UHCW publication: subtle tardive dyskinesia with paliperidone palmitate

The importance of clinical observation: A case of subtle tardive dyskinesia with paliperidone palmitate.
Omer, Hisham; Thompson, Andrew D
Aust N Z J Psychiatry. 2018 Jan 1:4867417750758. doi: 10.1177/0004867417750758.[letter - no abstract available]

The Yellow Card Scheme: guidance for healthcare professionals

Details of the Yellow Card Scheme, which is the system for recording adverse incidents with medicines and medical devices in the UK.

This was updated in November 2017.

National Paediatric Diabetes Audit Part 2: Hospital Admissions and Complications

This is the National Paediatric Diabetes Audit Report: Hospital Admissions, the second analysis of admissions data published by the Royal College of Paediatrics and Child Health. For the first time, data submitted by healthcare professionals working in paediatric diabetes units has been combined with Hospital Episode Statistics (HES) and data from the Patient Episode Database for Wales (PEDW) to provide a robust picture of diabetes-related admissions in England and Wales.

Evidence of ocular side effects of SSRIs and new warnings

Acute angle-closure glaucoma (AACG) may cause symptoms including eye pain, changes in vision, or swelling and redness and can rapidly lead to permanent blindness if not treated.1 Medications can precipitate AACG through adrenergic or anticholinergic-mediated pupillary dilation that results in the physical obstruction of the outflow of intraocular fluid in susceptible individuals. Case reports and a previous large database study from Ontario, Canada,2 have suggested an association between new use of selective serotonin reuptake inhibitors (SSRIs) and AACG. The potential mechanism underlying this association is unclear but may be related to effects on norepinephrine or serotonin receptors in the iris and ciliary body of the eye.

Evidence Based Mental Health, 20, (1) 27, 2017 (use your Athens username and password to access)

Calcium and phosphorus supplementation of human milk for preterm infants

Review to determine whether addition of calcium and phosphorus supplements to human milk leads to improved growth and bone metabolism of preterm infants without significant adverse effects

Cochrane Database of Systematic Reviews

Prevalence of hypoglycaemic episodes declines in hospitals, according to diabetes inpatient audit

Mild hypoglycaemia has fallen by five percentage points, from 23 per cent in 2011 to 18 per cent in 2016. Severe hypoglycaemia, which is more serious because it can cause loss of consciousness, has fallen from 11 per cent in 2011 to eight per cent in 2016.

The 2016 National Diabetes Inpatient Audit report (NaDIA), published by NHS Digital, also shows that there has been an overall reduction in the prevalence of the most severe, life-threatening hypoglycaemia which requires injectable rescue treatment for inpatients with diabetes5. This has fallen from 2.2 per cent in 2011 to 1.7 per cent in 2016.

Rapid Resolution and Redress Scheme for Severe Birth Injury Consultation

This PHE consultation seeks views on the proposed investigations into severe avoidable birth injury and the support and compensation scheme. This consultation closes on 26 May 2016.

Daily aspirin reduces pre-eclampsia for ‘at-risk’ women

Starting daily low-dose aspirin before 16 weeks of pregnancy in women at risk reduces pre-eclampsia, severe pre-eclampsia and foetal growth restriction. Aspirin started after 16 weeks is less beneficial, giving smaller risk reduction for pre-eclampsia and no effect on other outcomes. Defining who is ‘at risk’ remains challenging.

From the NIHR Dissemination Centre

A double centre retrospective study into rates of postpartum haemorrhage in women on low molecular weight heparin

British journal of haematology Volume 176, Issue 1 January 2017 Pages 141–143

UHCW Research: Carolina Arbuthnot, Rachael Browne, Sarah Nicole, Sarah J. Erb, Louise Farrall and Anton Borg

Assisted reproduction using donated eggs has higher risk of complications for mothers and babies

Assisted reproduction with donated eggs carries about double the chance of some risks for mothers and babies when compared to pregnancies from natural conceptions or assisted reproduction using the woman’s own eggs. These risks include high blood pressure and pre-eclampsia, preterm birth, low birthweight and a higher risk of caesarean section. In multiple pregnancies, high blood pressure and pre-eclampsia can affect more than 25% of mothers carrying multiple pregnancies following donated eggs.

From the NIHR Dissemination Centre

Postpartum Haemorrhage, Prevention and Management (Green-top Guideline No. 52)

This updated RCOG guideline provides information about the prevention and management of postpartum haemorrhage (PPH), primarily for clinicians working in obstetric-led units in the UK; recommendations may be less appropriate for other settings where facilities, resources and routine practices differ.

Some treatments for abnormal cervical cells increase risk of preterm birth

Women who receive the more radical treatments (like loop excisions) for abnormal cells on the cervix are more likely to experience preterm birth and other adverse pregnancy outcomes than those receiving more local treatments or those not needing treatment at all. Abnormal cells – termed cervical intraepithelial neoplasia (CIN) – can be picked up on cervical screening. These non-cancerous changes can develop into cancer in the future if left untreated. Various treatment options are available to either cut away or destroy the problem cells. The benefits of treatments need to be considered too.

From the NIHR Dissemination Centre

Maternity report shows trends in hospital deliveries

Hospital Maternity Activity, 2015-16, presents the number of delivery episodes during the last financial year, broken down by categories including, but not limited to:

• Method of delivery
• Age and ethnicity of the woman
• How deprived the area is where the woman lives
• Type of anaesthetic used before or during the delivery
• Length of hospital stay
• Delivery and birth complications, where appropriate
• Miscarriage and ectopic pregnancies that resulted in an NHS hospital stay.

The National Pregnancy in Diabetes Audit 2015

The National Pregnancy in Diabetes Audit 2015, published by NHS Digital, Diabetes UK and the Healthcare Quality Improvement Partnership (HQIP) found that few women with diabetes who become pregnant are well prepared, despite agreed national guidelines - resulting in increased risk of congenital abnormalities, stillbirth and large babies.

Pregnancy complications in older women are mostly due to multiple pregnancy or assisted conception

Women who give birth at a very advanced maternal age (48 years+) are at higher risk of pregnancy complications, however most can be explained by multiple pregnancy or the use of assisted conception, suggests a new study published in BJOG.

Vomiting is the most common adverse effect among children and young people sedated for emergency procedures

Vomiting is the most common adverse event when sedating a child or young person undergoing a procedure in the emergency department, occurring in 55.5 out of 1,000 cases. Agitation occurred in 17.9/1,000 cases, and hypoxia – lack of oxygen – in 14.8 out of 1,000 cases. Serious breathing problems needing intervention to provide ventilation were rare, but highlight the need for experienced staff when giving sedation to children.

From the NIHR Dissemination Centre