Inside Health

Big baby birth trial, Uveitis, Telephone triage, Burns


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Mention arthritis and most people think of older people with osteoarthritic hips or knees. But children get arthritis too, although it's an inflammatory condition where

the child's immune system attacks the lining of the joints causing pain, swelling and stiffness. But the joints aren't the only part of the body affected. Around one in six of the 12,000 children in the UK with juvenile idiopathic arthritis also develop worrying inflammation in their eyes, uveitis. This is a silent, symptomless condition which can result in significant visual impairment and even blindness. But a new drug treatment, tested in the UK, has proved to be so successful for this group of children that it has revolutionised treatment both in this country and around the world. The benefits were so large that the trial was stopped early and the new therapy adopted as frontline treatment. Dr Mark Porter visits the Bristol Eye Hospital and meets paediatric rheumatology consultant, Professor Athimalaipet Ramanan to find out more.

Bigger babies can get stuck in the final stages of labour - a condition called shoulder dystocia. Most are delivered safely but there are both enormous risks to the baby through lack of oxygen and a traumatic experience for the mother. Professor of Obstetrics at Warwick Medical School, Siobhan Quenby, tells Mark that a nationwide trial of big baby births aims to find out whether delivering the child two weeks early, at 38 weeks, reduces shoulder dystocia and makes the birth safer for mother and child.

A report by NHS England highlights cost savings of around £100,000 for GP practices that use telephone triage for patients. But the first independent evaluation of this system, where everyone speaks to a doctor on the phone before they get a face to face appointment suggests that policy makers should reconsider their unequivocal support. Inside Health contributor Dr Margaret McCartney, herself a GP, reviews the findings.

Several thousand people a year, many of them children, are admitted to hospital every year with serious burns. One of the country's leading centres for burns victims is at the Queen Elizabeth Hospital in Birmingham. As well as serving 13 million people in the local area, the Healing Foundation UK Burns Research Centre treats injured service personnel, airlifted from conflict zones in Iraq and Afghanistan. Mark gets a tour of the unit from director Naiem Moieman and finds out about the newest research on burns treatment which uses some of the oldest remedies.

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