Studies examined concerns with mobile applications (n=14), internet (n=9), social media (n=3), interactive online treatment programmes (n=3), telehealth (n=1), devices (n=3) or a combination (n=5). Children and young people’s main concerns were labelling and identity; accessibility; privacy and reliability; and trustworthiness of information. Discussion This review highlights important concerns that children and young people may have before using technology to self-manage their long-term condition. In future, research should involve children and young people throughout the development of technology, from identifying their unmet needs through to design and evaluation of interventions.Objective To determine trends in emergency admission rates requiring different levels of critical care in hospitals with and without a paediatric intensive care unit (PICU). Design Birth cohort study created from Hospital Episode Statistics. Setting National Health Service funded hospitals in England. Patients 8 577 680 singleton children born between 1 May 2003 and 31 April 2017. Outcome measures Using procedure and diagnostic codes, we assigned indicators of high dependency care (eg, non-invasive ventilation) or intensive care (eg, invasive ventilation) to emergency admissions. Interventions Children were followed up until their fifth birthday to estimate high dependency and intensive care admission rates in hospitals with and without a PICU. We tested the yearly trend of high dependency and intensive care admissions to hospitals without a PICU using logistic regression models. Results Emergency admissions requiring high dependency care in hospitals without a PICU increased from 3.30 (95% CI 3.09 to 3.51) per 10 000 child-years in 2008/2009 to 7.58 (95% CI 7.28 to 7.89) in 2016/2017 and overtook hospitals with a PICU in 2015/2016. The odds of an admission requiring high dependency care to a hospital without a PICU compared with a hospital with a PICU increased by 9% per study year (OR 1.09, 95% CI 1.08 to 1.10). The same trend was not present for admissions requiring intensive care (OR 1.01, 95% CI 0.99 to 1.03). Conclusions Between 2008/2009 and 2016/2017, an increasing proportion of admissions with indicators of high dependency care took place in hospitals without a PICU.Dual energy X-ray absorptiometry (DXA) scanning is the most common investigating modality used to assess bone mineral density (BMD). Conditions causing tissue calcification and artefacts such as metallic objects may mislead the results of the DXA scan. We present here a case of a child with diabetes where the DXA images were distorted by faecal lumps, leading to falsely elevated BMD and an error in interpretation of the DXA scans. Our case suggests that DXA software may not, at times, differentiate between bone and other high-attenuating material within the regions of interest. Thus, DXA images should also be visually examined and verified with the numeric data before report preparation in these patients.Statin-induced autoimmune necrotising myopathy causes a severe progressive muscle weakness even when the statins are discontinued. First-line treatment is usually with high dose steroids followed by immunosuppressants, but this is often ineffective and there is a high risk of side effects. We describe a diabetic patient who had a very severe statin-induced autoimmune myopathy. He made a full recovery with regular intravenous immunoglobulin (IVIg) infusion in relatively low dose (55 g the first day followed by 50 g/day the second and third day, subsequently he was given 50 g/day for 3 days every 6 weeks). Selleckchem ONO-AE3-208 His symptoms relapsed when the IVIgs were discontinued for 28 weeks but remitted again following recommencement of IVIg infusions (50 g/day for 3 days every 7 weeks). Our case suggests IVIgs are an effective and well tolerated alternative to steroids and immunosuppressants.Behcet’s disease is a multisystem vasculitis which can be associated with cerebral venous thrombosis (CVT) leading to increased intracranial tension and papilloedema. We report a case of a 17-year-old boy who presented to us with inward deviation of right eye with bilateral disc oedema and on further investigations was found to be Human Leukocyte Antigen (HLA) B5 positive, along with CVT on magnetic resonance venography which further led us to the diagnosis of non-parenchymal neuro-Behcet’s.The midaortic syndrome (MAS) is a rare anomaly, characterised by narrowing of the distal aorta and its major branches. The most common symptom is severe arterial hypertension. The combination of hyponatremia, polyuria and renovascular hypertension caused by a unilateral renal artery stenosis is described as hyponatremic hypertensive syndrome. We report a case of MAS with unilateral renal artery stenosis in a preterm female neonate. A pregnant woman at 34 weeks of gestation was referred with fast growing abdominal circumference and pain. The ultrasound revealed severe polyhydramnios and fetal myocardial hypertrophy. Within the first 48 hours of the neonatal period, the diagnosis of MAS was made. We conclude that symptomatic MAS, caused by unilateral renal artery stenosis, resulting in increased renin-angiotensin-aldosterone system activity and subsequent polyuria of the non-stenotic kidney, lead to clinically significant polyhydramnios.Cholestasis is a rare distinct complication of hepatitis A infection. Usually it runs a long indolent course with significant pruritus and malabsorption lasting for few months. A 9-year-old boy presented with yellowish discolouration of eye for 1 month. Liver function test showed conjugated hyperbilirubinaemia. Serology was positive for hepatitis A IgM antibody. Liver biopsy showed features of hepatitis with cholestasis. Child successfully treated with oral steroids.For patients with acute ischaemic stroke, faster recanalisation improves the chances of a disability-free life and a quick discharge from the hospital. Hospital discharge, certainly after suffering a major life-changing event such as a stroke, is a complex and vulnerable phase in the patient’s journey. Elderly are particularly vulnerable to the stressors caused by hospitalisation. Recently hospitalised patients are not only recovering from their acute illness; they also experience a period of generalised risk for a range of adverse events. At the same time, elderly generally prefer living in their own homes and should be discharged from the hospital and return home as quickly as possible. Both premature and delayed discharge are potential threats to patient well-being. We present a 90-year-old patient who underwent successful thrombectomy but suffered from night-time confusion at the hospital and discuss the transition process from hospital to home.