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189 Indeed, as stated by McCullough, “The few clinical studies of (acetaminophen) and ibuprofen in children have struggled to find objective measures of pain capable of reliably distinguishing between active treatment and placebo.” 189 Thus it seems unwise to risk potentially permanent neurological injury for apparently ineffective pain relief

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Initial treatment may involve frequent injections followed by maintenance regimens, with periodic review of symptoms and, where appropriate, blood counts