Jornal de pediatria
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To describe the current knowledge and indications for use of hypertonic saline solutions in pediatrics patients. ⋯ Resuscitation by means of hypertonic saline solutions associated or not with colloid solutions is one of the most innovative concepts for primary resuscitation from trauma and shock established in the past decade. Currently, the spectrum of potential indications involves not only prehospital trauma care, but also perioperative and intensive care therapy. However, additional randomized double-blind studies are required with both children and adult patients to confirm the advantages of the method in terms of survival.
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To review the current therapeutic approach of intracranial hypertension in pediatric patients admitted to intensive care unit. ⋯ The goals of management of pediatric patients with intracranial hypertension include: normalizing the intracranial pressure, optimizing cerebral blood flow and cerebral perfusion pressure, preventing second insults that exacerbate secondary injury, and avoiding complications associated with the various treatment modalities employed.
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Jornal de pediatria · May 2003
Review[Acute upper respiratory tract infections: outpatient diagnosis and treatment].
To present an updated review of the most common upper respiratory infections (URI) in children seen by the pediatrician in outpatient clinics, for better diagnostic and therapeutic decisions. ⋯ URI are the most common cause of visits to pediatrician clinics. Therefore, update and critical concepts, as well as references are essential for a proper management of these illnesses, decreasing the indication of unnecessary diagnostic tests and avoiding non-effective and harmful treatments.
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Jornal de pediatria · Jan 2003
Review Comparative Study[Prognostic factors and survival in neonates with congenital diaphragmatic hernia].
To evaluate the prognostic factors importance to survival in neonatal period of newborns with congenital diaphragmatic hernia treated at Hospital das Clínicas, School of Medicine of Universidade de São Paulo, and to compare the outcome with data published in medical literature. So that the results of this study might allow updating family counseling and guiding changes in clinical management of our department. ⋯ Our high mortality rate of newborns with congenital diaphragmatic hernia is statistically similar to that described in international publications. In the group of non-responsive patients to standard treatment available, the use of extracorporeal membrane oxygenation should be able to reduce mortality. The impact of this therapeutical strategy in the overall survival depends on other factors that were not analyzed in the present study. Family counseling of patients' parents on congenital diaphragmatic hernia in our department may follow the same patterns referred in world medical literature.