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NIHR Signal Brain scan may predict long-term disabilities in babies with brain injury
Magnetic resonance spectroscopy, a type of scan which shows brain biochemistry, could help predict whether there will be long-term effects of brain injury (encephalopathy) in new-born babies. It is usually done alongside an MRI. Researchers scanned 82 babies being treated for brain injury, using MRI and also magnetic resonance spectroscopy. One biomarker tested at seven days after birth, thalamic N-acetylaspartate, correctly identified all babies who went on to have adverse developmental outcom...
NIHR Signal An ultrasound scan is not as useful as a CT scan in assessing trauma
Ultrasound scans can be a useful tool to help pinpoint internal bleeding or organ damage in the chest or abdomen, but a negative scan cannot rule out damage, especially in children. Many emergency departments use portable ultrasound scanners to assess for internal damage when someone has been subject to blunt trauma (for example, involved in a car accident or fallen from a height). Ultrasound is free from radiation, non-invasive and can be used at the bedside, making it convenient if CT is not ...
NIHR Signal London’s Low Emission Zone has not been shown to improve children’s respiratory health
The Low Emission Zone covering much of Greater London was introduced between 2008 and 2012 to improve air quality. Some measures of air pollution have slightly reduced over that time, but measures of children’s respiratory health and lung development have not significantly improved. This NIHR funded study assessed over 2,000 primary school children during the first five years of the Low Emission Zone, during which charges were phased in for several categories of commercial diesel vehicles...
NIHR Signal Paracetamol and alcohol are the most common substances taken by young people and rates of poisoning are increasing
The rates of the five most common types of poisoningin young people haveincreased three to five-fold from 1998 to 2014 and is cause for concern. A study including more than 1.7 million young people aged 10 to 24 in the UK found records of 31,509 people who had been treated for poisoning (2% of the total). Where the substance was recorded, 40% of poisonings involved paracetamol, and 33% involved alcohol. Other substances used included non-steroidal anti-inflammatory drugs, antidepressants and op...
NIHR Signal Steroids rapidly reduce children’s croup symptoms and shorten hospital stays
Corticosteroids reduce symptoms of croup in children within two hours and continue to do so for at least 24 hours. They also cut the amount of time children spend in hospital by 15 hours and reduce return visits or readmissions from about 20% to 10%. This Cochrane review assessed the effectiveness of corticosteroids such as dexamethasone and budesonide compared with placebo. It updates a previous review which concluded that corticosteroids reduce symptoms of croup at six hours. The review also...
NIHR Signal Insulin pumps offer little value over multiple injections for children at the onset of diabetes
Young people newly diagnosed with type 1 diabetes achieve similar blood glucose control by 12 months if they are treated with multiple daily insulin injections or continuously via an insulin pump. Adverse events are rare and occurat similar rates. Pumps are more expensive with no clear benefit to quality of life. Both regimens are used in the management of type 1 diabetes, and the number of children using insulin pumps is rising. This NIHR-funded trial suggests that at an additional cost of &po...
NIHR Signal Oral steroids do not help hearing for children with glue ear
Oral steroids do not improve hearing, symptoms, or quality of life in children with glue ear. This NIHR-funded trial compared oral steroids with placebo for 389 children with glue ear, also called otitis media with effusion, and found no significant effect on those outcomes. Glue ear is when the middle ear fills with fluid, often following an ear or respiratory infection. The fluid makes hearing more difficult. It usually resolves within three months without treatment, but if it lasts longer, t...
NIHR Signal Methylphenidate remains first-choice drug treatment for children and young people with ADHD
The stimulant methylphenidate has the best balance of effectiveness against side effects in children and young people with attention deficit hyperactivity disorder. Amphetamines are more effective, but also more likely to be stopped for a reason other than side effects. This large, NIHR-funded systematic review compared a range of drugs against each other through a network meta-analysis. Effectiveness and tolerability were assessed at about 12 weeks of treatment. Other second-line drug treatmen...
NIHR Signal Sodium thiosulfate reduces hearing loss in children treated with chemotherapy
Treatment with sodium thiosulfate alongside cisplatin chemotherapy can reduce hearing loss in children with a liver tumour called hepatoblastoma. The risk of hearing loss was reduced by 48% in children who had the combination treatment compared with those who had cisplatin only. This phase 3 trial involved 109 children with standard-risk hepatoblastoma and tested the addition of sodium thiosulfate six hours after cisplatin treatment. The additional drug caused few major side effects, and there ...
NIHR Signal Amphetamines probably the best first-choice treatment for adults with ADHD
There is further evidence to support the amphetamines as the most effective group of drugs for treating adults with attention deficit hyperactivity disorder in the short-term. Two of these drugs were shown to provide the most improvement in core symptoms of attention deficit hyperactivity disorder, are tolerated as well as any other drug treatment and are less likely to be stopped. The review did not identify data to determine whether amphetamines should continue to be used for longer than 12 ...
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