Anales españoles de pediatría
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To assess the frequency of the use of alternating antipyretics among Spanish pediatricians and to analyze the factors that determine this practice. ⋯ Despite the lack of scientific evidence to justify the practice, the use of alternating antipyretics is common in the treatment of febrile children. Predictive factors of this practice among pediatricians are male sex, having relatively little experience, considering ibuprofen as the drug of choice and recommending the administration of new doses of antipyretic to control mild fever.
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Medical practice is changing due to the more efficient use of the biomedical literature in making decisions on the care of individual patients. This constitutes a new scientific paradigm: evidence-based medicine (EBM). The factors that may explain the growing interest in EBM are awareness of variability in clinical practice, the importance of the efficacy, effectiveness and efficiency of new health technologies, and ease of access to biomedical literature (especially through the Internet). ⋯ EBM emphasizes benefit to the individual patient and its key point is efficacy, since the principal source of information are clinical trials and meta-analyses in "ideal" clinical practice. Medicine-based evidence, as the complement of EBM, emphasizes benefit to society and its key point is the effectiveness and efficiency of health interventions, since the main information sources are measures of health-related quality of life and economic analyses in "normal" clinical practice. Total quality management aims at medicine based evidence.
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Comparative Study
[Procalcitonin in the early diagnosis of invasive bacterial infection in febrile infants].
Procalcitonin (PCT) it is a new marker of bacterial infection. Because of its shorter half-life and earlier ascent it offers advantages over C-reactive protein (CRP). ⋯ The diagnostic performance of PCT was higher than that of CRP in the early detection of invasive infection in febrile infants, even when evolution was less than 12 hours.
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Bronchiolitis is the most frequent respiratory tract disease in the first 2 years of life. It occurs in epidemics in winter and spring. Etiology is viral and the most frequent causative agent is respiratory syncytial virus. ⋯ The present study provides a review of the medical literature on the most commonly used clinical scores and the therapeutic efficacy of the different drugs employed. A protocol for the practical management of bronchiolitis is provided. The use of inhaled adrenaline in the treatment of moderate-to-severe bronchiolitis in hospitalized infants, as well as oxygen and fluid therapy as support measures, are recommended.