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.
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.
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.
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.
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.
In a new report, the Education Policy Institute (EPI) has examined the state of child and adolescent mental health inpatient services in England. The analysis explores the latest evidence and NHS data on admissions, quality of care, staffing and capacity.
The number of children being diagnosed with both type 1 and type 2 diabetes is rising, but new cases of type 2 diabetes, the form associated with being overweight, has risen five-fold in about five years. New analysis in this NIHR-supported study suggest that type 2 diabetes now accounts for up to a third of diabetes diagnoses in children.