxcarbazepine for different forms of neuropathic pain.

OBJECTIVES: To determine the benefits and harms of oxcarbazepine for different forms of neuropathic pain.

Cochrane Systematic Review: EMLA and Amethocaine for reduction of children's pain associated with needle insertion

Cochrane Systematic Review: EMLA and Amethocaine for reduction of children's pain associated with needle insertion

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Lander JA, Weltman BJ, So SS

Lander JA, Weltman BJ, So SS

OBJECTIVES: To compare the topical anaesthetics amethocaine and an eutectic mixture of local anaesthetics (EMLA) in terms of anaesthetic efficacy, ease of needle insertion and adverse events when used for intravenous cannulation and venipuncture in children.

OBJECTIVES: To compare the topical anaesthetics amethocaine and an eutectic mixture of local anaesthetics (EMLA) in terms of anaesthetic efficacy, ease of needle insertion and adverse events when used for intravenous cannulation and venipuncture in children.

Cochrane Systematic Review: Hydromorphone for acute and chronic pain

Cochrane Systematic Review: Hydromorphone for acute and chronic pain

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Quigley C

Quigley C

OBJECTIVES: This review explores and assesses the evidence for the efficacy of hydromorphone in the management of pain.

OBJECTIVES: This review explores and assesses the evidence for the efficacy of hydromorphone in the management of pain.

Cochrane Systematic Review: Local anaesthetic sympathetic blockade for complex regional pain syndrome

Cochrane Systematic Review: Local anaesthetic sympathetic blockade for complex regional pain syndrome

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Stanton TR, Wand BM, Carr DB, Birklein F, Wasner GL, O'Connell NE

Stanton TR, Wand BM, Carr DB, Birklein F, Wasner GL, O'Connell NE

OBJECTIVES: To assess the efficacy of LASB for the treatment of pain in CRPS and to evaluate the incidence of adverse effects of the procedure.

OBJECTIVES: To assess the efficacy of LASB for the treatment of pain in CRPS and to evaluate the incidence of adverse effects of the procedure.

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

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, Ahola Kohut S, Hillgrove Stuart J, Stevens B, Gerwitz-Stern A

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).

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: NSAIDS or paracetamol, alone or combined with opioids, for cancer pain

Cochrane Systematic Review: NSAIDS or paracetamol, alone or combined with opioids, for cancer pain

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McNicol E, Strassels SA, Goudas L, Lau J, Carr DB

McNicol E, Strassels SA, Goudas L, Lau J, Carr DB

OBJECTIVES: To assess the effects of NSAIDs, alone or combined with opioids, for the treatment of cancer pain.

OBJECTIVES: To assess the effects of NSAIDs, alone or combined with opioids, for the treatment of cancer pain.

Cochrane Systematic Review: Oral morphine for cancer pain

Cochrane Systematic Review: Oral morphine for cancer pain

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Wiffen PJ, Wee B, Moore RA

Wiffen PJ, Wee B, Moore RA

OBJECTIVES: To determine the efficacy of oral morphine in relieving cancer pain, and assess the incidence and severity of adverse effects.

OBJECTIVES: To determine the efficacy of oral morphine in relieving cancer pain, and assess the incidence and severity of adverse effects.

Cochrane Systematic Review: Pharmacologic interventions for treating phantom limb pain

Cochrane Systematic Review: Pharmacologic interventions for treating phantom limb pain

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Alviar MJ, Hale T, Dungca M

Alviar MJ, Hale T, Dungca M

OBJECTIVES: This review aims to summarize the evidence of effectiveness of pharmacologic interventions in treating PLP.

OBJECTIVES: This review aims to summarize the evidence of effectiveness of pharmacologic interventions in treating PLP.

Cochrane Systematic Review: Sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age

Cochrane Systematic Review: Sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age

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Kassab M, Foster JP, Foureur M, Fowler C

Kassab M, Foster JP, Foureur M, Fowler C

OBJECTIVES: To determine the effectiveness of sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age compared with no treatment, placebo, other sweet-tasting solutions, or pharmacological or other non-pharmacological pain-relieving methods.

OBJECTIVES: To determine the effectiveness of sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age compared with no treatment, placebo, other sweet-tasting solutions, or pharmacological or other non-pharmacological pain-relieving methods.

Cochrane Systematic Review: Diclofenac for acute pain in children  (2009)

Cochrane Systematic Review: Diclofenac for acute pain in children

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Standing JF, Savage I, Pritchard D, Waddington M

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.

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.

Cochrane Systematic Review: Corticosteroids as standalone or add-on treatment for sore throat

Cochrane Systematic Review: Corticosteroids as standalone or add-on treatment for sore throat

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Hayward G, Thompson MJ, Perera R, Glasziou PP, Del Mar CB, Heneghan CJ.

Hayward G, Thompson MJ, Perera R, Glasziou PP, Del Mar CB, Heneghan CJ.

Objectives: To assess the clinical benefit and safety of corticosteroids for symptoms of sore throat in adults and children.

Objectives: To assess the clinical benefit and safety of corticosteroids for symptoms of sore throat in adults and children.

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

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.

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.

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: Symptomatic treatment of the cough in whooping cough

Cochrane Systematic Review: Symptomatic treatment of the cough in whooping cough

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Bettiol S, Wang K, Thompson MJ, Roberts NW, Perera R, Heneghan CJ, Harnden A.

Bettiol S, Wang K, Thompson MJ, Roberts NW, Perera R, Heneghan CJ, Harnden A.

Objectives: To assess the effectiveness and safety of interventions to reduce the severity of paroxysmal cough in whooping cough in children and adults.

Objectives: To assess the effectiveness and safety of interventions to reduce the severity of paroxysmal cough in whooping cough in children and adults.

Cochrane Systematic Review: Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children 2 to 59 months of age

Cochrane Systematic Review: Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children 2 to 59 months of age

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Haider BA, Lassi ZS, Ahmed A, Bhutta ZA.

Haider BA, Lassi ZS, Ahmed A, Bhutta ZA.

Objectives: To evaluate zinc supplementation, as an adjunct to antibiotics, in the treatment (clinical recovery) of pneumonia in children aged two to 59 months.

Objectives: To evaluate zinc supplementation, as an adjunct to antibiotics, in the treatment (clinical recovery) of pneumonia in children aged two to 59 months.

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

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.

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.

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: Early emergency department treatment of acute asthma with systemic corticosteroids

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.

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).

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

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.

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).

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

Cochrane Systematic Review: gastroesophageal reflux treatment for asthma in adults and children

Cochrane Systematic Review: gastroesophageal reflux treatment for asthma in adults and children

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Gibson PG, Henry RL, Coughlan JL.

Gibson PG, Henry RL, Coughlan JL.

Objectives: The objective of this review was to evaluate the effectiveness of treatments for gastroesophageal reflux in terms of their benefit on asthma.

Objectives: The objective of this review was to evaluate the effectiveness of treatments for gastroesophageal reflux in terms of their benefit on asthma.

Cochrane Systematic Review: gastroesophageal reflux treatment for prolonged non-specific cough in children and adults

Cochrane Systematic Review: gastroesophageal reflux treatment for prolonged non-specific cough in children and adults

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Chang AB, Lasserson TJ, Gaffney J, Connor FL, Garske LA.

Chang AB, Lasserson TJ, Gaffney J, Connor FL, Garske LA.

Objectives: To evaluate the efficacy of GORD treatment on chronic cough in children and adults with GORD and prolonged cough that is not related to an underlying respiratory disease, i.e. non-specific chronic cough.

Objectives: To evaluate the efficacy of GORD treatment on chronic cough in children and adults with GORD and prolonged cough that is not related to an underlying respiratory disease, i.e. non-specific chronic cough.

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

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.

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.

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 magnesium sulfate in the treatment of acute asthma

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.

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.

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: Adrenaline (epinephrine) for the treatment of anaphylaxis with and without shock

Cochrane Systematic Review: Adrenaline (epinephrine) for the treatment of anaphylaxis with and without shock

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Sheikh A, Shehata YA, Brown SG, Simons FE

Sheikh A, Shehata YA, Brown SG, Simons FE

OBJECTIVES: To assess the benefits and harms of adrenaline (epinephrine) in the treatment of anaphylaxis.

OBJECTIVES: To assess the benefits and harms of adrenaline (epinephrine) in the treatment of anaphylaxis.

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

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

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.

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: Antibiotic treatment for Burkholderia cepacia complex in people with cystic fibrosis experiencing a pulmonary exacerbation

Cochrane Systematic Review: Antibiotic treatment for Burkholderia cepacia complex in people with cystic fibrosis experiencing a pulmonary exacerbation

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Horsley A, Jones AM

Horsley A, Jones AM

OBJECTIVES: To assess the effectiveness and safety of different antibiotic regimens in people with cystic fibrosis experiencing an exacerbation, who are chronically infected with organisms of the Burkholderia cepacia complex.

OBJECTIVES: To assess the effectiveness and safety of different antibiotic regimens in people with cystic fibrosis experiencing an exacerbation, who are chronically infected with organisms of the Burkholderia cepacia complex.

Cochrane Systematic Review: Neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis

Cochrane Systematic Review: Neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis

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Jagannath VA, Asokan GV, Fedorowicz Z, Lee TW

Jagannath VA, Asokan GV, Fedorowicz Z, Lee TW

OBJECTIVES: To assess the effects of neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis.

OBJECTIVES: To assess the effects of neuraminidase inhibitors for the treatment of influenza infection in people with cystic fibrosis.

Cochrane Systematic Review: Pharmacological treatment for Attention Deficit Hyperactivity Disorder (ADHD) in children with comorbid tic disorders

Cochrane Systematic Review: Pharmacological treatment for Attention Deficit Hyperactivity Disorder (ADHD) in children with comorbid tic disorders

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Pringsheim T, Steeves T

Pringsheim T, Steeves T

OBJECTIVES: To assess the effects of pharmacological treatments for ADHD on ADHD symptoms and tic severity in children with ADHD and comorbid tic disorders.

OBJECTIVES: To assess the effects of pharmacological treatments for ADHD on ADHD symptoms and tic severity in children with ADHD and comorbid tic disorders.

Cochrane Systematic Review: Identification of children in the first four years of life for early treatment for otitis media with effusion

Cochrane Systematic Review: Identification of children in the first four years of life for early treatment for otitis media with effusion

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Simpson SA, Thomas CL, van der Linden MK, Macmillan H, van der Wouden JC, Butler C

Simpson SA, Thomas CL, van der Linden MK, Macmillan H, van der Wouden JC, Bu...

OBJECTIVES: The aim of this review was to assess evidence from randomised controlled trials about the effect, on language and behavioural outcomes, of screening and treating children with clinically important OME in the first four years of their life. The focus was on the first four years of life because this is the time of most rapid language development. The consequences of hearing loss are likely to be most serious during this time. In addition, children of this age are least likely to be able to report or seek help for impaired hearing, particularly if these problems have a slow onset and are subtle.

OBJECTIVES: The aim of this review was to assess evidence from randomised controlled trials about the effect, on language and behavioural outcomes, of screening and treating children with clinically important OME in the first four years of their life. The focus was on the first four years of life because this is the time of most rapid language development. The consequences of hearing loss are likely to be most serious during this time. In addition, children of this age are least likely to be able to report or seek help for impaired hearing, particularly if these problems have a slow onset and are subtle.

Cochrane Systematic Review: Propofol versus thiopental sodium for the treatment of refractory status epilepticus

Cochrane Systematic Review: Propofol versus thiopental sodium for the treatment of refractory status epilepticus

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Prabhakar H, Bindra A, Singh GP, Kalaivani M. Propofol versus thiopental sodium for the treatment of refractory status epilepticus. Cochrane Database Syst R...

Prabhakar H, Bindra A, Singh GP, Kalaivani M. Propofol versus thiopental sod...

OBJECTIVES: To compare the efficacy, adverse effects, and short- and long-term outcomes of RSE treated with one of the two anaesthetic agents, thiopental sodium or propofol.

OBJECTIVES: To compare the efficacy, adverse effects, and short- and long-term outcomes of RSE treated with one of the two anaesthetic agents, thiopental sodium or propofol.

Cochrane Systematic Review: Treatment of Lennox-Gastaut syndrome

Cochrane Systematic Review: Treatment of Lennox-Gastaut syndrome

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Hancock EC, Cross JH

Hancock EC, Cross JH

OBJECTIVES: To compare the effects of pharmaceutical therapies used to treat LGS in terms of control of seizures and adverse effects. Many people who suffer from this syndrome will already be receiving other antiepileptic medications at the time of their entry into a trial. However, for the purpose of this review we will only consider the effect of the single therapeutic agent being trialled (often as add-on therapy).

OBJECTIVES: To compare the effects of pharmaceutical therapies used to treat LGS in terms of control of seizures and adverse effects. Many people who suffer from this syndrome will already be receiving other antiepileptic medications at the time of their entry into a trial. However, for the purpose of this review we will only consider the effect of the single therapeutic agent being trialled (often as add-on therapy).

Cochrane Systematic Review: Adenosine versus intravenous calcium channel antagonists for the treatment of supraventricular tachycardia in adults

Cochrane Systematic Review: Adenosine versus intravenous calcium channel antagonists for the treatment of supraventricular tachycardia in adults

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Holdgate A, Foo A

Holdgate A, Foo A

OBJECTIVES: To examine the relative effects of adenosine and calcium channel antagonists and, if possible, to determine which is most appropriate for the management of supraventricular tachycardia.

OBJECTIVES: To examine the relative effects of adenosine and calcium channel antagonists and, if possible, to determine which is most appropriate for the management of supraventricular tachycardia.

Cochrane Systematic Review: Anti-inflammatory treatment for carditis in acute rheumatic fever

Cochrane Systematic Review: Anti-inflammatory treatment for carditis in acute rheumatic fever

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Cilliers A, Manyemba J, Adler AJ, Saloojee H

Cilliers A, Manyemba J, Adler AJ, Saloojee H

OBJECTIVES: To assess the effects of anti-inflammatory agents such as aspirin, corticosteroids, immunoglobulin and pentoxifylline for preventing or reducing further heart valve damage in patients with acute rheumatic fever.

OBJECTIVES: To assess the effects of anti-inflammatory agents such as aspirin, corticosteroids, immunoglobulin and pentoxifylline for preventing or reducing further heart valve damage in patients with acute rheumatic fever.

Cochrane Systematic Review: Antibiotic treatment for travellers' diarrhoea

Cochrane Systematic Review: Antibiotic treatment for travellers' diarrhoea

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De Bruyn G, Hahn S, Borwick A. Antibiotic treatment for travellers' diarrhoea. Cochrane Database Syst Rev. 2000;(3):CD002242. Review. PubMed PMID: 10908534.

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.

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: Physical methods versus drug placebo or no treatment for managing fever in children

Cochrane Systematic Review: Physical methods versus drug placebo or no treatment for managing fever in children

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Meremikwu M, Oyo-Ita A

Meremikwu M, Oyo-Ita A

OBJECTIVES: To evaluate the benefits and harms of physical cooling methods used for managing fever in children.

OBJECTIVES: To evaluate the benefits and harms of physical cooling methods used for managing fever in children.

Cochrane Systematic Review: Treatment of infantile spasms

Cochrane Systematic Review: Treatment of infantile spasms

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Hancock EC, Osborne JP, Edwards SW

Hancock EC, Osborne JP, Edwards SW

OBJECTIVES: To compare the effects of single pharmaceutical therapies used to treat infantile spasms in terms of control of the spasms, resolution of the EEG, relapse rates, psychomotor development, subsequent epilepsy, side effects, and mortality.

OBJECTIVES: To compare the effects of single pharmaceutical therapies used to treat infantile spasms in terms of control of the spasms, resolution of the EEG, relapse rates, psychomotor development, subsequent epilepsy, side effects, and mortality.

Cochrane Systematic Review: Decompressive craniectomy for the treatment of refractory high intracranial pressure in traumatic brain injury

Cochrane Systematic Review: Decompressive craniectomy for the treatment of refractory high intracranial pressure in traumatic brain injury

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Sahuquillo J, Arikan F

Sahuquillo J, Arikan F

OBJECTIVES: To assess the effects of secondary decompressive craniectomy (DC) on outcome and quality of life in patients with severe TBI in whom conventional medical therapeutic measures have failed to control raised ICP.

OBJECTIVES: To assess the effects of secondary decompressive craniectomy (DC) on outcome and quality of life in patients with severe TBI in whom conventional medical therapeutic measures have failed to control raised ICP.

Cochrane Systematic Review: Recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia

Cochrane Systematic Review: Recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia

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Simpson E, Lin Y, Stanworth S, Birchall J, Doree C, Hyde C

Simpson E, Lin Y, Stanworth S, Birchall J, Doree C, Hyde C

OBJECTIVES: To assess the effectiveness of rFVIIa when used therapeutically to control active bleeding or prophylactically to prevent (excessive) bleeding in patients without haemophilia.

OBJECTIVES: To assess the effectiveness of rFVIIa when used therapeutically to control active bleeding or prophylactically to prevent (excessive) bleeding in patients without haemophilia.

Cochrane Systematic Review: Treatment of seizures in multiple sclerosis

Cochrane Systematic Review: Treatment of seizures in multiple sclerosis

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Koch MW, Polman SK, Uyttenboogaart M, De Keyser J

Koch MW, Polman SK, Uyttenboogaart M, De Keyser J

OBJECTIVES: To evaluate the efficacy and safety of antiepileptic treatments in patients with MS.

OBJECTIVES: To evaluate the efficacy and safety of antiepileptic treatments in patients with MS.

Cochrane Systematic Review: Medical treatment for botulism

Cochrane Systematic Review: Medical treatment for botulism

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Chalk CH, Benstead TJ, Keezer M

Chalk CH, Benstead TJ, Keezer M

OBJECTIVES: To assess the effects of medical treatments on mortality, duration of hospitalization, mechanical ventilation, tube or parenteral feeding and risk of adverse events in botulism.

OBJECTIVES: To assess the effects of medical treatments on mortality, duration of hospitalization, mechanical ventilation, tube or parenteral feeding and risk of adverse events in botulism.

Cochrane Systematic Review: Salicylate for the treatment of Kawasaki disease in children

Cochrane Systematic Review: Salicylate for the treatment of Kawasaki disease in children

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Baumer JH, Love SJ, Gupta A, Haines LC, Maconochie I, Dua JS

Baumer JH, Love SJ, Gupta A, Haines LC, Maconochie I, Dua JS

OBJECTIVES: The objective of this review was to evaluate the effectiveness of salicylate in treating and preventing cardiac consequences of Kawasaki disease in children.

OBJECTIVES: The objective of this review was to evaluate the effectiveness of salicylate in treating and preventing cardiac consequences of Kawasaki disease in children.

Cochrane Systematic Review: Non-corticosteroid treatment for nephrotic syndrome in children

Cochrane Systematic Review: Non-corticosteroid treatment for nephrotic syndrome in children

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Pravitsitthikul N, Willis NS, Hodson EM, Craig JC

Pravitsitthikul N, Willis NS, Hodson EM, Craig JC

OBJECTIVES: To evaluate the benefits and harms of non-corticosteroid immunosuppressive medications in relapsing SSNS in children.

OBJECTIVES: To evaluate the benefits and harms of non-corticosteroid immunosuppressive medications in relapsing SSNS in children.

Cochrane Systematic Review: Treatment for lupus nephritis

Cochrane Systematic Review: Treatment for lupus nephritis

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Henderson L, Masson P, Craig JC, Flanc RS, Roberts MA, Strippoli GF, Webster AC

Henderson L, Masson P, Craig JC, Flanc RS, Roberts MA, Strippoli GF, Webster AC

OBJECTIVES: To assess the benefits and harms of different immunosuppressive treatments in biopsy-proven proliferative lupus nephritis.

OBJECTIVES: To assess the benefits and harms of different immunosuppressive treatments in biopsy-proven proliferative lupus nephritis.

Cochrane Systematic Review: Cisapride treatment for gastroesophageal reflux in children

Cochrane Systematic Review: Cisapride treatment for gastroesophageal reflux in children

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Maclennan S, Augood C, Cash-Gibson L, Logan S, Gilbert RE. Cisapride treatment for gastroesophageal reflux in children. Cochrane Database Syst Rev. 2010 Apr...

Maclennan S, Augood C, Cash-Gibson L, Logan S, Gilbert RE. Cisapride treatme...

OBJECTIVES: To determine the effectiveness of cisapride versus placebo or non-surgical treatments for symptoms of GOR.

OBJECTIVES: To determine the effectiveness of cisapride versus placebo or non-surgical treatments for symptoms of GOR.

Cochrane Systematic Review: Honey as a topical treatment for wounds  (2013)

Cochrane Systematic Review: Honey as a topical treatment for wounds

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Jull AB, Walker N, Deshpande S

Jull AB, Walker N, Deshpande S

OBJECTIVES: The objective was to determine whether honey increases the rate of healing in acute wounds (e.g. burns, lacerations) and chronic wounds (e.g. skin ulcers, infected surgical wounds).

OBJECTIVES: The objective was to determine whether honey increases the rate of healing in acute wounds (e.g. burns, lacerations) and chronic wounds (e.g. skin ulcers, infected surgical wounds).

Cochrane Systematic Review: Topical treatment for facial burns

Cochrane Systematic Review: Topical treatment for facial burns

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Hoogewerf CJ, Van Baar ME, Hop MJ, Nieuwenhuis MK, Oen IM, Middelkoop E

Hoogewerf CJ, Van Baar ME, Hop MJ, Nieuwenhuis MK, Oen IM, Middelkoop E

OBJECTIVES: To assess the effects of topical interventions on wound healing in people with facial burns of any depth.

OBJECTIVES: To assess the effects of topical interventions on wound healing in people with facial burns of any depth.

Cochrane Systematic Review: Pharmacological treatment other than corticosteroids, intravenous immunoglobulin and plasma exchange for Guillain-Barr syndrome  (2013)

Cochrane Systematic Review: Pharmacological treatment other than corticosteroids, intravenous immunoglobulin and plasma exchange for Guillain-Barr syndrome

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Hughes RA, Pritchard J, Hadden RD

Hughes RA, Pritchard J, Hadden RD

OBJECTIVES: To review systematically the evidence from randomised controlled trials (RCTs) for pharmacological agents other than plasma exchange, intravenous immunoglobulin and corticosteroids.

OBJECTIVES: To review systematically the evidence from randomised controlled trials (RCTs) for pharmacological agents other than plasma exchange, intravenous immunoglobulin and corticosteroids.

Systematic Review: Age- and severity-adjusted treatment of proximal humerus fractures in children and adolescents-A systematical review and meta-analysis  (2017)

Systematic Review: Age- and severity-adjusted treatment of proximal humerus fractures in children and adolescents-A systematical review and meta-analysis

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Hohloch L, Eberbach H, Wagner FC, Strohm PC, Reising K, Sdkamp NP, Zwingmann J

Hohloch L, Eberbach H, Wagner FC, Strohm PC, Reising K, Sdkamp NP, Zwingmann J

The aim of this systematic review was to gather the best evidence of different treatment methods and their associated functional outcome, complication rates, rates of limb length discrepancies and radiological outcome for proximal humerus fractures in children and adolescents.

The aim of this systematic review was to gather the best evidence of different treatment methods and their associated functional outcome, complication rates, rates of limb length discrepancies and radiological outcome for proximal humerus fractures in children and adolescents.

Systematic Review: Plate Fixation Versus Nonoperative Treatment for Displaced Midshaft Clavicular Fractures: A Meta-Analysis of Randomized Controlled Trials  (2017)

Systematic Review: Plate Fixation Versus Nonoperative Treatment for Displaced Midshaft Clavicular Fractures: A Meta-Analysis of Randomized Controlled Trials

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Woltz S, Krijnen P, Schipper IB

Woltz S, Krijnen P, Schipper IB

The aim was to analyze whether patients with a displaced midshaft clavicular fracture are best managed with plate fization or nonoperative treatment with respect to nonunion, secondary operations, and functional outcome, by evaluating all available randomized controlled trials on this subject.

The aim was to analyze whether patients with a displaced midshaft clavicular fracture are best managed with plate fization or nonoperative treatment with respect to nonunion, secondary operations, and functional outcome, by evaluating all available randomized controlled trials on this subject.

Systematic Review: Outcomes of Nonoperative Treatment of Salter-Harris II Distal Radius Fractures: A Systematic Review  (2016)

Systematic Review: Outcomes of Nonoperative Treatment of Salter-Harris II Distal Radius Fractures: A Systematic Review

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Larsen MC, Bohm KC, Rizkala AR, Ward CM

Larsen MC, Bohm KC, Rizkala AR, Ward CM

This systematic review was conducted of studies examining the radiographic and clinical outcomes of nonoperatively managed SH II distal radius fractures.

This systematic review was conducted of studies examining the radiographic and clinical outcomes of nonoperatively managed SH II distal radius fractures.

Review: Pediatric and Adolescent Forearm Fractures: Current Controversies and Treatment Recommendations  (2016)

Review: Pediatric and Adolescent Forearm Fractures: Current Controversies and Treatment Recommendations

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Pace JL

Pace JL

Pediatric and adolescent forearm fractures continue to present treatment challenges. Despite high-level evidence to the contrary, traditional guidelines for nonsurgical treatment have been challenged in favor of surgical intervention, but it is unclear if this results in improved outcomes. Recent evidence suggests that certain open fractures in children may be successfully treated nonsurgically. Good results have been achieved with closed reduction and appropriate casting and clinical follow-up. Further research investigating functional outcomes into adulthood is needed

Pediatric and adolescent forearm fractures continue to present treatment challenges. Despite high-level evidence to the contrary, traditional guidelines for nonsurgical treatment have been challenged in favor of surgical intervention, but it is unclear if this results in improved outcomes. Recent evidence suggests that certain open fractures in children may be successfully treated nonsurgically. Good results have been achieved with closed reduction and appropriate casting and clinical follow-up. Further research investigating functional outcomes into adulthood is needed

Systematic Review: The treatment of displaced supracondylar humerus fractures: evidence-based guideline  (2012)

Systematic Review: The treatment of displaced supracondylar humerus fractures: evidence-based guideline

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Mulpuri K, Wilkins K

Mulpuri K, Wilkins K

The purpose of this paper is to summarize and highlight the major findings from the systematic review that developed a clinical practice guideline from the American Academy of Orthopaedic Surgeons regarding treatment for type III supracondylar fractures.

The purpose of this paper is to summarize and highlight the major findings from the systematic review that developed a clinical practice guideline from the American Academy of Orthopaedic Surgeons regarding treatment for type III supracondylar fractures.

Key studies

Key Study: Reducing Time to Pain Medication Administration for Pediatric Patients with Long Bone Fractures in the Emergency Department  (2018)

Key Study: Reducing Time to Pain Medication Administration for Pediatric Patients with Long Bone Fractures in the Emergency Department

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Schuman, S S, Regen, R B, Stuart, L H, Harrell, C, Jones, T L, Stewart, B M, Berg, A M, Longjohn, M and Kink, R J

Schuman, S S, Regen, R B, Stuart, L H, Harrell, C, Jones, T L, Stewart, B M, ...

The purpose of this quality improvement project was to develop a protocol with the goal to administer pain medication to children presenting with suspected long bone fractures 47 minutes of emergency department arrival.

The purpose of this quality improvement project was to develop a protocol with the goal to administer pain medication to children presenting with suspected long bone fractures 47 minutes of emergency department arrival.

Key Study: Expedited Delivery of Pain Medication for Long-Bone Fractures Using an Intranasal Fentanyl Clinical Pathway  (2015)

Key Study: Expedited Delivery of Pain Medication for Long-Bone Fractures Using an Intranasal Fentanyl Clinical Pathway

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Schacherer, N M, Erikson Ramirez, D, Frazier, S B and Perkins, A M

Schacherer, N M, Erikson Ramirez, D, Frazier, S B and Perkins, A M

This study aims to determine whether a pathway designed to facilitate the use of intranasal (IN) fentanyl for long-bone fractures will expedite the delivery of pain medication, decrease the total length of emergency department (ED) stay, and provide faster analgesia compared with intravenous (IV) morphine.

This study aims to determine whether a pathway designed to facilitate the use of intranasal (IN) fentanyl for long-bone fractures will expedite the delivery of pain medication, decrease the total length of emergency department (ED) stay, and provide faster analgesia compared with intravenous (IV) morphine.

Key Study: Evaluation of low dose prostaglandin E1 treatment for ductus dependent congenital heart disease  (1995)

Key Study: Evaluation of low dose prostaglandin E1 treatment for ductus dependent congenital heart disease

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Kramer HH, Sommer M, Rammos S, Krogmann O

Kramer HH, Sommer M, Rammos S, Krogmann O

This study reports experience with low-dose prostaglandin E1 (PGE1) treatment of 91 newborns with ductus dependent congenital heart disease (CHD).

This study reports experience with low-dose prostaglandin E1 (PGE1) treatment of 91 newborns with ductus dependent congenital heart disease (CHD).

Key Study: Reducing resource utilization during non-operative treatment of pediatric proximal humerus fractures  (2017)

Key Study: Reducing resource utilization during non-operative treatment of pediatric proximal humerus fractures

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Gladstein AZ, Schade AT, Howard AW, Camp MW

Gladstein AZ, Schade AT, Howard AW, Camp MW

The primary outcome of the study was the proportion of proximal humerus fractures, initially treated non-operatively, for which displacement or angulation on follow-up radiographs led to a change to operative treatment.

The primary outcome of the study was the proportion of proximal humerus fractures, initially treated non-operatively, for which displacement or angulation on follow-up radiographs led to a change to operative treatment.

Key Study: Functional outcomes following non-operative versus operative treatment of clavicle fractures in adolescents  (2017)

Key Study: Functional outcomes following non-operative versus operative treatment of clavicle fractures in adolescents

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Herzog MM, Whitesell RC, Mac LM, Jackson ML, Culotta BA, Axelrod JR, Busch MT, Willimon SC

Herzog MM, Whitesell RC, Mac LM, Jackson ML, Culotta BA, Axelrod JR, Busch MT...

This study aimed to assess shoulder function in adolescents following shortened clavicle fracture and compare operative versus non-operative treatment.

This study aimed to assess shoulder function in adolescents following shortened clavicle fracture and compare operative versus non-operative treatment.

Key Study: Emerging U.S. National Trends in the Treatment of Pediatric Supracondylar Humeral Fractures  (2017)

Key Study: Emerging U.S. National Trends in the Treatment of Pediatric Supracondylar Humeral Fractures

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Holt JB, Glass NA, Bedard NA, Weinstein SL, Shah AS

Holt JB, Glass NA, Bedard NA, Weinstein SL, Shah AS

Understanding national treatment trends will provide important insight into variations in regional treatment standards and help identify areas for improvement in value in care delivery.

Understanding national treatment trends will provide important insight into variations in regional treatment standards and help identify areas for improvement in value in care delivery.

Key Study: Capitellar Fractures in Children and Adolescents: Classification and Early Results of Treatment  (2017)

Key Study: Capitellar Fractures in Children and Adolescents: Classification and Early Results of Treatment

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Murthy PG, Vuillermin C, Naqvi MN, Waters PM, Bae DS

Murthy PG, Vuillermin C, Naqvi MN, Waters PM, Bae DS

The purpose of this investigation was to characterize capitellar fracture patterns in children and adolescents and to assess early clinical and radiographic treatment outcomes.

The purpose of this investigation was to characterize capitellar fracture patterns in children and adolescents and to assess early clinical and radiographic treatment outcomes.

Key Study: Childhood Obesity Increases the Risk of Failure in the Treatment of Distal Forearm Fractures  (2016)

Key Study: Childhood Obesity Increases the Risk of Failure in the Treatment of Distal Forearm Fractures

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Auer RT, Mazzone P, Robinson L, Nyland J, Chan G

Auer RT, Mazzone P, Robinson L, Nyland J, Chan G

A retrospective case-controlled study was conducted to determine whether obesity is an independent risk factor for the failure of closed reduction and casting.

A retrospective case-controlled study was conducted to determine whether obesity is an independent risk factor for the failure of closed reduction and casting.

Key Study: Functional Outcomes After Treatment of Scaphoid Fractures in Children and Adolescents  (2016)

Key Study: Functional Outcomes After Treatment of Scaphoid Fractures in Children and Adolescents

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Bae DS, Gholson JJ, Zurakowski D, Waters PM

Bae DS, Gholson JJ, Zurakowski D, Waters PM

The purpose of this investigation was to characterize the functional outcomes of children and adolescents treated for scaphoid fractures.

The purpose of this investigation was to characterize the functional outcomes of children and adolescents treated for scaphoid fractures.

Key Study: Radiographic Evaluation During Treatment of Pediatric Forearm Fractures: Implications on Clinical Care and Cost  (2016)

Key Study: Radiographic Evaluation During Treatment of Pediatric Forearm Fractures: Implications on Clinical Care and Cost

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Luther G, Miller P, Waters PM, Bae DS

Luther G, Miller P, Waters PM, Bae DS

The purpose of this study was to analyze the clinical utility and cost of the week 4 radiograph following closed treatment of pediatric forearm fractures.

The purpose of this study was to analyze the clinical utility and cost of the week 4 radiograph following closed treatment of pediatric forearm fractures.

Key Study: Reducing Cost and Radiation Exposure During the Treatment of Pediatric Greenstick Fractures of the Forearm  (2016)

Key Study: Reducing Cost and Radiation Exposure During the Treatment of Pediatric Greenstick Fractures of the Forearm

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Ting BL, Kalish LA, Waters PM, Bae DS

Ting BL, Kalish LA, Waters PM, Bae DS

The purpose of this investigtion was to evaluate the LOR rate requiring intervention - including either repeat closed reduction or surgical reduction and fixation- following closed reduction and cast immobilization of pediatric greenstick forearm fractures.

The purpose of this investigtion was to evaluate the LOR rate requiring intervention - including either repeat closed reduction or surgical reduction and fixation- following closed reduction and cast immobilization of pediatric greenstick forearm fractures.

Key Study: Synthetic versus plaster of Paris casts in the treatment of fractures of the forearm in children: a randomised trial of clinical outcomes and patient satisfaction  (2013)

Key Study: Synthetic versus plaster of Paris casts in the treatment of fractures of the forearm in children: a randomised trial of clinical outcomes and patient satisfaction

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Inglis M, McClelland B, Sutherland LM, Cundy PJ

Inglis M, McClelland B, Sutherland LM, Cundy PJ

The aim of this study was to investigate which cast material is superior for the management of fractures of the forearm.

The aim of this study was to investigate which cast material is superior for the management of fractures of the forearm.

Key Study: Simple treatment for torus fractures of the distal radius  (2001)

Key Study: Simple treatment for torus fractures of the distal radius

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Davidson JS, Brown DJ, Barnes SN, Bruce CE

Davidson JS, Brown DJ, Barnes SN, Bruce CE

Based on the results of a postal questionnaire and a prospective randomised trial, this study descibes a simple treatement for a torus fracture of the distal radius, which saves both time and money.

Based on the results of a postal questionnaire and a prospective randomised trial, this study descibes a simple treatement for a torus fracture of the distal radius, which saves both time and money.

Key Study: Emergency room closed reduction versus in situ splinting in the treatment of paediatric supracondylar humerus fractures  (2019)

Key Study: Emergency room closed reduction versus in situ splinting in the treatment of paediatric supracondylar humerus fractures

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Sylvia, SM, Maguire, KJ, Molho, DA, Levens, BJ, Stone, MEJ, Hanstein, R, Schulz, JF and Fornari, ED

Sylvia, SM, Maguire, KJ, Molho, DA, Levens, BJ, Stone, MEJ, Hanstein, R, Schu...

The purpose of this study was to investigate if outcomes or complications differ between two management methods.

The purpose of this study was to investigate if outcomes or complications differ between two management methods.

Key Study: A comparison of intervention and conservative treatment for angulated fractures of the distal forearm in children (AFIC): study protocol for a randomized controlled trial  (2015)

Key Study: A comparison of intervention and conservative treatment for angulated fractures of the distal forearm in children (AFIC): study protocol for a randomized controlled trial

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Adrian, M, Wachtlin, D, Kronfeld, K, Sommerfeldt, D and Wessel, LM

Adrian, M, Wachtlin, D, Kronfeld, K, Sommerfeldt, D and Wessel, LM

The primary objective of this trial is to assess whether or not the long-term functional outcome in remodeling patients is inferior to patients receiving closed reduction and K-wire pinning.

The primary objective of this trial is to assess whether or not the long-term functional outcome in remodeling patients is inferior to patients receiving closed reduction and K-wire pinning.

Key Study: Multiple interventions improve analgesic treatment of supracondylar humerus fractures in a pediatric emergency department  (2015)

Key Study: Multiple interventions improve analgesic treatment of supracondylar humerus fractures in a pediatric emergency department

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Porter, RN, Chafe, RE, Newhook, LA and Murnaghan, KD

Porter, RN, Chafe, RE, Newhook, LA and Murnaghan, KD

To measure the effectiveness of a set of interventions in improving the rate and timeliness of analgesic medication administration, as well as appropriate backslab immobilization (application of a moldable plaster or fiberglass splint), in a pediatric ED.

To measure the effectiveness of a set of interventions in improving the rate and timeliness of analgesic medication administration, as well as appropriate backslab immobilization (application of a moldable plaster or fiberglass splint), in a pediatric ED.

Antipyretic treatment in young children with fever: acetaminophen, ibuprofen, or both alternating in a randomized, double-blind study  (2006)

Antipyretic treatment in young children with fever: acetaminophen, ibuprofen, or both alternating in a randomized, double-blind study

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Sarrell EM, Wielunsky E, Cohen HA.

Sarrell EM, Wielunsky E, Cohen HA.

To compare the antipyretic benefit of acetaminophen or ibuprofen monotherapy with an alternating regimen of both drugs in young children aged 6 to 36 months.

To compare the antipyretic benefit of acetaminophen or ibuprofen monotherapy with an alternating regimen of both drugs in young children aged 6 to 36 months.

Other

Emergency Medicine Cases Podcast: Pediatric abdominal pain & appendicitis  (2010)

Emergency Medicine Cases Podcast: Pediatric abdominal pain & appendicitis

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Dr. Anna Jarvis & Dr. Stephen Freedman

Dr. Anna Jarvis & Dr. Stephen Freedman

Episode 19 Part 1:In Part 1 of this Episode on Pediatric Abdominal Pain, Dr. Anna Jarvis & Dr. Stephen Freedman discuss the nuances of the history, physical and work up of Pediatric Abdominal Pain & Appendicitis and key pearls on how to distinguish serious surgical causes from the very common diagnosis of gastroenteritis. An in-depth discussion on the pearls of the history, physical exam, lab tests, imaging including serial ultrasounds vs CT abdomen, clinical decision rules such as the Alvarado Score, best analgesics and antibiotics in pediatric appendicitis follows. Published online: December 2011.  

Episode 19 Part 1:In Part 1 of this Episode on Pediatric Abdominal Pain, Dr. Anna Jarvis & Dr. Stephen Freedman discuss the nuances of the history, physical and work up of Pediatric Abdominal Pain & Appendicitis and key pearls on how to distinguish serious surgical causes from the very common diagnosis of gastroenteritis. An in-depth discussion on the pearls of the history, physical exam, lab tests, imaging including serial ultrasounds vs CT abdomen, clinical decision rules such as the Alvarado Score, best analgesics and antibiotics in pediatric appendicitis follows. Published online: December 2011.  

Emergency Medicine Cases Podcast: Pediatric Pain Management  (2015)

Emergency Medicine Cases Podcast: Pediatric Pain Management

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Dr. Samina Ali & Dr. Anthony Crocco

Dr. Samina Ali & Dr. Anthony Crocco

Episode 67: Pain is the most common reason for seeking health care. It accounts for 80% of ED visits. The WHO has declared that “optimal pain treatment is a human right”. As has been shown in multiple ED-based Pediatric pain management studies, Pediatric pain is all too often under-estimated and under-treated. Why does this matter? Under-estimating and under-treating pediatric pain may have not only short term detrimental effects but life-long detrimental effects as well; not to mention, screaming miserable children disturbing other patients in your ED and complaints to the hospital from parents. Whether it’s venipuncture, laceration repair, belly pain or reduction of a fracture we need to have the skills and knowledge to optimize efficient and effective pain management in all the kids we see in the ED. What are the indications for intranasal fentanyl? intranasal ketamine? Why should codeine be contra-indicated in children? How do triage-initaited pain protocols improve pediatric pain management? Which are most effective skin analgesics for venipuncture? To help you make these important pediatric pain management decisions, in this podcast we have one of the most prominent North American researchers and experts in Emergency Pediatric pain management, Dr. Samina Ali and not only the chief of McMaster Children’s ED but also the head of the division of Pediatric EM at McMaster University, Dr. Anthony Crocco.

Episode 67: Pain is the most common reason for seeking health care. It accounts for 80% of ED visits. The WHO has declared that “optimal pain treatment is a human right”. As has been shown in multiple ED-based Pediatric pain management studies, Pediatric pain is all too often under-estimated and under-treated. Why does this matter? Under-estimating and under-treating pediatric pain may have not only short term detrimental effects but life-long detrimental effects as well; not to mention, screaming miserable children disturbing other patients in your ED and complaints to the hospital from parents. Whether it’s venipuncture, laceration repair, belly pain or reduction of a fracture we need to have the skills and knowledge to optimize efficient and effective pain management in all the kids we see in the ED. What are the indications for intranasal fentanyl? intranasal ketamine? Why should codeine be contra-indicated in children? How do triage-initaited pain protocols improve pediatric pain management? Which are most effective skin analgesics for venipuncture? To help you make these important pediatric pain management decisions, in this podcast we have one of the most prominent North American researchers and experts in Emergency Pediatric pain management, Dr. Samina Ali and not only the chief of McMaster Children’s ED but also the head of the division of Pediatric EM at McMaster University, Dr. Anthony Crocco.

Manitoba Adolescent Treatment Centre- Centre de traitement des adolescents du Manitoba  (2021)

Manitoba Adolescent Treatment Centre- Centre de traitement des adolescents du Manitoba

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MATC provides a range of mental health services to children and adolescents who experience psychiatric and/or emotional disorders.

Le MATC offre une gamme de services de santé mentale aux enfants et aux adolescents qui souffrent de troubles psychiatriques ou émotionnels.

MATC provides a range of mental health services to children and adolescents who experience psychiatric and/or emotional disorders.

Le MATC offre une gamme de services de santé mentale aux enfants et aux adolescents qui souffrent de troubles psychiatriques ou émotionnels.

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Canadian Paediatric Society Position Statement: Pain Management

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