Gabrielle J Williams

Children's Hospital at Westmead

Background: In patients with CKD, the risk of developing colorectal cancer is high and outcomes are poor. Screening using fecal immunochemical testing (FIT) is effective in reducing mortality from colorectal cancer, but performance characteristics of FIT in CKD are unknown. Methods: To determine the detection rates and performance characteristic...

Background: Urinary tract infection (UTI) is common in children. Symptoms include fever, lethargy, anorexia, and vomiting. UTI is caused by Escherichia coli in over 80% of cases and treatment is a course of antibiotics. Due to acute illness caused by UTI and the risk of pyelonephritis-induced permanent kidney damage, many children are given long-t...

Background: Vesicoureteric reflux (VUR) results in urine passing retrograde up the ureter. Urinary tract infections (UTI) associated with VUR have been considered a cause of permanent renal parenchymal damage in children with VUR. Management has been directed at preventing UTI by antibiotic prophylaxis and/or surgical correction of VUR. This is an...

Objective The aim was to compare quality of life (QoL) among children and adolescents with different stages of chronic kidney disease (CKD) and determine factors associated with changes in QoL. Design Cross-sectional. Setting The Kids with CKD study involved five of eight paediatric nephrology units in Australia and New Zealand. Patients There w...

To the Editor: The Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial reported by Hoberman et al. (June 19 issue)(1) was similar to our Prevention of Recurrent Urinary Tract Infection in Children with Vesicoureteric Reflux and Normal Renal Tracts (PRIVENT) trial.(2) Despite differences in the study populations of the PRIV...

Commentary on ; RIVUR Trial Investigators, Hoberman A, Greenfield SP, Mattoo TK, et al. Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med 2014;370:2367–76.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Urinary tract infections (UTIs) are common in children and can cause considerable morbidity; furthermore, UT...

The leukocyte count is frequently used to evaluate suspected bacterial infections but estimates of its test performance vary considerably. We evaluated its accuracy for the detection of serious bacterial infections in febrile children. Prospective cohort study. Paediatric emergency department. Febrile 0-5-year-olds who had a leukocyte count on pres...

Body temperature is a time-honored marker of serious bacterial infection but there are few studies of its test performance. The aim of our study was to determine the accuracy of temperature measured on presentation to medical care for detecting serious bacterial infection. Febrile children 0-5 years of age, presenting to the emergency department of...

Consolidation on chest radiography is widely used as the reference standard for defining pneumonia and variability in interpretation is well known but not well explored or explained. Three pediatric sub-specialists (infectious diseases, radiology and respiratory medicine) viewed 3,033 chest radiographs in children aged under 5 years of age who pres...

Clinical question: Are cranberry products (juice, tablets, capsules, and syrup) associated with prevention of urinary tract infections (UTIs) compared with placebo or other treatments? Bottom line: Cranberry products are not associated with prevention of UTIs. However, lack of association of cranberry products with a reduced incidence of UTIs in...

Urinary tract infection (UTI) is common in children, causes them considerable discomfort, as well as distress to parents and has a tendency to recur. Approximately 20% of those children who experience one infection will have a repeat episode. Since 1975, 11 trials of long-term antibiotics compared with placebo or no treatment in 1,550 children have...

To determine the accuracy of a clinical decision rule (the traffic light system developed by the National Institute for Health and Clinical Excellence (NICE)) for detecting three common serious bacterial infections (urinary tract infection, pneumonia, and bacteraemia) in young febrile children. Retrospective analysis of data from a two year prospec...

Supplementary table 4: Proportion of children who had urine analysis according to patient characteristics

Cranberries have been used widely for several decades for the prevention and treatment of urinary tract infections (UTIs). This is the third update of our review first published in 1998 and updated in 2004 and 2008. To assess the effectiveness of cranberry products in preventing UTIs in susceptible populations. Search methods: We searched MEDLINE,...

Cranberries (usually as cranberry juice) have been used to prevent urinary tract infections (UTIs). Cranberries contain a substance that can prevent bacteria from sticking on the walls of the bladder. This may help prevent bladder and other UTIs. This review identified 24 studies (4473 participants) comparing cranberry products with control or alte...

Low participation rates in randomised controlled trials involving children are almost a universal problem, leading to high cost and low statistical power. Trial, parent/family, child, and physician factors have been reported to influence parental willingness to consent for paediatric trials. To identify modifiable and unmodifiable factors associate...

Pediatric practice is not different from other medical specialties: it is full of beliefs—some true and some false, some harmful and some not. Generations of budding pediatricians have been educated about the perils of urinary tract infection (UTI) in children. Since the 1950s we have been taught that UTI is not like other acute infectious illnesse...

: Vesicoureteric reflux (VUR) results in urine passing retrograde up the ureter. Urinary tract infections (UTI) associated with VUR have been considered a cause of permanent renal parenchymal damage in children with VUR. Management of these children has been directed at preventing UTI by antibiotic prophylaxis and/or surgical correction of VUR. The...

Background: Urinary tract infection (UTI) is common in children. Symptoms include fever, lethargy, anorexia, and vomiting. UTI is caused by Escherichia coli in over 80% of cases and treatment is a course of antibiotics. Due to acute illness caused by UTI and the risk of pyelonephritis-induced permanent kidney damage, many children are given long-t...

A young child presents to their primary health provider with fever and irritability. How likely is a urinary tract infection? How should a urine sample be collected? How accurate are urinary dipsticks and microscopy compared with culture for the diagnosis? What route and type of antibiotics should be used? What imaging is indicated? Diagnosing and...

Systematic reviews of randomized controlled trials are well-recognized as the best evidence for an intervention and are also becoming more available for diagnostic test evaluation. In the absence of a well-conducted and well-reported systematic review clinicians must rely on primary studies to determine how best to interpret and understand diagnost...

Web table A Frequency of factors and model estimates for predicting pneumonia, urinary tract infection, and bacteraemia

Web table B Additional variables for urine analysis and urinary tract infection

Web extra file Variables that were not selected in the final model

To evaluate current processes by which young children presenting with a febrile illness but suspected of having serious bacterial infection are diagnosed and treated, and to develop and test a multivariable model to distinguish serious bacterial infections from self limiting non-bacterial illnesses. Design Two year prospective cohort study. Setting...

Rapid urine tests, such as microscopy, for bacteria and white cells, and dipsticks, for leucocyte esterase and nitrites, are often used in children that are unwell to guide early diagnosis and treatment of urinary tract infection. We aimed to establish whether these tests were sufficiently sensitive to avoid urine culture in children with negative...

Renal tract imaging after urinary tract infection (UTI) has been widely recommended but clinical practice varies substantially among paediatricians. To describe changes in knowledge and reported ordering practices of paediatricians in response to an evidence based summary about prevalence of abnormalities and test performance of renal tract imaging...

Antibiotics are widely administered to children with the intention of preventing urinary tract infection, but adequately powered, placebo-controlled trials regarding efficacy are lacking. This study from four Australian centers examined whether low-dose, continuous oral antibiotic therapy prevents urinary tract infection in predisposed children. We...

Urinary tract infection (UTI) in children is common (5-10%) and recurs in 10-30%. UTI causes an unpleasant, usually febrile illness in children. This review focuses on studies evaluating interventions to prevent UTI in children and published between January 2007 and June 2008. Three relevant updated Cochrane reviews, six randomized trials and an ev...

Vesicoureteral reflux (VUR), the retrograde flow of urine from the bladder toward the kidney, is common in young children. About 30% of children with urinary tract infections will be diagnosed with VUR after a voiding cystourethrogram. For most, VUR will resolve spontaneously; 20% to 30% will have further infections, but few will experience long-te...

To describe paediatricians' reported ordering of renal tract imaging of children following urinary tract infection. This is a piloted self-administered survey. A total of 354 randomly sampled practising paediatricians in Australia participated in the survey. The survey included 12 clinical scenarios that varied with age, gender and fever. Responden...

The purpose of this study was to evaluate the test performance of duplex sonographic parameters in screening for hemodynamically significant renal artery stenosis, which occurs in approximately 5% of persons with hypertension. A comprehensive literature search was conducted to find studies on the diagnosis of renal artery stenosis in which duplex s...

Background: Acute urinary tract infection (UTI) is common in children. By the age of seven 8.4% of girls and 1.7% of boys will have suffered at least one episode. Symptoms include fever, lethargy, anorexia, and vomiting. UTI is caused by Escherichia coli in over 80% of cases and treatment consists of a course of antibiotics. Due to acute illness c...

Objective: The objective was to evaluate the effectiveness of low-dose, long-term antibiotics for the prevention of symptomatic urinary tract infection (UTI) in children. Design: This was a systematic review of randomized controlled trials with a random effects model meta-analysis. Participants: Five trials involving 463 children were performed. Re...

Acute urinary tract infection (UTI) is common in children. By the age of seven years, 8.4% of girls and 1.7% of boys will have suffered at least one episode. Symptoms are systemic rather than localised in early childhood and consist of fever, lethargy, anorexia, and vomiting. UTI is caused by E. coli in over 80% of cases and treatment consists of a...