Fever and antipyretic use in children.
ABSTRACT Fever in a child is one of the most common clinical symptoms managed by pediatricians and other health care providers and a frequent cause of parental concern. Many parents administer antipyretics even when there is minimal or no fever, because they are concerned that the child must maintain a "normal" temperature. Fever, however, is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection. There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications. Thus, the primary goal of treating the febrile child should be to improve the child's overall comfort rather than focus on the normalization of body temperature. When counseling the parents or caregivers of a febrile child, the general well-being of the child, the importance of monitoring activity, observing for signs of serious illness, encouraging appropriate fluid intake, and the safe storage of antipyretics should be emphasized. Current evidence suggests that there is no substantial difference in the safety and effectiveness of acetaminophen and ibuprofen in the care of a generally healthy child with fever. There is evidence that combining these 2 products is more effective than the use of a single agent alone; however, there are concerns that combined treatment may be more complicated and contribute to the unsafe use of these drugs. Pediatricians should also promote patient safety by advocating for simplified formulations, dosing instructions, and dosing devices.
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ABSTRACT: Many parents consider fever a disease in itself and feel disempowered when their child is ill. Numerous guidelines have been produced; however, their target audience remains healthcare professionals and not carers of children in general. A reliable source of information will decrease worry in parents and carers when managing a febrile child. A systematic search will be conducted in nine electronic databases. Articles published in English, or with an abstract published in English, will be eligible for inclusion in the review. Unpublished literature, grey literature and consultation with experts in the area will be used to supplement database searching. Titles and abstracts of studies will be screened for inclusion in the study by two independent reviewers against pre-determined inclusion and exclusion criteria. A data extraction form will be designed and data will be extracted to provide detail of the included studies by a further two reviewers. Quality assessment of studies will be conducted by two additional independent reviewers and results will be used to moderate included studies. All disagreements will be resolved through discussion until consensus is reached. Thematic synthesis will be used to analyse results. Correct management of fever in children is not well understood in the general population. Although carers can identify fever and febrile illness in children, determination of the severity of fever proves challenging. Research is needed to cohere existing evidence and identify knowledge gaps. It is envisaged that results of this review will contribute to the development of trustworthy, accessible guidelines for parents and carers of children with fever or febrile illness. PROSPERO CRD42014009812.03/2015; 4(1). DOI:10.1186/s13643-015-0021-7
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ABSTRACT: A novel molecular imprinted polymeric (MIP) micelle was prepared via macromolecule self-assembly of an amphiphilic photo-crosslinkable copolymer in combination with a molecular imprinting technique using paracetamol as the template molecule, and applied as a molecular recognition element to construct paracetamol (PCM) electrochemical sensor. The template molecules (PCM) were imbedded in the copolymer micelle during the self-assembly micellization of amphiphilic copolymers through the interactions between PCM and copolymer chain. A robust MIP film was formed in situ on the electrode surface by electrodeposition of the MIP micelles and subsequent photo-crosslinking, leading to successful construction of a MIP sensor. Using differential pulse stripping voltammetry (DPSV), selective detection of PCM in a linear concentration range of 1 mu M-4 mM was obtained, revealing wider linear response and higher upper detection limit of detection compared to previously reported PCM electrochemical sensors, which was attributed to numerous effective recognition sites among the polymer matrix due to the large specific surface area of MIP micelles. In addition, this MIP sensor showed excellent selectivity to PCM, and the interferences from structurely similar analogs were effectively avoided. Excellent stability and repeatability has also been exhibited. Finally, it was successfully applied to detect PCM in real samples with good recoveries. Together, these results indicate that our MIP sensor is a promising platform for accurate and reproducible detection of PCM.Sensors and Actuators B Chemical 11/2013; 188:909-916. DOI:10.1016/j.snb.2013.07.088 · 3.84 Impact Factor