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OBJECTIVE Previous research has identified clinical predictors for urinary tract infection (UTI) to guide urine screening in febrile children <24 months of age. These studies have been limited to single centers, and few have focused on young infants who may be most at risk for complications if a UTI is missed. The objective of this study was to identify(More)
Urinary tract infection (UTI) is among the most commonly diagnosed bacterial infections of childhood. Although frequently encountered and well researched, diagnosis and management of UTI continue to be a controversial issue with many challenges for the clinician. Prevalence studies have shown that UTI may often be missed on history and physical examination,(More)
BACKGROUND The evaluation of young febrile infants is controversial, in part because it is unclear whether clinical evidence of a viral infection significantly reduces the risk of serious bacterial infections (SBIs). Specifically, it remains unclear whether the risk of SBI is altered in a meaningful way in the presence of respiratory syncytial virus (RSV)(More)
OBJECTIVES Bronchiolitis is a leading cause of infant hospitalization in the United States; the mean length of stay (LOS) is 3.3 days. We sought to identify the initial clinical characteristics of bronchiolitis associated with admission and with longer LOS in a large multicenter clinical trial. METHODS This study was a secondary analysis of a randomized(More)
Viral bronchiolitis is a leading cause of acute illness and hospitalization of young children. Research into the variation in treatment and outcomes for bronchiolitis across different settings has led to evidence-based clinical practice guidelines. Ongoing investigation continues to expand this body of evidence. Authors of recent surveillance studies have(More)
OBJECTIVE To determine if the addition of ipratropium bromide to the emergency department (ED) treatment of childhood asthma reduces time to discharge, number of nebulizer treatments before discharge, and the rate of hospitalization. METHODS Patients >12 months of age were eligible if they were to be treated according to a standardized ED protocol for(More)
OBJECTIVE Prior studies have reported low rates of follow-up with a primary care provider (PCP) after emergency department (ED) treatment for asthma. We sought to identify predictors associated with PCP follow-up. METHODS As part of a randomized trial we surveyed parents of children aged 2-18 years being discharged after ED asthma treatment. Parents(More)
Viral bronchiolitis is a common clinical syndrome affecting infants and young children. Concern about its associated morbidity and cost has led to a large body of research that has been summarised in systematic reviews and integrated into clinical practice guidelines in several countries. The evidence and guideline recommendations consistently support a(More)
BACKGROUND Bronchiolitis, the most common infection of the lower respiratory tract in infants, is a leading cause of hospitalization in childhood. Corticosteroids are commonly used to treat bronchiolitis, but evidence of their effectiveness is limited. METHODS We conducted a double-blind, randomized trial comparing a single dose of oral dexamethasone (1(More)
OBJECTIVE Cerebrospinal fluid (CSF) white blood cell (WBC) counts for neonates and young infants are usually interpreted on the basis of values reported in reference texts or handbooks; however, current reference texts either present normal CSF parameters without citation or cite studies with significant limitations. The objective of this study was to(More)