Ian K. Hewitt

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BACKGROUND Children with febrile urinary tract infection commonly have vesicoureteral reflux. Because trial results have been limited and inconsistent, the use of antimicrobial prophylaxis to prevent recurrences in children with reflux remains controversial. METHODS In this 2-year, multisite, randomized, placebo-controlled trial involving 607 children(More)
OBJECTIVES Febrile urinary tract infections are common in children and associated with the risk for renal scarring and long-term complications. Antimicrobial prophylaxis has been used to reduce the risk for recurrence. We performed a study to determine whether no prophylaxis is similar to antimicrobial prophylaxis for 12 months in reducing the recurrence of(More)
From the Department of Pediatrics, Azi en­ da Ospedaliero–Universitaria Sant’Orsola­ Mal pighi, Bologna, Italy (G.M.); the De­ partment of Pediatric Nephrology, Great Or mond Street Hospital, London (K.T.); and Princess Margaret Hospital for Chil­ dren, Perth, Australia (I.H.). Address reprint requests to Dr. Montini at the Department of Pediatrics, Azienda(More)
OBJECTIVE To evaluate the yield, economic, and radiation costs of 5 diagnostic algorithms compared with a protocol where all tests are performed (ultrasonography scan, cystography, and late technetium(99)dimercaptosuccinic acid scan) in children after the first febrile urinary tract infections. METHODS A total of 304 children, 2 to 36 months of age, who(More)
OBJECTIVES The American Academy of Pediatrics recommendation for febrile infants and young children suspected of having a urinary tract infection is early antibiotic treatment, given parenterally if necessary. In support of this recommendation, data suggesting that delay in treatment of acute pyelonephritis increases the risk of kidney damage are cited.(More)
OBJECTIVE We examined the diagnostic accuracy of routine imaging studies (ultrasonography and micturating cystography) for predicting long-term parenchymal renal damage after a first febrile urinary tract infection. METHODS This study addressed the secondary objective of a prospective trial evaluating different antibiotic regimens for the treatment of(More)
Urinary tract infections, with or without reflux, are the most frequent reason for long-term antibacterial prophylaxis in infants and children. When one is considering the use of prophylaxis in these children, what is clear from existing published data? Up to 2006 there were a small number of poor quality studies, with no reliable evidence of the(More)
Linear growth of 17 children receiving CAPD was compared with growth in 18 patients receiving hemodialysis and 20 who had undergone transplantation, as well as with the previous growth in 11 of the 17 patients. Growth was normal in 10 receiving CAPD, fair in six others, and poor in only one. Growth velocity indexes in those receiving CAPD were significantly(More)
Urinary red cell morphology has been used to indicate the source of renal tract bleeding. A double blind study was undertaken to evaluate the reliability of urinary red cell morphology in predicting the source of hematuria in a pediatric population. Two independent observers used phase-contrast microscopy, one also using Nomarski differential interference(More)
The immune system, and disturbed T lymphocyte function in particular, has previously been implicated in the pathogenesis of childhood idiopathic nephrotic syndrome. As this disorder is commonly responsive to steroid therapy, we set out to determine whether in vitro suppresion of lymphocyte blastogenic response to the mitogen phytohaemagglutinin (PHA) could(More)