BMJ : British medical journal
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Randomized Controlled Trial Multicenter Study
Paracetamol plus ibuprofen for the treatment of fever in children (PITCH): randomised controlled trial.
To investigate whether paracetamol (acetaminophen) plus ibuprofen are superior to either drug alone for increasing time without fever and the relief of fever associated discomfort in febrile children managed at home. ⋯ Parents, nurses, pharmacists, and doctors wanting to use medicines to supplement physical measures to maximise the time that children spend without fever should use ibuprofen first and consider the relative benefits and risks of using paracetamol plus ibuprofen over 24 hours.
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Randomized Controlled Trial Multicenter Study Comparative Study
Minimal access surgery compared with medical management for chronic gastro-oesophageal reflux disease: UK collaborative randomised trial.
To determine the relative benefits and risks of laparoscopic fundoplication surgery as an alternative to long term drug treatment for chronic gastro-oesophageal reflux disease (GORD). ⋯ At least up to 12 months after surgery, laparoscopic fundoplication significantly increased measures of health status in patients with GORD.
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Multicenter Study
Manchester triage system in paediatric emergency care: prospective observational study.
To validate use of the Manchester triage system in paediatric emergency care. ⋯ The Manchester triage system has moderate validity in paediatric emergency care. It errs on the safe side, with much more over-triage than under-triage compared with an independent reference standard for urgency. Triage of patients with a medical problem or in younger children is particularly difficult.
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Multicenter Study
Quality of clinical aspects of call handling at Dutch out of hours centres: cross sectional national study.
To assess the quality of telephone triage by following the consecutive phases of its care process and the quality of the clinical questions asked about the patient's clinical condition, of the triage outcome, of the content of the home management advice, and of the safety net advice given at out of hours centres. ⋯ In determining the outcome of the care process, triagists often reached a conclusion after asking a minimal number of questions. By analysing the quality of different phases within the process of telephone triage, evaluation of whether an appropriate triage outcome has been arrived at by means of good clinical reasoning or by an educated guess is possible. In terms of enhancing the overall clinical safety of telephone triage, apart from obtaining an appropriate clinical history, adequate home management and safety net advice must also be given.
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Multicenter Study
What oncologists tell patients about survival benefits of palliative chemotherapy and implications for informed consent: qualitative study.
To examine how much oncologists tell patients about the survival benefit of palliative chemotherapy during consultations at which decisions about treatment are made. ⋯ Most patients were not given clear information about the survival gain of palliative chemotherapy. To aid decision making and informed consent, we recommend that oncologists sensitively describe the benefits and limitations of this treatment, including survival gain.