A5061803401- Urinary Tract Infections Management
- Pediatric Urology and Nephrology Studies
- Urinary Bladder and Prostate Research
- Pneumonia and Respiratory Infections
- Respiratory and Cough-Related Research
- Streptococcal Infections and Treatments
- Pelvic floor disorders treatments
- Antibiotic Use and Resistance
- Otolaryngology and Infectious Diseases
- Gastroesophageal reflux and treatments
- Complementary and Alternative Medicine Studies
- Heart Rate Variability and Autonomic Control
- Nosocomial Infections in ICU
- Urological Disorders and Treatments
- Quality and Safety in Healthcare
- Biomedical and Engineering Education
- Nicotinic Acetylcholine Receptors Study
- Vagus Nerve Stimulation Research
- Diabetic Foot Ulcer Assessment and Management
- Laser Applications in Dentistry and Medicine
- Adolescent and Pediatric Healthcare
- Scientific Computing and Data Management
- Pediatric health and respiratory diseases
- Child and Adolescent Health
- Emergency and Acute Care Studies
University of Southampton
2016-2023
Royal Veterinary College
2021
University of Bristol
2013-2016
National Institute for Health Research
2016
It is not clear which young children presenting acutely unwell to primary care should be investigated for urinary tract infection (UTI) and whether or dipstick testing used inform antibiotic treatment.To develop algorithms accurately identify pre-school in whom urine obtained; assess urinalysis provides additional diagnostic information; model algorithm cost-effectiveness.Multicentre, prospective cohort study.Children < 5 years old with an acute illness and/or new symptoms.One hundred seven...
BackgroundAntibiotic resistance is a global public health threat. Antibiotics are very commonly prescribed for children presenting with uncomplicated lower respiratory tract infections (LRTIs), but there little evidence from randomised controlled trials of the effectiveness antibiotics, both overall or among key clinical subgroups. In ARTIC PC, we assessed whether amoxicillin reduces duration moderately bad symptoms in (non-pneumonic) LRTI primary care, and subgroups.MethodsARTIC PC was...
<h3>Importance</h3> Acute sore throat poses a significant burden on primary care and is source of inappropriate antibiotic prescribing. Corticosteroids could be an alternative symptomatic treatment. <h3>Objective</h3> To assess the clinical effectiveness oral corticosteroids for acute in absence antibiotics. <h3>Design, Setting, Participants</h3> Double-blind, placebo-controlled randomized trial (April 2013-February 2015; 28-day follow-up completed April 2015) conducted 42 family practices...
<h3>PURPOSE</h3> Up to 50% of urinary tract infections (UTIs) in young children are missed primary care. Urine culture is essential for diagnosis, but urine collection often difficult. Our aim was derive and internally validate a 2-step clinical rule using (1) symptoms signs select collection; (2) symptoms, signs, dipstick testing guide antibiotic treatment. <h3>METHODS</h3> We recruited acutely unwell aged under 5 years from 233 care sites across England Wales. Index tests were...
Neuromodulation of the immune system has been proposed as a novel therapeutic strategy for treatment inflammatory conditions. We recently demonstrated that stimulation near-organ autonomic nerves to spleen can be harnessed modulate response in an anesthetized pig model. The development neuromodulation therapy clinic requires chronic efficacy and safety testing large animal This manuscript describes effects longitudinal conscious splenic nerve chronically-implanted pigs. Firstly,...
<h3>Background</h3> The prevalence of targeted and serendipitous treatment for, associated recovery from, urinary tract infection (UTI) in pre-school children is unknown. <h3>Aim</h3> To determine the frequency suspicion UTI who are acutely ill, along with details antibiotic prescribing, its appropriateness, whether that appropriateness impacted on symptom improvement recovery. <h3>Design setting</h3> Prospective observational cohort study primary care sites urban rural areas England Wales....
Antibiotic treatment recommendations based on susceptibility data from routinely submitted urine samples may be biased because of variation in sampling, laboratory procedures and inclusion repeat samples, leading to uncertainty about empirical treatment.To describe compare susceptibilities Escherichia coli cultured with E. causing urinary tract infection (UTI) a cohort systematically sampled, acutely unwell children.Susceptibilities 1458 isolates during the course routine primary care for...
<h3>Background</h3> The added diagnostic utility of nappy pad urine samples and the proportion that are contaminated is unknown. <h3>Aim</h3> To develop a clinical prediction rule for diagnosis urinary tract infection (UTI) based on sampling using method. <h3>Design setting</h3> Acutely unwell children <5 years presenting to 233 UK primary care sites. <h3>Method</h3> Logistic regression identify independent associations symptoms, signs, dipstick test results with UTI; quantified as area...
In the UK, urinary tract infections (UTIs) are most common bacterial infection presented by women in primary care. Recurrent (RUTIs) defined as three episodes of UTI last 12 months, or two 6 months. Between 20 and 30 % who have had one episode will an RUTI, approximately 25 these develop subsequent recurrent episodes. RUTIs can a significant negative effect on quality life, high impact health care costs result outpatient visits, diagnostic tests prescriptions. Chinese herbal medicine (CHM)...
Management of acute sore throat poses a significant burden on UK general practices, with almost 10% registered patients attending their GP every year. Nearly half all presenting are treated antibiotics, despite limited effect. In recent systematic review we demonstrated that single dose steroids reduced the severity and time to resolution throat. However, trials included looked at use alongside antibiotics only one was in primary care setting. This trial aims assess efficacy...
To compare the validity of diagnosis urinary tract infection (UTI) through urine culture between samples processed in routine health service laboratories and those a research laboratory.We conducted prospective diagnostic cohort study 4808 acutely ill children aged <5 years attending UK primary care. UTI, defined as pure/predominant growth ≥105 CFU/mL uropathogen (the reference standard), was diagnosed at central laboratory by samples. We calculated areas under receiver-operator curve (AUC)...
Antimicrobial resistance is a global health threat. Antibiotics are commonly prescribed for children with uncomplicated lower respiratory tract infections, but there little randomised evidence to support the effectiveness of antibiotics in treating these either overall or relating key clinical subgroups which antibiotic prescribing common (chest signs; fever; physician rating unwell; sputum/rattly chest; shortness breath).
<h3>Aim</h3> To develop a clinical algorithm based on symptoms, signs and urine dipstick results to assist the identification of children who require sampling, antibiotic treatment and/or laboratory analysis. <h3>Methods</h3> We conducted diagnostic cohort study <5 years presenting acutely (≤28 days) unwell primary care in UK. collected detailed information presence/absence severity symptoms signs, as well socio-demographic past medical history data. Urine was sampled by clean catch...