ObjectiveWe examined relationships between clinical features and pulmonary function before and after inhaled corticosteroid (ICS) treatment in wheezy preschool children, and specifically, whether measuring bronchodilator response (BDR) could predict benefit from ICS.DesignClinical non-randomised intervention studySettingSecondary care.PatientsPreschool children (2 years to <6 years) with recurrent wheeze.InterventionsInhaled beta-agonist, ICS.Outcome measuresWe measured prebronchodilator and postbronchodilator interrupter resistance (Rint) and symptom scores at 0 (V1), 4 (V2) and 12 (V3) weeks. At V2, those with a predetermined symptom level commenced ICS. Modified Asthma Predictive Index (mAPI) and parental perception of response to bronchodilator were recorded. Response to ICS was defined as a reduction in daily symptom score of >0.26. Positive BDR was defined as fall in Rint of ≥0.26 kPa.s/L, ≥35% predicted or ≥1.25 Z Scores.ResultsOut of 138 recruited children, 67 completed the full study. Mean (SD) prebronchodilator Rint at V2 was 1.22 (0.35) kPa.s/L, and fell after starting ICS (V3) to 1.09 (0.33) kPa.s/L (p<0.001), while mean (SD) daily symptom score fell from 0.56 (0.36) to 0.28 (0.36) after ICS (p<0.001). Positive Rint BDR before ICS (at V1 and/or V2), using all three threshold criteria, was significantly associated with response to ICS on symptom scores at V3 (p<0.05). mAPI was not significantly associated with response to ICS, and parents’ perception of response to bronchodilator was not related to measured Rint BDR .ConclusionsRint BDR may be helpful in selecting which wheezy preschool children are likely to benefit from ICS.

We retrospectively reviewed children who had been prescribed emergency oral corticosteroids (OCS) in a routine tertiary paediatric respiratory clinic appointment. We subsequently assessed adherence from prescription uptake of inhaled corticosteroids or combination inhalers in the 6 months prior to the episode. In 2 years, 25 children received 32 courses of prednisolone. Median adherence was 33%, but 28% for those with repeated OCS prescriptions. Prescribing acute OCS in a routine clinic is a red flag for potential poor adherence to preventer therapies, and may also indicate the child has poor perception of the severity of their symptoms. An assessment of adherence should be carried out and help given to the child and their family to improve poor adherence when detected.

(BASHH) standards for the management of STIs recommends treatment "in as short a timescale as possible". The National Chlamydia Screening Programme (NCSP) sets a key indicator of treating ‡95% of those testing positive within six weeks of test date. Aim(s)/objectives To explore the feasibility of services achieving a shorter time to treatment standard. Methods National audit data from the most recent NCSP turnaround time audit were used to explore how many services would meet treatment targets of three and two weeks from test date. Results The current time to treatment standard of ‡95% treated within six weeks was achieved by 39% of providers (91% of positive patients receiving treatment within six weeks, due to large services having a proportionately greater impact). Using the targets of three and two weeks this fell to 28% and 4% of providers, respectively. However, this represents 88% of patients treated within three weeks and 76% within two weeks (Table 1). Background/introduction Identifying and assessing the risk of child sexual exploitation (CSE) in young people is a fundamental role of sexual health clinics. The 'Spotting the signs' proforma developed by BASHH recommends assessing all those <18 yrs for risk factors. Aim(s)/objectives The aim of this audit was to review those <18 yr olds attending the GU clinic in Brighton assessed as medium or high risk to investigate the areas of concern, the appropriateness of interventions and follow up.Methods EPR records for all <18 yr olds between 1/4/14 and 31/10/14 were reviewed.Results 56 patients identified, 86 attendances. 36/56 (64%) were 16-17 yrs. 48/56 (86%) were female. 23/56 (41%) were seen in the Young Person's Clinic, the rest seen throughout the service. Concerns included: sexual assault/non-consensual sex 41%, drugs and alcohol 39%, difficulties at home/in care 37%, mental health 37% and partner age/coercion 11%. 20% had concerns in ‡ 3 areas. Interventions: 24/56 (53%) already had social work or other agency involvement, 27% were referred to agencies for the first time as a consequence of their visit to the clinic. Further clinic follow up was arranged in 33/56 (59%). All patients had a clear action plan.