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Paul T. Dick

Other affiliations: York University
Bio: Paul T. Dick is an academic researcher from University of Toronto. The author has contributed to research in topics: Population & Cohort study. The author has an hindex of 24, co-authored 35 publications receiving 2446 citations. Previous affiliations of Paul T. Dick include York University.

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TL;DR: CT had a significantly higher sensitivity than did US in studies of children and adults; from the safety perspective, however, one should consider the radiation associated with CT, especially in children.
Abstract: Purpose: To perform a meta-analysis to evaluate the diagnostic performance of ultrasonography (US) and computed tomography (CT) for the diagnosis of appendicitis in pediatric and adult populations. Materials and Methods: Medical literature (from 1986 to 2004) was searched for articles on studies that used US, CT, or both as diagnostic tests for appendicitis in children (26 studies, 9356 patients) or adults (31 studies, 4341 patients). Prospective and retrospective studies were included if they separately reported the rate of true-positive, true-negative, false-positive, and false-negative diagnoses of appendicitis from US and CT findings compared with the positive and negative rates of appendicitis at surgery or follow-up. Clinical variables, technical factors, and test performance were extracted. Three readers assessed the quality of studies. Results: Pooled sensitivity and specificity for diagnosis of appendicitis in children were 88% (95% confidence interval [CI]: 86%, 90%) and 94% (95% CI: 92%, 95%), ...

637 citations

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TL;DR: Methodologically sound, prospective studies are needed to assess whether children with their first urinary tract infection who have routine diagnostic imaging are better off than children who have imaging for specific indications.

178 citations

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TL;DR: The notion that circumcision may protect boys from UTI, the magnitude of this effect may be less than previously estimated is supported.

162 citations

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TL;DR: In this article, a double-blind randomized, placebo-controlled trial involving 70 children <24 months old in the emergency department with Respiratory Disease Assessment Instrument ≥6.5 was conducted to examine the efficacy of oral dexamethasone in acute bronchiolitis.

144 citations

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TL;DR: Infants with typical bronchiolitis do not need imaging because it is almost always consistent with bronchiolaitis, and risk of airspace disease appears particularly low in children with saturation higher than 92% and mild to moderate distress.

144 citations


Cited by
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Journal ArticleDOI
21 Apr 2011-Blood
TL;DR: This review identified the need for additional studies in many key areas of the therapy of ITP such as comparative studies of "front-line" therapy for ITP, the management of serious bleeding in patients withITP, and studies that will provide guidance about which therapy should be used as salvage therapy for patients after failure of a first-line intervention.

1,601 citations

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1,484 citations

Journal ArticleDOI
01 May 2008-Thorax
TL;DR: These guidelines have been replaced by British Guideline on the Management of Asthma.
Abstract: These guidelines have been replaced by British Guideline on the Management of Asthma. A national clinical guideline. Superseded By 2012 Revision Of 2008 Guideline: British Guideline on the Management of Asthma. Thorax 2008 May; 63(Suppl 4): 1–121.

1,475 citations

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TL;DR: According to the National Ambulatory Medical Care Survey (NAMCS) as discussed by the authors, the most common bacterial infection in the United States is UTI, accounting for nearly 7 million office visits and 1 million emergency department visits, resulting in 100,000 hospitalizations.

1,417 citations

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TL;DR: Data from the most recent 6 studies do not support the use of antimicrobial prophylaxis to prevent febrile recurrent UTI in infants without vesicoureteral reflux or with grade I to IV VUR, and a voiding cystourethrography (VCUG) is not recommended routinely after the first UTI.
Abstract: OBJECTIVE: To revise the American Academy of Pediatrics practice parameter regarding the diagnosis and management of initial urinary tract infections (UTIs) in febrile infants and young children. METHODS: Analysis of the medical literature published since the last version of the guideline was supplemented by analysis of data provided by authors of recent publications. The strength of evidence supporting each recommendation and the strength of the recommendation were assessed and graded. RESULTS: Diagnosis is made on the basis of the presence of both pyuria and at least 50 000 colonies per mL of a single uropathogenic organism in an appropriately collected specimen of urine. After 7 to 14 days of antimicrobial treatment, close clinical follow-up monitoring should be maintained to permit prompt diagnosis and treatment of recurrent infections. Ultrasonography of the kidneys and bladder should be performed to detect anatomic abnormalities. Data from the most recent 6 studies do not support the use of antimicrobial prophylaxis to prevent febrile recurrent UTI in infants without vesicoureteral reflux (VUR) or with grade I to IV VUR. Therefore, a voiding cystourethrography (VCUG) is not recommended routinely after the first UTI; VCUG is indicated if renal and bladder ultrasonography reveals hydronephrosis, scarring, or other findings that would suggest either high-grade VUR or obstructive uropathy and in other atypical or complex clinical circumstances. VCUG should also be performed if there is a recurrence of a febrile UTI. The recommendations in this guideline do not indicate an exclusive course of treatment or serve as a standard of care; variations may be appropriate. Recommendations about antimicrobial prophylaxis and implications for performance of VCUG are based on currently available evidence. As with all American Academy of Pediatrics clinical guidelines, the recommendations will be reviewed routinely and incorporate new evidence, such as data from the Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR) study. CONCLUSIONS: Changes in this revision include criteria for the diagnosis of UTI and recommendations for imaging.

1,362 citations