NHS England Specification: Multiple Sclerosis Management Service for Children

This service specification also covers children with suspected Multiple Sclerosis (MS) or equally rare ‘MS-like’, recurrent acquired demyelinating syndromes (ADS) or who have had a first demyelination episode and have a high risk of relapse which require similar treatments, including:

  • Neuromyelitis Optica Spectrum Disorder (NMO, NMOSD) and other AQP4 antibody associated demyelination;
  • Myelin Oligodendrocyte Glycoprotein (MOG) antibody associated relapsing demyelination and
  • Other forms of recurrent relapsing demyelination

Link to 17 page document here


Conservative treatment versus surgery for uncomplicated appendicitis in children: a systematic review and meta-analysis


image: google images – copyright free


Objectives To compare conservative treatment with index admission appendicectomy in children with acute uncomplicated appendicitis.

Conclusions Conservative treatment was less efficacious and was associated with a higher readmission rate. Index admission appendicectomy should in the present still be considered to be the treatment of choice for the management of uncomplicated appendicitis in children.

Link to article here

Cochrane review: Sildenafil for pulmonary hypertension in neonates


Persistent pulmonary hypertension in the neonate (PPHN) is associated with high mortality. Currently, the therapeutic mainstay for PPHN consists of assisted ventilation and administration of inhaled nitric oxide (iNO). However, nitric oxide is costly, and its use may not be appropriate in resource-poor settings. Approximately 30% of patients fail to respond to iNO. High concentrations of phosphodiesterases in the pulmonary vasculature have led to the use of phosphodiesterase inhibitors such as sildenafil or milrinone.

Conclusions: Sildenafil used for treatment of pulmonary hypertension has potential for reducing mortality and improving oxygenation in neonates, especially in resource-limited settings where iNO is not available.

Link to review here

Talking therapy given by parents shows promise for childhood anxiety disorders

talking therapy
image: Google images

Published on 8 August 2017

Brief guided cognitive behavioural therapy (CBT) delivered by parents was as good as a commonly used treatment, delivered by a therapist, in improving anxiety levels in children. Anxiety continued to improve after the end of treatment and by six months about 70% had recovered. The brief CBT was potentially the more cost-effective option.

This NIHR-funded trial compared recovery from a range of common anxiety disorders in children aged five to 12 following these brief psychological treatments. CBT was delivered by parents instructed and supported in its use by a mental health worker. It was compared with a treatment commonly used in the NHS, a solution-focused brief therapy delivered directly by a trained therapist.

Link to full article here

Revolving door: Are vulnerable children being overlooked?

Revolving door

Action for Children has published a report which examines whether children who are vulnerable but don’t meet the criteria for statutory support, were directed to early help services that could help them and their families.  It highlights that opportunities to intervene early are being missed and that some children are stuck in a cycle of referral and assessment.

Link to report here

RCPCH publishes new guidance on breastfeeding, highlighting the health benefits and importance of tackling UK’s low rates


Social stigma is a major barrier to breastfeeding, and more must be done to support women to continue breastfeeding beyond the first few weeks according to new recommendations published today by the Royal College of Paediatrics and Child Health (RCPCH). The new guidance, backed by midwives and health visitors, is based on the latest research and aims to give practical advice on how long women should consider breastfeeding. It also makes the case for the health benefits of breastfeeding for both mother and child, as well as the cost savings to families and health services.

Link to report here